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Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan

OBJECTIVES: To analyse the cognitive processes involved in the decision-making of older adults who are not in the end-of-life stage regarding the selection of a preferred place of death. DESIGN: A qualitative cross-sectional study based on semistructured in-depth interviews. The interview scripts we...

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Autores principales: Tsuchida, Tomoya, Onishi, Hirotaka, Ono, Yoshifumi, Machino, Aco, Inoue, Fumiko, Kamegai, Manabu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174769/
https://www.ncbi.nlm.nih.gov/pubmed/35613762
http://dx.doi.org/10.1136/bmjopen-2021-059421
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author Tsuchida, Tomoya
Onishi, Hirotaka
Ono, Yoshifumi
Machino, Aco
Inoue, Fumiko
Kamegai, Manabu
author_facet Tsuchida, Tomoya
Onishi, Hirotaka
Ono, Yoshifumi
Machino, Aco
Inoue, Fumiko
Kamegai, Manabu
author_sort Tsuchida, Tomoya
collection PubMed
description OBJECTIVES: To analyse the cognitive processes involved in the decision-making of older adults who are not in the end-of-life stage regarding the selection of a preferred place of death. DESIGN: A qualitative cross-sectional study based on semistructured in-depth interviews. The interview scripts were sectioned by context, then summarised, conceptualised and categorised. Post-categorisation, the relationships between the conceptual factors were examined. SETTING: Tama City, Tokyo, Japan, from November 2015 to March 2016. PARTICIPANTS: 20 long-term care users and their families or care providers were interviewed about their preferred places of death and the factors behind their decisions. RESULTS: Three categories based on the preferred place of end-of-life care and death were extracted from the interview transcripts: (A) discouraging the decision of a preferred place of death, (B) enhancing the desire for home death and (C) enhancing the desire for a hospital/long-term care facility death. Category A consists of concerns about the caregiver’s health, anxiety about solitary death, and constraints of and concerns about the household budget. Both categories B and C consist of subcategories of reinforcing and inhibiting factors of whether to desire a home death or a hospital/long-term care facility death. If their previous experiences with care at home, a hospital or a care facility were positive, they preferred the death in the same setting. If those experiences were negative, they tend to avoid the death in the same setting. CONCLUSIONS: One’s mindset and decision regarding a preferred place of death include the consideration of economic factors, concerns for caregivers, and experiences of care at home or in a hospital/long-term care facility. Furthermore, health professionals need to be aware of the ambivalence of senior citizens to support their end-of-life decisions.
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spelling pubmed-91747692022-06-16 Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan Tsuchida, Tomoya Onishi, Hirotaka Ono, Yoshifumi Machino, Aco Inoue, Fumiko Kamegai, Manabu BMJ Open Geriatric Medicine OBJECTIVES: To analyse the cognitive processes involved in the decision-making of older adults who are not in the end-of-life stage regarding the selection of a preferred place of death. DESIGN: A qualitative cross-sectional study based on semistructured in-depth interviews. The interview scripts were sectioned by context, then summarised, conceptualised and categorised. Post-categorisation, the relationships between the conceptual factors were examined. SETTING: Tama City, Tokyo, Japan, from November 2015 to March 2016. PARTICIPANTS: 20 long-term care users and their families or care providers were interviewed about their preferred places of death and the factors behind their decisions. RESULTS: Three categories based on the preferred place of end-of-life care and death were extracted from the interview transcripts: (A) discouraging the decision of a preferred place of death, (B) enhancing the desire for home death and (C) enhancing the desire for a hospital/long-term care facility death. Category A consists of concerns about the caregiver’s health, anxiety about solitary death, and constraints of and concerns about the household budget. Both categories B and C consist of subcategories of reinforcing and inhibiting factors of whether to desire a home death or a hospital/long-term care facility death. If their previous experiences with care at home, a hospital or a care facility were positive, they preferred the death in the same setting. If those experiences were negative, they tend to avoid the death in the same setting. CONCLUSIONS: One’s mindset and decision regarding a preferred place of death include the consideration of economic factors, concerns for caregivers, and experiences of care at home or in a hospital/long-term care facility. Furthermore, health professionals need to be aware of the ambivalence of senior citizens to support their end-of-life decisions. BMJ Publishing Group 2022-05-23 /pmc/articles/PMC9174769/ /pubmed/35613762 http://dx.doi.org/10.1136/bmjopen-2021-059421 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Geriatric Medicine
Tsuchida, Tomoya
Onishi, Hirotaka
Ono, Yoshifumi
Machino, Aco
Inoue, Fumiko
Kamegai, Manabu
Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan
title Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan
title_full Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan
title_fullStr Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan
title_full_unstemmed Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan
title_short Factors associated with preferred place of death among older adults: a qualitative interview study in Tama City, Tokyo, Japan
title_sort factors associated with preferred place of death among older adults: a qualitative interview study in tama city, tokyo, japan
topic Geriatric Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174769/
https://www.ncbi.nlm.nih.gov/pubmed/35613762
http://dx.doi.org/10.1136/bmjopen-2021-059421
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