Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain

Moderator Effect of Transplant Waiting Time on the Relationship Between Hopelessness and Death Anxiety in Patients Waiting for Organ Transplant

The study aimed to examine the moderator effect of organ transplant waiting time on hopelessness and death anxiety. The study was conducted in a descriptive and correlational design with 378 patients on the transplant waiting list (Agust 2021- March 2022). Multiple linear regression and PROCESS macro-Model 1 were used in the analyses. In this study, the STROBE checklist was followed. According to the results of the regression analysis, waiting for a transplant for 6-10 years reduced death anxiety by 9.38 times and waiting for a transplant for 16-20 years increased death anxiety by 31.3 times. The predictors in the regression analysis explained 33% of the model. The moderator effect constituted 6.4% of the explained part of the model, which was 25.4%; the R2 change was 3.4% and significant. We found that the longer the waiting period for organ transplant recipients, the higher the hopelessness and death anxiety.

Perspectives of elders and their adult children of Black and minority ethnic heritage on end-of-life conversations: A meta-ethnography

BACKGROUND

People of Black and minority ethnic heritage are more likely to die receiving life supporting measures and less likely to die at home. End-of-life care decision making often involves adult children as advance care planning is uncommon in these communities. Physicians report family distress as being a major factor in continuing with futile care.

AIM

To develop a deeper understanding of the perspectives of elders of Black and minority ethnic heritage and their children, about end-of-life conversations that take place within the family, using a meta-ethnographic approach.

DESIGN

Systematic interpretive exploration using the process of meta-ethnography was utilised.

DATA SOURCES

CINAHL, MEDLINE, PubMed and PsycINFO databases were searched. Inclusion criteria included studies published between 2005 and 2019 and studies of conversations between ethnic minority elders and family about end-of-life care. Citation snowballing was used to ensure all appropriate references were identified. A total of 13 studies met the inclusion criteria and required quality level using Critical Appraisal Skills Programme.

RESULTS

The following four storylines were constructed: 'My family will carry out everything for me; it is trust'; 'No Mum, don't talk like that'; 'I leave it in God's hands'; and 'Who's going to look after us?' The synthesis reflected the dichotomous balance of trust and burden avoidance that characterises the perspectives of Black and minority ethnic elders to end-of-life care planning with their children.

A time to be born and a time to die: Exploring the determinants of death anxiety among university students in a western Canadian city

Using data collected from a questionnaire survey of 501 university students in a western Canadian city, this article explores the death anxiety among young adults and the factors influencing their levels of death anxiety. Results demonstrated that respondents displayed a moderate level of death anxiety. Multiple regression analysis further revealed that females, non-Caucasians and those who demonstrated to be less religious, indicated a higher level of loneliness, scored lower on the purpose in life scale, expressed dissatisfaction with their self-image, and reported a higher socio-economic status were found to exhibit a higher level of death anxiety.

Czech version of OPQOL-35 questionnaire: the evaluation of the psychometric properties

BACKGROUND

Both prognoses and real demographic trends in developed countries point to the increasing proportion in the population of people above 65 years of age. One of important themes of care for seniors is the assessment of their quality of life. To evaluate the quality of life of seniors three types of tools can be used: general generic tools; generic tools used for the age group of elderly persons; specific tools to detect the quality of life of the elderly who are affected by specific diseases.

METHODS

The second type of tool is represented by the OPQOL - 35 questionnaire (Older People's Quality of Life Questionnaire), which was developed in the UK. It has 35 items and deals with 8 domains of quality of life. With the consent of the author the questionnaire was translated into Czech and verified in a group of 478 seniors aged 60 and above (40 % males, 60 % females). Unlike the British version, the Czech version has seven factors: 1 Role of belief, religion and culture; 2 Health; independence, active life; 3 Financial situation; 4 Family and safe environment; 5 Loneliness; 6 Satisfaction with life; 7 Positive approach to life.

RESULTS

The Czech version has a very good reliability (Cronbach's alpha ranges from .726 to .905). It also has satisfactory validity. The results show that with increasing age and number of health problems the satisfaction of the elderly is declining in all seven domains. Conversely, the degree of autonomy in the way of living is positively associated with the satisfaction of seniors. Old people who live alone at home, are self-sufficient and do not need the help of others, are more satisfied with their quality of life than other seniors (i.e..those who are living with their children, in sheltered accommodation or in homes for the elderly). Single, married seniors and seniors with a partner are happier than the widowed ones.

CONCLUSIONS

The questionnaire gives good guidance for assessing the current state of the quality of life of seniors, changes in quality over time and for targeted interventions as well.

The impact of the environment on patient experiences of hospital admissions in palliative care

OBJECTIVE

To explore the impact of environment on experiences of hospitalisation from the perspective of patient's with palliative care needs.

METHODS

A qualitative study design using longitudinal semistructured, face-to-face interviews were used to elicit the views of patients with palliative care needs admitted to hospital in 1 large urban acute hospital in New Zealand. The sample comprised of 14 patients admitted to hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need.

RESULTS

Almost all participants described a range of factors associated with the environment which impacted negatively on their experiences of hospitalisation. This included challenges with the physical surroundings, the impact on social relationships with other patients, families and health professionals and the influence of the cultural milieu of the hospital setting.

CONCLUSIONS

Emulating the 'ideal' environment for palliative care such as that provided in a hospice setting is an unrealistic goal for acute hospitals. Paying attention to the things that can be changed, such as enabling family to stay and improving the flexibility of the physical environment while improving the social interplay between patients and health professionals, may be a more realistic approach than replicating the hospice environment in order to reduce the burden of hospitalisations for patients with palliative care needs.

Health care and end-of-life decisions: community engagement with adults in East Harlem

This was a model of community engagement for a Hispanic population in East Harlem, New York City to assess health care decision-making processes, with a focus on end-of-life decisions, among older men and women. The design involved two senior center-based semi-structured focus groups conducted in Spanish and English followed by a series of bilingual skills-building workshops focusing on situational decision-making. All program aspects were conducted between April and June of 2013. The themes for the workshops included: "Getting the most from your pharmacist encounter;" "How to prepare for your primary care visit;" and "I am getting discharged from the hospital: what do I do?" For the two focus groups, 21 community members participated, each of whom self-identified as Hispanic or Latina/o. Ten common themes emerged from a two-stage/two coder, grounded theory-based qualitative analysis and included: Where Community Members Receive Care; General Challenges, Cultural Challenges, and Benefits of Health Care in New York City/East Harlem; Key Facilitators in Health Care Decision Making; Key Facilitators in End-of-Life Decision Making; and Perceptions of Health Care Disparity. Themes and their subcategories, discussed herein, may offer guidance for area health providers and health care delivery entities. This project served as formative, qualitative data collection for a larger scale forthcoming community assessment while offering community benefit related to health decision-making, especially end-of-life decision making, in the context of a rapidly changing urban American health care delivery landscape. Application of this synergistic community benefit and data collection model is recommended for similar and other communities in the U.S. and other countries.