Does Dying at Home Influence the Good Death of Terminal Cancer Patients? Chien-An Yao MD, MPHa, Wen-Yu Hu RN, PhDa, , Yun-Fong Lai MDa, Shao-Yi Cheng MD, MPHa, Ching-Yu Chen MDa and Tai-Yuan Chiu MD, MHSci, a, aDepartment of Family Medicine (C.-A.Y., Y.-F.L., S.-Y.C., C.-Y.C., T.-Y.C.) and School of Nursing (W.-Y.H.), College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan Abstract To investigate whether dying at home influences the likelihood that a terminal cancer patient will achieve a good death despite the limited medical resources available in many communities, this study investigated the relationship between the achievement of a good death and the performance of good-death services in two groups with different places of death, and explored the possible factors associated with this relationship. Three hundred and seventy-four consecutive patients with terminal cancers admitted to a palliative care unit were enrolled. Two instruments, the good-death scale and the audit scale for good-death services, were used in the study. Mean age of the 374 patients was 65.45 ± 14.77 years. The total good-death score in the home-death group (n = 307) was significantly higher than that in hospital-death group (n = 67), both at the time of admission (t = −5.741, P < 0.001) and prior to death (t = −3.027, P < 0.01). However, the score of item “degree of physical comfort” assessed prior to death in the home-death group was lower than that in hospital-death group (P = 0.185). As to the audit scale for good-death services, each subscale score and total scores in the home-death group were significantly higher than that in hospital-death group, with the exception of the subscale “continuity of social support” (4.72 vs. 4.61, P = 0.132). Bereavement support (odds ratio = 1.01, 95% confidence interval = 0.62–1.39; multiple regression), alleviation of anxiety (0.81, 0.46–1.15), decision-making participation (0.61, 0.26–0.95), fulfillment of last wish (0.45, 0.08–0.82), and survival time (0.00, 0.00–0.01) were independent correlates of the good-death score (35.8% of explained variance). However, the place of death was not in the model. The study conclusively suggests the necessity for palliative home care to strengthen the competence of physical care. Moreover, earlier incorporation of palliative care into anticancer therapies can lead to better death preparation and good-death services, and thus be helpful to achieve a good death. Journal of Pain and Symptom Management doi:10.1016/j.jpainsymman.2007.01.004 July 2007 online Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.