Aceptación de la muerte y su deshospitalización / Acceptance of death and its dehospitalisation

INTRODUCCIÓN: La muerte forma parte de la vida. La conciencia de que la muerte es inevitable puede causar trastornos mentales. OBJETIVO: Determinar el nivel de ansiedad frente a la muerte en la gente mayor y su relación con la edad, el género, los aspectos sociales, la actividad física, el ocio, la autoestima, la religión y la enfermedad avanzada. Conocer sus preferencias respecto el lugar donde quieren morir. MATERIAL Y MÉTODO: Estudio observacional transversal. Entrevista estructurada y escala ansiedad frente la muerte Templer a 300 participantes sin diagnóstico de demencia seleccionados aleatoriamente entre población ≥75 años en cuatro centros de atención primaria. RESULTADOS: Un total de 288 entrevistas. Edad media 84,8 (DE: 15,2) años, 147 (51,0%) >85 años y 148 (51,4%) mujeres. El grado de ansiedad media-alta en la DAS fue mayor en las mujeres (50-39,6%; p = 0,030), en los que no realizaban actividad física (68-26,4%; p < 0,001), en los que no hacían actividades de ocio (63,5-41,7%; p = 0,007), en los pacientes con ánimo deprimido (60,4-41,6%; p < 0,008) y en los pacientes sin enfermedad crónica avanzada (48,3-35,8%; p = 0,036). La actividad física redujo 5,3 veces el riesgo de presentar ansiedad media/alta (OR=0,188; p < 0,001) y el cribado positivo para depresión la aumentó 2,9 veces (OR=2,943; p = 0,014). Un total de 255 (88,5%) afirmaron tener miedo a una muerte dolorosa; 177 (61,5%) prefieren morir en casa y 28 (9,7%) en el hospital. CONCLUSIONES: La gente mayor tiene miedo a sufrir una muerte dolorosa, aunque en general presenta niveles medios-bajos de ansiedad frente a ella. El género masculino y realizar actividades físicas/ocio se asocian a niveles más bajos de ansiedad. La enfermedad crónica avanzada produce mayor aceptación de la muerte. Predomina el deseo de morir en casa y deshospitalizar la muerte

INTRODUCTION: Death is part of life. The awareness that death is inevitable could be the cause of mental disorders. OBJECTIVE: To determine the level of death anxiety in old people as regards age, gender, social aspects, physical and leisure activities, self-esteem, religion or advanced disease, as well as their preferences on the place where they want to die. MATERIAL AND METHOD: Cross-sectional observational study. Face-to-face interviews and Death Anxiety Scale (DAS) of Templer on 300 patients over 75 years-old without a diagnosis of dementia, selected randomly in four health centres. RESULTS: A total of 288 surveys were completed. The mean age was 84.8 (15.2) years, and 147 (51.0%) were older than 85 years. The score of medium-high anxiety observed in the DAS was higher in women (50%-39.6%; P=.030), in those who did not perform physical activity (68%-26.4%; P<.001), in those who did not take part in leisure activities (63.5%-41.7%; P=.007), in patients with depressed mood (60.4%-41.6%; P<.008), and in patients without advanced disease (48.3%-3 5.8%; P=.036). The fear of having a painful death was present in 255 (88.5%). Physical activity reduced the risk of medium-high anxiety by 5.3 times (OR=.188, P<.001), and screening positive for depression increased it by 2.9 times (OR=2.943, P=.014). As regards the place where they would prefer to die, 177 (61.5%) answered «at home», and 28 (9.7%) «in the hospital.» CONCLUSIONS: Older people do fear a painful death, but they are not really afraid of dying. Male gender and performing physical or leisure activities is related to low levels of death anxiety. Advanced disease leads to greater acceptance of the end of life. The desire to die at home, and to «dehospitalise» the death prevails

[Acceptance Of Death And Its Dehospitalisation]. / Aceptación de la muerte y su deshospitalización.

INTRODUCTION: Death is part of life. The awareness that death is inevitable could be the cause of mental disorders. OBJECTIVE: To determine the level of death anxiety in old people as regards age, gender, social aspects, physical and leisure activities, self-esteem, religion or advanced disease, as well as their preferences on the place where they want to die. MATERIAL AND METHOD: Cross-sectional observational study. Face-to-face interviews and Death Anxiety Scale (DAS) of Templer on 300 patients over 75years-old without a diagnosis of dementia, selected randomly in four health centres. RESULTS: A total of 288 surveys were completed. The mean age was 84.8 (15.2) years, and 147 (51.0%) were older than 85years. The score of medium-high anxiety observed in the DAS was higher in women (50%-39.6%; P=.030), in those who did not perform physical activity (68%-26.4%; P<.001), in those who did not take part in leisure activities (63.5%-41.7%; P=.007), in patients with depressed mood (60.4%-41.6%; P<.008), and in patients without advanced disease (48.3%-3 5.8%; P=.036). The fear of having a painful death was present in 255 (88.5%). Physical activity reduced the risk of medium-high anxiety by 5.3 times (OR=.188, P<.001), and screening positive for depression increased it by 2.9 times (OR=2.943, P=.014). As regards the place where they would prefer to die, 177 (61.5%) answered «at home¼, and 28 (9.7%) «in the hospital.¼ CONCLUSIONS: Older people do fear a painful death, but they are not really afraid of dying. Male gender and performing physical or leisure activities is related to low levels of death anxiety. Advanced disease leads to greater acceptance of the end of life. The desire to die at home, and to «dehospitalise¼ the death prevails.