scholarly journals Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

2019 ◽  
Vol 24 (8) ◽  
pp. 3001-3012 ◽  
Author(s):  
Rafaela Jorge ◽  
Natália Calanzani ◽  
Adelaide Freitas ◽  
Rui Nunes ◽  
Liliana Sousa
Keyword(s):  
Older People ◽  
Associated Factors ◽  
Good Health ◽  
Place Of Death ◽  
Home Death ◽  
Factors Associated ◽  
Binomial Regression ◽  
Belo Horizonte ◽  
The City ◽  
At Home

Abstract We examined people’s preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: very good health) and selecting “choosing who makes decisions about your care” as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.

scholarly journals Can This Patient Be Discharged Home? Factors Associated With At-Home Death Among Patients With Cancer

2011 ◽  
Vol 29 (9) ◽  
pp. 1159-1167 ◽  
Author(s):  
Alberto Alonso-Babarro ◽  
Eduardo Bruera ◽  
María Varela-Cerdeira ◽  
María Jesús Boya-Cristia ◽  
Rosario Madero ◽  
...  
Keyword(s):  
Social Support ◽  
Decision Making ◽  
Perceived Social Support ◽  
Acute Care Hospital ◽  
Place Of Death ◽  
Care Hospital ◽  
Home Death ◽  
Factors Associated ◽  
Decision Making Model ◽  
At Home

Purpose The purpose of this study was to identify factors associated with at-home death among patients with advanced cancer and create a decision-making model for discharging patients from an acute-care hospital. Patients and Methods We conducted an observational cohort study to identify the association between place of death and the clinical and demographic characteristics of patients with advanced cancer who received care from a palliative home care team (PHCT) and of their primary caregivers. We used logistic regression analysis to identify the predictors of at-home death. Results We identified 380 patients who met the study inclusion criteria; of these, 245 patients (64%) died at home, 72 (19%) died in an acute-care hospital, 60 (16%) died in a palliative care unit, and three (1%) died in a nursing home. Median follow-up was 48 days. We included the 16 variables that were significant in univariate analysis in our decision-making model. Five variables predictive of at-home death were retained in the multivariate analysis: caregiver's preferred place of death, patients' preferred place of death, caregiver's perceived social support, number of hospital admission days, and number of PHCT visits. A subsequent reduced model including only those variables that were known at the time of discharge (caregivers' preferred place of death, patients' preferred place of death, and caregivers' perceived social support) had a sensitivity of 96% and a specificity of 81% in predicting place of death. Conclusion Asking a few simple patient- and family-centered questions may help to inform the decision regarding the best place for end-of-life care and death.

scholarly journals TRENDS AND FACTORS ASSOCIATED WITH PLACE OF DEATH AMONG INDIVIDUALS WITH CARDIOVASCULAR DISEASE IN THE UNITED STATES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S132-S133 ◽  
Author(s):  
Sarah H Cross ◽  
Brystana G Kaufman ◽  
Haider Warraich
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
College Education ◽  
Hypertensive Heart Disease ◽  
The United States ◽  
Place Of Death ◽  
Home Death ◽  
Factors Associated ◽  
At Home

Abstract While most patients prefer to die at home, trends and factors associated with place of death for patients dying of cardiovascular disease (CVD) remain unknown. Using data from the National Center for Health Statistics from 2003-2017, we described trends and conducted multivariable logistic regression to evaluate associations between demographic characteristics and place of death among CVD patients in the United States. From 2003-2017, the rate of CVD deaths occurring at home increased from 21.3% to 30.9%, and rate of hospice facility deaths increased from practically none to 6.0%. Over the same period, the rate of hospital deaths decreased from 36.5% to 27.3%, and nursing facility deaths decreased from 25.1% to 20.6%. With the exception of conduction disorders, temporal trends in place of death were consistent across CVD diagnosis subgroups: ischemic heart disease, hypertensive heart disease, heart failure/cardiomyopathy, cerebrovascular disease, aortic stenosis, and all other CVDs. Differences between demographic groups persisted over the study period, with reduced odds of home death among Hispanic versus non-Hispanic (OR=.942; 95% CI .929-.955) decedents, Black versus White (OR=.837; CI .809-.866) decedents and greater odds of home death among decedents with some college education or more (OR=1.08; CI 1.06-1.09) versus decedents with a high-school education or less. In 2014, home surpassed hospital as the most common place of death for CVD patients. CVD patients often have acute and intense needs at the end of life that are challenging to manage in the home and the quality of care these patients receive should be further investigated.

scholarly journals Insights into the factors associated with achieving the preference of home death in terminal cancer: A national population-based study

2017 ◽  
Vol 16 (6) ◽  
pp. 749-755 ◽  
Author(s):  
Finian Bannon ◽  
Victoria Cairnduff ◽  
Deirdre Fitzpatrick ◽  
Janine Blaney ◽  
Barbara Gomes ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Population Based ◽  
Postal Questionnaire ◽  
Place Of Death ◽  
Home Death ◽  
District Nurse ◽  
Terminally Ill Cancer Patients ◽  
Factors Associated ◽  
Dying At Home ◽  
At Home

ABSTRACTObjectives:Most terminally ill cancer patients prefer to die at home, yet only a minority are able to achieve this. Our aim was to investigate the factors associated with cancer patients achieving their preference to die at home.Methods:This study took the form of a mortality followback, population-based, observational survey of the relatives of deceased cancer patients in Northern Ireland. Individuals who registered the death of a friend or relative (aged ≥ 18 years) between 1 December 2011 and 31 May 2012, where the primary cause of death was cancer (ICD10: C00–D48), who were invited to take part. Preferred and actual place of death, and patient, service, and clinical data were collected using the QUALYCARE postal questionnaire. Multivariable logistic regression was employed to investigate the factors associated with achieving a home death when preferred.Results:Some 467 of 1,493 invited informants completed the survey. The 362 (77.5%) who expressed a preference for dying at home and spent time at home in their final 3 months were included in our analysis. Of these, 53.4% achieved their preference of a home death. Factors positively associated with achieving a home death were: living in an affluent area, receipt of good and satisfactory district nurse care, discussing place of death with health professionals, and the caregiver's preference for a home death. Being older than 80 years of age, being a Presbyterian, and being unconscious most of the time during their final week were negatively associated with achieving a home death.Significance of Results:Communication, care satisfaction, and caregiver preferences were all associated with home death. Our findings will help inform the design of future interventions aimed at increasing the proportion of patients achieving their preferred place of death at home, for example, by targeting interventions toward older patients and those from the most deprived communities.

scholarly journals SOCIODEMOGRAPHIC FACTORS ASSOCIATED WITH AT-HOME DEATH AMONG HOSPICE PATIENTS

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 190-190
Author(s):  
M Inoue ◽  
M Kestenbaum ◽  
C Muir
Keyword(s):  
Sociodemographic Factors ◽  
Home Death ◽  
Factors Associated ◽  
Hospice Patients ◽  
At Home

scholarly journals Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study

2012 ◽  
Vol 23 (6) ◽  
pp. 746-752 ◽  
Author(s):  
Júnia Maria Serra-Negra ◽  
Saul Martins Paiva ◽  
Sheyla Márcia Auad ◽  
Maria Letícia Ramos-Jorge ◽  
Isabela Almeida Pordeus
Keyword(s):  
Associated Factors ◽  
Case Control Study ◽  
Clinical Signs ◽  
Sleep Bruxism ◽  
Case Control ◽  
Social Vulnerability Index ◽  
Wake Time ◽  
Belo Horizonte ◽  
The City ◽  
Control Study

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.

scholarly journals Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Emmanuel Arinaitwe ◽  
Joaniter I. Nankabirwa ◽  
Paul Krezanoski ◽  
John Rek ◽  
Victor Kamya ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Generalized Estimating Equations ◽  
Regression Models ◽  
Estimating Equations ◽  
Factors Associated ◽  
Tororo District ◽  
Binomial Regression ◽  
Llin Use ◽  
Long Lasting Insecticidal Nets ◽  
At Home

Abstract Background The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognized as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda. Methods Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within 4 weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Results Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI 0.60–0.89, p = 0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52–0.83, p = 0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67–1.40, p = 0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31–2.46, p < 0.001) and duration of travel (> 7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07–3.64, p = 0.03). Conclusions Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than 1 week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.

scholarly journals Binge drinking and associated factors among adolescents in a city in southeastern Brazil: a longitudinal study

2017 ◽  
Vol 33 (2) ◽  
Author(s):  
Kelly Oliva Jorge ◽  
Raquel Conceição Ferreira ◽  
Efigênia Ferreira e Ferreira ◽  
Miriam Pimenta Vale ◽  
Ichiro Kawachi ◽  
...  
Keyword(s):  
Binge Drinking ◽  
Social Vulnerability ◽  
Associated Factors ◽  
Alcoholic Beverages ◽  
Southeastern Brazil ◽  
Increased Risk ◽  
Minas Gerais State ◽  
Belo Horizonte ◽  
Substance Involvement ◽  
The City

Abstract: The aim of this study was to investigate changes in the frequency of binge drinking and associated factors in the city of Belo Horizonte, Minas Gerais State, Brazil. The sample consisted of 436 adolescents. Data collection involved the Alcohol Use Disorders Identification Test and the Alcohol, Smoking and Substance Involvement Screening Test. Ordinal logistic regression was used in the multivariate analysis. An increase in the frequency of binge drinking was found among adolescents who lived in areas of greater social vulnerability (OR = 1.64; 95%CI: 1.01-2.68), those whose mothers consumed alcoholic beverages (OR = 1.75; 95%CI: 1.05-2.92), those whose fathers consumed alcoholic beverages (OR = 2.02; 95%CI: 1.11-3.68), those with an increased risk of tobacco use (OR = 2.82; 95%CI: 1.07-7.42) and those who attended religious services (OR = 2.10; 95%CI: 1.30-3.38). Knowledge regarding factors associated with a change in the frequency of binge drinking among adolescents can assist in the establishment of public policies directed at health promotion and the prevention of adverse health conditions.

A Study of the Association Between Multidisciplinary Home Care and Home Death Among Thai Palliative Care Patients

2016 ◽  
Vol 34 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Kittiphon Nagaviroj ◽  
Thunyarat Anothaisintawee
Keyword(s):  
Palliative Care ◽  
Logistic Regression ◽  
Home Care ◽  
Home Visits ◽  
Place Of Death ◽  
Home Death ◽  
Data Set ◽  
Palliative Home Care ◽  
Palliative Care Teams ◽  
At Home

Purpose: Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death. Methods: A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient’s profile, disease status, functional status, patient’s symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient’s actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home. Results: A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38). Conclusion: Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand.

scholarly journals Socioeconomy as a prognostic factor for location of death in Swedish palliative cancer patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jonas Nilsson ◽  
Georg Holgersson ◽  
Gustav Ullenhag ◽  
Malin Holmgren ◽  
Bertil Axelsson ◽  
...  
Keyword(s):  
Cancer Patients ◽  
End Of Life Care ◽  
Community Support ◽  
Place Of Death ◽  
Hospital Death ◽  
Home Death ◽  
Location Of Death ◽  
Community Support Services ◽  
Dying At Home ◽  
At Home

Abstract Background An important aspect of end-of-life care is the place of death. A majority of cancer patients prefer home death to hospital death. At the same time, the actual location of death is often against patient’s last-known wish. The aim of this study was to analyze whether socioeconomic factors influence if Swedish palliative cancer patients die at home or at a hospital. There is no previous study on location of death encompassing several years in Swedish cancer patients. Methods Data was collected from the Swedish Register of Palliative Care for patients diagnosed with brain tumor, lung, colorectal, prostate or breast cancer recorded between 2011 and 2014. The data was linked to the Swedish Cancer Register, the Cause of Death Register and the Longitudinal Integration Database for health-insurance and labor-market studies. A total of 8990 patients were included. Results We found that marital status was the factor that seemed to affect the place of death. Lack of a partner, compared to being married, was associated with a higher likelihood of dying at a hospital. Conclusion Our findings are in line with similar earlier studies encompassing only 1 year and based on patients in other countries. Whether inequalities at least partly explain the differences remains to be investigated. Patients dying of cancer in Sweden, who do not have a life partner, may not have the option of dying at home due to lack of informal support. Perhaps the need of extensive community support services to enable home death have to improve, and further studies are warranted to answer this question.

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