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Opinions of patients with cancer on the relative importance of place of death in the context of a ‘good death’
  1. Melanie Waghorn1,
  2. Holly Young2 and
  3. Andrew Davies1
  1. 1Palliative Care, St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
  2. 2Palliative Care, Trinity Hospice, London, UK
  1. Correspondence to Dr Andrew Davies, Palliative Care, St Luke's Cancer Centre, Royal Surrey County Hospital, Egerton Road, Guildford GU2 7XX, UK; adavies12{at}nhs.net

Abstract

Objective The primary objective of the study was to determine the relative importance of place of death to patients with advanced cancer being treated at a cancer centre in England.

Methods Demographic data were collected from the electronic patient record system, with additional information obtained from the patients themselves. Patients were questioned about a variety of end of life issues, including preferred place of death (PPD), and ‘acceptable’ places of death. They were also asked to rank the importance of factors previously linked to a ‘good death’.

Results 120 patients participated in the study. 51 (42.5%) patients stated that ‘home’ was their PPD, while 80 (67%) patients stated that home was an acceptable place of death. Patients from areas with worse deprivation scores were less likely to want to die at home than patients from areas with better deprivation scores (p=0.03). The most important factors associated with a good death were ‘to have my pain/symptoms well controlled’, ‘to not be a burden to my family’ and ‘to have sorted out my personal affairs’ respectively. Place of death was ranked as the seventh most important factor.

Discussion Place of death is undoubtedly an important factor in achieving a good death for some patients and carers. However, for others a home death is either unimportant or to be avoided. The results of this study, and the results of similar studies, suggest that place of death may not be a good marker of the quality of end of life care.

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  • Accepted 28 July 2011.
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Footnotes

  • Funding The study was funded by the Palliative Care Research Fund 345 at the Royal Marsden Hospital. The authors would like to acknowledge the support of their charitable donors, particularly Joe Goodall and the other family and friends of Debora Matthews.

  • Competing interests None.

  • Ethics approval The study was approved by St Mary's Hospital REC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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