What are the acceptances and associated influences of hospice care in Mainland China? A national cross-sectional study

Xinyue Zhang; Xun Zhang; Yiqi Li; Tianle Chen; Lixuen Siow; Xinxin Ye; Yinlin Wang; Yujia Wang; Wai-Kit Ming; Xinying Sun; Ze Xiang; Yibo Wu; Jian Wu

doi:10.3389/fpubh.2022.985218

What are the acceptances and associated influences of hospice care in Mainland China? A national cross-sectional study

Front Public Health. 2022 Sep 23:10:985218. doi: 10.3389/fpubh.2022.985218. eCollection 2022.

Authors

Xinyue Zhang¹, Xun Zhang^{2

3}, Yiqi Li^{3

4}, Tianle Chen⁴, Lixuen Siow¹, Xinxin Ye⁵, Yinlin Wang¹, Yujia Wang⁶, Wai-Kit Ming⁷, Xinying Sun⁸, Ze Xiang³, Yibo Wu⁸, Jian Wu⁹

Affiliations

¹ Key Laboratory of Oral Biomedical Research of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Hangzhou, China.
² Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
³ Zhejiang University School of Medicine, Hangzhou, China.
⁴ Chu Kochen Honors College of Zhejiang University, Zhejiang University, Hangzhou, China.
⁵ School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China.
⁶ College of Humanities and Social Sciences, Harbin Medical University, Harbin, China.
⁷ Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China.
⁸ Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
⁹ Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.

Abstract

Background: China ranks 53^rd out of 81 countries in the Quality of Death Index for 2021. Although hospice care demand is increasing, the progress remains slow. It is of great significance to explore the acceptances and associated influencing factors of hospice care.

Methods: A cross-sectional survey by quota sampling was conducted in China from July 10^th to September 15^th, 2021. We collected demographic data and hospice care acceptance. A stepwise linear regression analysis was used.

Results: This survey contained 11,031 valid questionnaire results to investigate the hospice care acceptance. It was found that individuals with undergraduate or above (β = 0.04), more properties [2 (β = 0.02), 3 (β = 0.01)], and higher reimbursement types of medical insurance [employee health insurance and commercial health (β = 0.03), government insurance (β = 0.04)] had higher hospice acceptance willingness, while males (β = -0.02) were less willing to accept than females. Psychological conditions [mild anxiety (β = 0.03), moderate anxiety (β = 0.01), moderate stress (β = 0.05), and severe stress (β = 0.06)] also played an important role. The Self-Management Scale (SHMS) (β = 0.12), EuroQol Five Dimensions Questionnaire (EQ-5D) (β = 0.05), EuroQol Visual Analog Scale (EQ-VAS) (β = 0.21), Short-Form Family Health Scale (FHS-SF) (β = 0.12), higher scores of the Short-Form Health Literacy Instrument (HLS-SF12) (β = 0.16), and Perceived Social Support Scale (PSSS) (β = 0.10) also contributed. Gender subgroup showed that in the male group, age, highest educational level, marital status, number of properties, whether having children, psychological conditions, the SHMS, EQ-5D, EQ-VAS, HLS-SF12, and PSSS showed significant difference. Urban and rural subgroups showed that age, highest educational level, number of properties, whether having chronic disease or psychological conditions, the SHMS, EQ-VAS, HLS-SF12, and PSSS were contributing factors in rural areas.

Conclusion: The average score of acceptance of hospice care was 65.02 points. Gender, house, anxiety, pressure, social support, and health literacy were the main influencing factors on residents' attitudes.

Keywords: China; affecting factors; cross-sectional study; hospice care; personal intention; public education.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
China
Cross-Sectional Studies
Female
Health Status*
Hospice Care*
Humans
Male
Quality of Life