![]() Participants were enrolled in a study to identify the components of quality of life at the end of life. To obtain additional information about preferences for the very end of life, we also asked several closed-ended questions. To obtain rich data that were not influenced by any investigator's preconceived ideas of good and bad deaths, we opted to use open-ended questions. We also were interested in how components from these descriptions contributed to a good or bad death. ![]() 15 Our goal was to study the perspective of older patients with common terminal illnesses, cancer, and end-stage heart disease.Ī primary goal of this study was to learn how a group of terminally ill men described good and bad deaths. 13 - 15 Only 1 of these studies limited enrollment to individuals who were actively facing a terminal illness with an estimated life expectancy of 6 months or less, and that study examined relatively young patients with advanced AIDS. 7 - 12 Several studies have focused on patients' perspectives of good and bad deaths. 6 Other studies, however, have illustrated that patients, families, and clinicians may all interpret the experience of dying differently. Previous attempts to define good and bad deaths have relied on input from family members, 1 - 3 a combination of patients, family and/or clinicians, 4, 5 and end-of-life experts. To help those with terminal illness achieve the best possible experience of dying, clinicians need to know what their patients want and what they want to avoid at the very end of life. The discussion can then focus on what might interfere with patients' attainment of their preferred dying experience and what may be available to help them achieve a death that is most consistent with their wishes. Participants did not hold uniform views about the presence of others at the very end of life or preferred location of dying.Ĭonclusions In discussing the end of life with terminally ill patients, clinicians may want to identify not only their patients' views of good and bad deaths but also how the identified attributes contribute to a good or bad death. Participants voiced multiple reasons for why dying in one's sleep led to a good death and why prolonged dying or suffering led to a bad death. Results We found heterogeneity in responses to questions about good deaths, bad deaths, and preferred dying experiences. The closed-ended questions were analyzed using descriptive statistics. The open-ended questions were tape recorded, transcribed, and analyzed using grounded theory methods. Participants also answered closed-ended questions about specific end-of-life scenarios. Participants described good and bad deaths in a section of open-ended questions. Methods We conducted semistructured interviews with 26 men identified as having terminal heart disease or cancer. This study aimed to learn how terminally ill men conceptualize good and bad deaths. Our current understanding of good and bad deaths, however, comes primarily from input from families and clinicians. Shared Decision Making and Communicationīackground Understanding the range of patients' views about good and bad deaths may be useful to clinicians caring for terminally ill patients. ![]()
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