|
| “何以善终”：居家临终对高龄人群临终质量的文化诠释 |
| ‘How to Achieve a Good Death’: A Cultural Interpretation of Dying at Home on the Quality of Death Among the Oldest Old |
| 投稿时间：2025-08-03 修订日期：2025-11-05 |
| DOI： |
| 中文关键词: 少子高龄化 临终关怀 临终地点 临终质量 “养儿防老” |
| 英文关键词: advanced aging with declining fertility end-of-life care place of death quality of death ‘raising sons for old-age support’ |
| 基金项目:教育部哲学社会科学研究重大课题攻关项目“中国式现代化建设的人口机遇、挑战与政策研究”（课题号：23JZD028） |
|
| 摘要点击次数: 386 |
| 全文下载次数: 0 |
| 中文摘要: |
| 探讨高龄老人（80岁及以上）“何以善终”的问题对于积极应对少子高龄化的严峻挑战具有重要的现实和文化意义。中国传统文化中“在家去世”的愿望，籍由“身归土”的空间归属机制和“魂归天”的血脉传承体系，深刻塑造了高龄老人对临终场所与家庭支持的偏好。然而以往鲜有定量研究从文化的视角来探析临终地点对临终质量的影响。本文通过分析中国老年健康影响因素跟踪调查(CLHLS2014-2018)的混合截面数据，在控制人口、病理及家庭条件变量后发现：首先，与在养老机构或者医院相比，高龄老人在家中去世会有较好的临终质量，因此，在制定和实施临终关怀政策时，应优先以家庭为单位输送支持和资源，重视“家”在我国高龄老人临终关怀中的核心作用；其次，与子女同住有助于提升高龄老人的临终质量，且儿子与女儿并无显著差异，可见仅仅依靠“养儿防老”的传统养老观念已经发生了重要改变；然而，调节效应进一步表明，仅在与儿子同住的情况下，居家去世才能显著提升高龄老人的临终质量，可见即使当下也不容忽视 “与儿子同住”在推动高龄老人居家临终关怀中独特的文化慰藉作用。 |
| 英文摘要: |
| Exploring the question of ‘how to achieve a good death’ among the oldest-old (aged 80 and above) holds significant practical and cultural implications for actively addressing the severe challenges posed by declining fertility and population advanced aging. In Chinese traditional culture, the desire to ‘die at home’ is deeply shaped by the spatial belonging mechanism of ‘body to earth’ and the lineage inheritance system of ‘soul to heaven’, which profoundly influences the oldest-old’s preferences for end-of-life care locations and family support. However, few quantitative studies have examined the impact of place of death on the quality of death from a cultural perspective. This paper analyzes mixed cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2014-2018). After controlling for demographic, pathological, and family-related variables, the findings reveal that compared to dying in nursing institutions or hospitals, the oldest-old who die at home experience better end-of-life quality. Therefore, when formulating and implementing end-of-life care policies, priority should be given to delivering support and resources at the household level, emphasizing the central role of ‘home’ in end-of-life care for Chinese oldest-old. Moreover, co-residence with children remains crucial in facilitating a good death, with no significant direct effect difference between sons and daughters, indicating a notable shift from the traditional belief of ‘raising sons for old-age support’. However, further moderation analysis indicates that dying at home significantly improves end-of-life quality only for the oldest-old who co-reside with sons. This suggests that even today, the unique cultural comfort of ‘co-residing with sons’ in promoting end-of-life care at home for the oldest-old should not be overlooked. |
|
View Fulltext
查看/发表评论 下载PDF阅读器 |
