Association between immigrant status and advanced cancer patients' location and quality of death.
Association between immigrant status and advanced cancer patients' location and quality of death.
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移民状况与晚期癌症患者的位置和死亡质量之间的关联。
DOI：
10.1002/cncr.34385
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发表时间：
2022-09-15
期刊：
影响因子：
6.2
通讯作者：
Maciejewski, Paul K.
中科院分区：
文献类型：
--
作者：
Tergas, Ana, I;Prigerson, Holly G.;Shen, Megan J.;Dinicu, Andreea, I;Neugut, Alfred, I;Wright, Jason D.;Hershman, Dawn L.;Maciejewski, Paul K.
癌症患者通常更喜欢在家中死亡，因为这是一个与更好的死亡质量（QoD）相关的地点。几项研究表明，在美国移民人群中，临终关怀存在差异。本研究旨在评估移民身份如何影响美国晚期癌症患者的死亡地点和质量。数据来源于应对癌症，这是一项由联邦政府资助的针对晚期癌症患者和护理人员的多地点前瞻性研究。对研究期间死亡的患者样本进行加权（N w = 308），以减少移民（N w = 49）和非移民（N w = 259）研究参与者之间的统计学显著差异。主要结局为死亡地点、首选死亡地点和不良QoD。经协变量校正的分析表明，移民患者在医院死亡的可能性大于在家中死亡的可能性（校正优势比[AOR]， 3.33； 95%置信区间[CI]， 1.65-6.71），在自己喜欢的地方死亡的可能性较小（AOR, 0.42; 95% CI, 0.20-0.90）。此外，移民更可能有较差的QoD （AOR, 5.47; 95% CI, 2.70-11.08）。与非移民相比，移民更有可能死在医院环境中，更不可能死在他们首选的地点，并且更有可能有较差的qd。癌症患者通常更喜欢在自己家里死去，这与提高死亡质量有关。然而，在美国移民人群中，临终关怀的差异仍然很大。我们的研究发现，移民不太可能死在他们喜欢的地方，更有可能死在医院，导致死亡质量较差。临终关怀和死亡质量的差异在移民中普遍存在。这项研究的结果表明，在美国的移民更有可能死于医院，而不太可能死于他们首选的地点。
Cancer patients often prefer to die at home, a location associated with better quality of death (QoD). Several studies demonstrate disparities in end‐of‐life care among immigrant populations in the United States. This study aimed to evaluate how immigrant status affects location and quality of death among patients with advanced cancer in the United States. Data were derived from Coping with Cancer, a federally funded multi‐site prospective study of advanced cancer patients and caregivers. The sample of patients who died during the study period was weighted (N w = 308) to reduce statistically significant differences between immigrant (N w = 49) and nonimmigrant (N w = 259) study participants. Primary outcomes were location of death, death at preferred location, and poor QoD. Analyses adjusted for covariates indicated that patients who were immigrants were more likely to die in a hospital than home (adjusted odds ratio [AOR], 3.33; 95% confidence interval [CI], 1.65–6.71) and less likely to die where they preferred (AOR, 0.42; 95% CI, 0.20–0.90). Furthermore, immigrants were more likely to have poor QoD (AOR, 5.47; 95% CI, 2.70–11.08). Immigrants, as compared to nonimmigrants, are more likely to die in hospital settings, less likely to die at their preferred location, and more likely to have poor QoD. Cancer patients typically prefer to die in their own homes, which is associated with improved quality of death. However, disparities in end‐of‐life care among immigrant populations in the United States remain significant. Our study found that immigrants are less likely to die in their preferred locations and more likely to die in hospital settings, resulting in poorer quality of death. Disparities in end‐of‐life care and quality of death are prevalent among immigrants. The findings of this study illustrate that immigrants in the United States are more likely to die in hospital settings and less likely to die at their preferred location.
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影响因子：
120.7
作者：
Phelps, Andrea C.;Maciejewski, Paul K.;Prigerson, Holly G.
通讯作者：
Prigerson, Holly G.
影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
3.8
作者：
Piggott, Katrina Lynn;Patel, Ameen;You, John J.
通讯作者：
You, John J.
影响因子：
1.7
作者：
Lawson, Beverley J.;Burge, Frederick I.
通讯作者：
Burge, Frederick I.
DOI：
10.1177/1049909111418777
发表时间：
2012-06-01
影响因子：
1.9
作者：
Colon, Merydawilda
通讯作者：
Colon, Merydawilda