End-of-Life Experiences and Quality of Dying in Canada
Notice bibliographique
Résumé
Background: Understanding the factors that contributed to a peaceful and dignified death was essential for improving end-of-life (EoL) care in Canada. Despite ongoing efforts to enhance palliative and hospice services, variations persisted in the quality of death experiences based on location, medical decisions, and personal characteristics. Objectives: This thesis examined the personal and end-of-life factors associated with peace with dying among older adults in Canada. It also explored how location of death and the consideration or receipt of medical assistance in dying (MAiD) influenced the perceived quality of death and dying. Methods: A secondary analysis of data from the Canadian Longitudinal Study on Aging (CLSA) was conducted. The study included next-of-kin interviews of deceased CLSA participants who died between June 2016 and March 2022. Logistic regression was used to assess the association between demographic, clinical, and EoL characteristics and peace with dying. Additionally, the impact of location of death and MAiD on various quality-of-death indicators, including dying with dignity, dying without pain, and dying in one’s preferred place, was examined. Results: Among 3,672 deceased CLSA participants, 1,287 (35.0%) had completed next-of-kin interviews and were included in the analysis. While 66% were reported to have experienced peace with dying, 17% did not. Individuals who were widowed, had an appointed substitute decision-maker, or died of cancer were more likely to experience peace with dying. Those who died at home were more likely to pass away in their preferred location, while individuals in palliative care units or hospices experienced lower levels of pain. Of the decedents, 25.4% had considered MAiD, and 6.7% had received it. Those who considered or received MAiD were more likely to die in their preferred location and experience a positive death process as reported by their next of kin. Conclusion: Nearly one in five older Canadians did not experience peace with dying, highlighting the need to improve EoL care services. While dying at home aligned with individual preferences, hospice and palliative care settings better addressed pain management. MAiD appeared to enhance the quality of dying for those who pursued it. These findings underscored the importance of advanced care planning and patient-centered EoL interventions to ensure dignified and peaceful deaths across care settings in Canada.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,007 | 0,002 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».