1. In this systematic review, seven core elements of a good death among cancer patients were identified, including being aware of cancer, pain and symptom management, dying well, being remembered after death, individual perspectives of a good death, individual behaviors leading to a good death, and culture and religion.
2. In addition, a framework was proposed which may be used to promote having a good death for patients.
Evidence Rating Level: 1 (Excellent)
At the end of life, patients with cancer often experience significant physical and psychological distress – making the experience of a “good death” of clinical importance. Although a good death has been evaluated in the literature in other heterogeneous groups, these experiences may not be as applicable to patients with cancer. As a result, the objective of the present study was to further understand how cancer patients perceive having a good death.
Of 1,432 identified records, 5 studies were included from various databases from inception to March 2022. Studies were included if they explored the perception of a good death among patients with cancer in any setting. Studies were excluded if they focused on the certificate of death or if participants were a heterogeneous group of the terminally ill. The review was performed using PRISMA guidelines. The risk of bias was assessed using the JBI Critical Appraisal Checklist for Qualitative Research (JBI CACQR). The primary outcome was elements comprising a good death in cancer patients.
The results demonstrated that seven main factors were associated with a good death, including being aware of cancer, pain and symptom management, dying well, being remembered after death, individual perspectives of a good death, individual behaviors leading to a good death, and culture and religion. Furthermore, the authors proposed a framework combining external and internal factors that may support patients seeking a good death. Despite these results, the study was limited by the exclusion of studies involving a heterogenous population, which may have eliminated some perspectives of cancer patients. Nonetheless, the present study added considerable evidence to suggest that a good death for cancer patients may be achieved through the interplay of both internal and external factors.
Click to read the study in BMJ Supportive & Palliative Care
Image: PD
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