Perceptions Of Family Members Research Articles

Enhancing special education programs’ curricula for students with intellectual disabilities in saudi arabia: A call for personalized approaches and inclusive practices

Background/AimsIn Saudi Arabia, students with intellectual disabilities (ID) receive some of their education through textbooks. However, using textbooks with students with ID contradicts the principles of providing services based on individuals with ID needs personalized plans to develop their individual abilities. This study aimed to investigate family and teacher perceptions of middle and high school curricula for students with ID in Saudi Arabia. This study focused specifically on the extent to which these curricula contribute to the development of academic and life skills among these students. Method and procedureA 21-item scale was used to measure the perceptions of family members and teachers of individuals with intellectual disability. The scale validity and reliability were examined and supported. The sample comprised of 113 family members and 111 teachers of students with ID. Outcomes and resultsFamily members and teachers both expressed low satisfaction regarding the improvement in academic and life skills of students as a result of the current curricular in the surveyed programs. Additionally, they conveyed dissatisfaction with the overall outcomes of services provided for individuals with intellectual disabilities. Conclusions and implicationsThis study highlights the inadequacies of a one-size-fits-all approach to designing curricula for students with ID. There is a need to improve and enhance curriculum content to meet the diverse learning needs of these individuals.

Embracing family presence: exploring the reasons for family decision-making dependence on in-hospital palliative care for cancer patients

The implementation of home-based palliative care is widely recognized as a commendable and effective model of care provision. However, it is noteworthy that families residing in Indonesia exhibit a propensity to predominantly seek palliative care services within hospital environments for their family members afflicted with palliative-stage cancer. Therefore, the aim of this research was to investigate the perceptions of family members in their decision-making process regarding the care of palliative-stage cancer patients at home. This qualitative study employed a descriptive phenomenological approach. Data were obtained through in-depth interviews with ten Indonesian family members of palliative-stage cancer patients refusing discharge, and were analyzed using the Colaizzi method. Furthermore, the inclusion criteria were that the dominant family member who cares for the patient lives with the patient and is involved in the decision-making process. Two themes emerged from this study: i) a lack of support in decision-making, and ii) pain and chronic sorrow. Home-based palliative care for cancer patients presents significant decision-making challenges and persistent grief for families, necessitating robust support and education from healthcare professionals such as nurses and policymakers. Additionally, a national health insurance system that enables effective palliative care is crucial.

Navigating tensions when life-sustaining treatment is withdrawn: A thematic synthesis of nurses' and physicians' experiences.

To synthesise nurses' and physicians' experiences with withdrawing life-sustaining treatment in an intensive care unit. The chosen methodology is thematic synthesis. The Preferred Reporting Items for Systematic Review and Meta-Analyses and Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement. A systematic search is conducted in APA PsycINFO, CINAHL Plus, EMBASE, PubMed and Web of Science following the inclusion and exclusion criteria in April 2023. Two reviewers independently screened and extracted the qualitative data. Subsequently, data analysis was conducted using thematic analysis of qualitative research. This study was not registered with any review registry due to the irrelevance of the data to health-related outcomes. From the 16 articles, 267 quotes were extracted and analysed. The findings of the study revealed five analytical themes: (1) tensions between interdependent collaboration and hierarchical roles; (2) tensions between dignified dying or therapeutic perspectives; (3) family members' reflections of patient's wishes; (4) tensions in family members' positions; and (5) double-sidedness of distress. This study contributes to nursing knowledge by providing a more nuanced understanding of this complex phenomenon of withdrawing life-sustaining treatment. The findings of this study have revealed significant variations globally in the practices surrounding the withdrawal of life-sustaining treatment in intensive care units, emphasising the need for further research to inform clinical practices that cater to diverse contexts. Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement (ENTREQ statement). Since this study reported a potential collision between the patient's dignified dying and the family member's perceptions and interests, the family member's wishes should be carefully distinguished from the patient's quality of end of life in practice.

Role of occupational therapy in person-centred dementia care: Exploring family member and clinician perceptions.

This study aimed to explore the role of occupational therapy in dementia facilities using a person-centred model of care, from the perspective of family members, occupational therapists and multidisciplinary health professionals. A descriptive qualitative approach was adopted, and all data were evaluated using thematic analysis. Semi-structured interviews were completed with eight family members and five multidisciplinary health professionals. Four occupational therapists practising in dementia care also provided qualitative data via an online survey. The analysis identified two key themes around perceptions of occupational therapy in person-centred dementia care. These themes were (1) the poorly defined scope of the occupational therapy role and (2) the perceived features of the occupational therapy role. While the perceptions and experiences of participants varied, the scope of this role is currently poorly defined. Occupational therapists in this setting commonly facilitate positive social interaction and present-oriented occupational engagement with residents and are also recognised as building workforce capacity with multidisciplinary colleagues. Without a clearly defined scope of practice, the role of occupational therapy in enabling health and well-being for people with dementia cannot be coherently articulated. This could lead to underutilisation of occupational therapy services, and lost opportunities for residents to experience improved health and well-being.

Bereaved Respondent Perceptions of Quality of Care by Inpatient Palliative Care Utilization in the Last Month of Life.

Under traditional Medicare, accountability measures are specific to each healthcare setting. With the growth of alternative payment models such as Medicare Advantage, the focus of accountability measures can be on the longitudinal episode of care. Using the last month of life as the episode of care, examine bereaved family member perceptions of the quality of care by site of death and inpatient palliative/hospice care. Retrospective cohort study using the National Health Aging Trends Study waves 3-11. US decedents age 65 and older with family member or close friend survey response. Overall rating of the quality of care, perceptions of symptom management, being treated with respect, emotional/spiritual support, communication, and receipt of care that the decedent did not want. Among 2796 interviews (weighted N = 12.6 million), 25.7% died at home with hospice, 10.9% at home without hospice, 10.0% in the ICU, 6.4% at a palliative care unit (PCU), 6.4% at a hospice IPU, 9.1% at hospital without inpatient palliative care, 13.2% at a nursing home without hospice, 9.8% in a nursing home with hospice, 4.1% at a hospice residence, and 4.4% at other locations without hospice. Dying at home with hospice received the highest rating of quality of care (60.2% stated excellent care) while the adjusted marginal differences in sites of death with inpatient palliative care services were rated lower: hospice residence 25.6% points lower (95% CI (-13.7%, -37.5%)) and a freestanding IPU was 16.9% points lower (95% CI (- 4.9%, -29.0%)). Examining the episode of care as the last month of life, hospice at home is associated with higher rating of the quality of care while inpatient palliative care services in hospital, hospice residence, or hospice IPU settings are rated lower.

A Sibling’s Sense of Self

It is commonly viewed that siblings of those with disabilities are positioned as caregivers and tasked to support their sibling with a disability. Family members of those with disabilities are particularly viewed as impacted heavily by the burden of care placed on them. However, truth be told, there are many influential and positive attributes that are acquired by one’s upbringing and living with a family member who has a disability. Typically overlooked by researchers in the field, there are dismissed perceptions of family members that should be accounted for. Further, individuals who have grown up alongside of members of their family with a disability have unique perceptions that influence their self-perceptions and ways of living. This study found that an individual with a sibling with a disability has experienced in childhood up to current time circumstantial practices relative to their family position which influence the way they currently carry and perceive themselves. Further indicated in this study is the importance of family relationships, dynamics and stability in support of the care to the sibling with a disability. Particular qualities and characteristics are highlighted in this study to showcase the intricate yet complex lives of individuals with siblings who have disabilities. Proven is the need for augmented initiatives and enhanced supports to address gaps and needs among individual family members who are related to someone with a disability. The objective of this study was to gain a deeper understanding of how individuals perceive themselves based on their experiences growing up with a family member who identifies as having a disability. The aim was to investigate the perceived experiences of these individuals and their reflections on their personal identities and sense of perception. A total of 10 individuals over the age of 18 who have siblings with disabilities from across Ontario, Canada completed virtual or in-person interviews. To reflect participants' upbringing, current experiences, and anticipated future roles within their families, themes naturally surfaced and were identified as means to represent consistent data responses. In general, the findings revealed a range of experiences that impact their sense of self and family responsibilities. Many unique and positive perceptions of self were conveyed by participants in reference to their lived experiences. This study fills gaps in disability studies by highlighting the positive outcomes of sibling relationships and the unique lived experiences of individuals who have siblings with disabilities. It emphasizes the importance of recognizing an individuals’ experiences and stories relative to having a sibling with a disability.

Vítimas indiretas da violência: um olhar sobre os impactos na saúde

Abstract We sought to investigate the perceptions of indirect victims or family members of homicide victims, about the repercussions of these deaths on their health. A qualitative, exploratory, descriptive study was carried out, based on eight semi-structured individual interviews with two groups: family members of police officers victimized by lethal violence, and family members of people killed as a result of police intervention, designated here as homicide. Both groups reported the perception that their health deteriorated after the homicide, and mentioned problems such as depression, panic disorder, insomnia, heart conditions and eating disorders. They also highlighted the acquisition of habits that are harmful to health, such as the consumption of alcoholic beverages, tobacco and self-medication, and the worsening of pre-existing health issues. It was observed that the homicide committed and suffered by police agents affects various aspects of the lives of indirect victims that are inseparable from health issues in a broader sense. These people are also victims of this violence, although their suffering is often made invisible. Studying this topic helps to give space to the suffering and mourning of these people and to subsidize the best performance of the institutions and services involved.

Indirect victims of violence: a look at health impacts.

We sought to investigate the perceptions of indirect victims or family members of homicide victims, about the repercussions of these deaths on their health. A qualitative, exploratory, descriptive study was carried out, based on eight semi-structured individual interviews with two groups: family members of police officers victimized by lethal violence, and family members of people killed as a result of police intervention, designated here as homicide. Both groups reported the perception that their health deteriorated after the homicide, and mentioned problems such as depression, panic disorder, insomnia, heart conditions and eating disorders. They also highlighted the acquisition of habits that are harmful to health, such as the consumption of alcoholic beverages, tobacco and self-medication, and the worsening of pre-existing health issues. It was observed that the homicide committed and suffered by police agents affects various aspects of the lives of indirect victims that are inseparable from health issues in a broader sense. These people are also victims of this violence, although their suffering is often made invisible. Studying this topic helps to give space to the suffering and mourning of these people and to subsidize the best performance of the institutions and services involved.

Family member incarceration and loneliness among low-income U.S. veterans.

Exposure to incarceration can have significant ramifications for one's social relationships. However, the study of how the incarceration of a family member influences loneliness, including among specific segments of the population that experience elevated levels of loneliness, such as U.S. military veterans, has gone understudied. This study aimed to examine the relationship between family member incarceration and perceptions of loneliness among a sample of low-income U.S. military veterans. Data are from the National Veteran Homeless and Other Poverty Experiences Study-a national survey of low-income U.S. veterans collected in December 2022 and January 2023. Multiple Poisson is used to assess the relationship between family member incarceration and a loneliness index, and multinomial logistic regression was used to estimate the relationship with specific constructs in the loneliness index. The results indicate that respondents who ever experienced the incarceration of a family member reported significantly more loneliness (incidence risk ratio = 1.189, 95% CI [1.035, 1.366]). Further, analyses of the specific items in the loneliness index revealed that family member incarceration was related to an increased risk of reporting feelings of often lacking companionship (relative risk ratio = 1.598, 95% CI [1.077, 2.370]) and often feeling isolated from others (1.711, 95% CI [1.014, 2.886]). Given the potential adverse consequences of loneliness and family member incarceration for well-being, the results from this study emphasize the need for increased attention and coordinated approaches in addressing feelings of loneliness, developing efforts to mitigate the harms of family member incarceration within the U.S. veteran community. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Case Study of Sandplay Therapy for a Mother with Insecure Attachment and the Impact on Family Members

The purpose of this study was to investigate the changes in a mother's attachment and emotional control resulting from Sandplay Therapy in cases of insecure adult attachment. Additionally, the study aimed to examine the changes in family perception and attachment to the mother's changes. One mother with a high insecure adult attachment score and her family were selected as subjects for this study. Attachment scales, emotional control scales, sentence completion tests (SCTs), and interviews were conducted before and after the therapy to study the subjects' changes in attachment and emotional control, as well as the changes perceived by family members. The mother then underwent 12 sessions of Sandplay Therapy. The results showed that: After Sandplay therapy, the mother's attachment and emotional control demonstrated positive changes. The mother's changes through Sandplay Therapy contributed to the improvement of the family's positive perception and attachment level. The Sandplay box underwent a process of individualization, leading to self-realization. In conclusion, Sandplay Therapy helps stabilize the attachment and emotion of insecure attachment mothers, and the changes in mothers have a positive impact on the perception and attachment of family members. A follow-up study, it is necessary to expand the number of study subjects by attachment type.

Perceptions of Married Female Teachers Regarding the Impact of Job on their Family Life

The impact of job on the family life of married female teachers was the title of the research. The purpose of this study was to explore the impact of the job on the family life of married female teachers and to describe the perceptions of family members regarding married female jobs. The entire primary school teacher constituted the population for the study. A sample of 100 married female teachers from 34 schools was randomly selected for this study. A quantitative research design was used for which a five-point Likert-type rating scale consisting of 12 items was designed. Data was collected from the married female primary school teachers. Percentage was used as a statistical tool for analysis of the collected data. Based on the findings, it was concluded that half of the female teachers feel that they face problems in getting permission to teach. The majority of female teachers feel that the distance of school from home also lowered their job satisfaction level. Most of the participants believed teaching jobs cause differences among their husbands. Most of the female teachers were that they had enough time for their husbands.

Lived experiences of patients and families with decentralised drug-resistant tuberculosis care in the Eastern Cape, South Africa.

South Africa adopted the decentralised Drug Resistant Tuberculosis (DR-TB) care model in 2011 with a view of improving clinical outcomes. This study explores the experiences and perceptions of patients and family members on the effectiveness of a decentralised community DR-TB care model in the Oliver Reginald Kaizana (OR) Tambo district municipality of the Eastern Cape, South Africa. In this phenomenological qualitative research design, a semi-structured interview with prompts was conducted on 30 participants (15 patients and 15 family members). Framework approach to thematic content analysis was adopted for qualitative data analysis. Four themes emerged from the patients' interviews: adequate knowledge of DR-TB and its transmission, fear of death and isolation, long travel distances, and exorbitant transportation cost. A 'ready' health system influenced the effectiveness of community DR-TB management, while interviews with family members yielded five themes: misconceptions about DR-TB, rapid diagnosis and adherence counselling, long travel distances, activated healthcare workers, and little role of traditional healer. A perceived effectiveness of a community DR-TB care model in the OR Tambo district was demonstrated through the quality and comprehensiveness of care rendered by a 'ready' health system with activated health care workers (HCWs) who provided robust support and adequate knowledge of DR-TB and its treatment/side effects. However, misconceptions about DR-TB, long travel distances to treatment facilities, high cost of transportation and stigma remained challenging for most patients and family members.Contribution: This study provides insight into the lived experiences of a decentralised community DR-TB care model in the OR Tambo district in 2020.

Perceptions of family members on family collaboration during pregnancy

Background: Family collaboration is the interactive coordination between family members aimed towards achieving a common goal and putting individual differences aside. The collaboration received from the family makes the pregnant woman feel valued. However, family members have been identified as not collaborating in meeting basic needs of the pregnant woman. They have been found to maltreat pregnant women, by giving them chronic house-hold chores, depriving them of food and blocking access to health care. The study creates awareness on involvement of family in caring for the pregnant woman. The educational pamphlet developed, serves as educational resource on usefulness of family collaboration during pregnancy. Objectives: To explore family collaboration during pregnancy from the perspectives of family members of pregnant women, as well as also to develop an educational pamphlet from the findings to enhance family collaboration. Method: Qualitative research, using open-ended questionnaire. Fourteen family members participated, until data became saturated. Content analysis method by Erlingsson and Brysiewicz, was used in analyzing data, as this is well suited for qualitative analysis. Questionnaires were read thoroughly, and texts were formed into meaning units, these were concisely condensed while retaining the core meaning, the units were labeled by formulating codes. Codes related were formulated into Categories. The categories formed the themes of the pamphlet. Result: The findings are presented in form of a pamphlet that has been attached as a download to this article (refer to Download pamphlet). Conclusion: The study described perceptions of family members on family collaboration, through the categories that emerged from the findings and the pamphlet highlight ways that family can support a pregnant member during pregnancy.

Experiences and perceptions of family members of emergency first responders with post-traumatic stress disorder.

Experiences and perceptions of family members of emergency first responders with post-traumatic stress disorder.

Family members’ perception of their needs in critical care units at a tertiary hospital in Malawi: A qualitative study

BackgroundFamily members experience an emotional crisis when their loved one is critically ill and admitted to a critical care unit (CCU). An extensive literature has explored optimal ways to interact with families in the critical care setting, including intervention studies. What is less explored are perceptions of family members in low-income settings including Malawi. In such settings, perceptions may differ as a consequence of different cultural practices and resource limitations (personnel and technology). Therefore, this study explored family members’ perceptions of their needs in CCUs at a tertiary hospital in Malawi.Study designs and methodsThe study used a qualitative descriptive design. Data were gathered through interviews with 12 participants who were purposively selected from immediate family members of patients hospitalized for 48 h or more in adult intensive care unit (ICU) and high dependency unit (HDU). The interviews were audio recorded and transcribed verbatim. Data analysis followed the steps of content analysis.FindingsThe following four themes were identified: perceived information, physical, and psychosocial needs, and coping mechanisms of the family members. The family members needed information about their patient’s progress frequently and viewed this as a priority compared to other needs such as comfort and food.ConclusionThis study suggests that there should be a collaborative relationship between the CCU team and family members in order to meet their needs. Findings affirm the need for health professionals to develop guidelines or standards that promote frequent discussions with CCU family members as a means to provide support and lessen anxiety.

Perceptions of crime severity and stigma toward family members grieving the loss of a person to incarceration

ABSTRACT Family members of incarcerated persons may experience grief related to the incarceration. We examined laypeople’s perceptions of family members grieving the loss of an individual to incarceration. Participants (N = 1095) were randomized to read vignettes that varied by grief trajectory (prolonged vs. resilient), race (Black vs. White vs. Latine), and crime type (violent vs. non-violent). Participants answered questions assessing grief response appropriateness, comfort providing support to the grieving person, beliefs that the grieving person should seek therapy, and how severe they believed the incarcerated person’s crime was. Results indicated that prolonged grief trajectories and greater perceived crime severity were associated with decreased ratings of grief response appropriateness. Participants were more likely to endorse the need for therapy-seeking for individuals with prolonged grief (vs. resilience). Participants were less likely to recommend therapy for Black (vs. White) individuals, and women were more likely to recommend seeking therapy than men. The results suggest stigma might exist toward family members grieving the loss of individuals who committed crimes perceived to be more severe by laypeople, which could contribute to negative bereavement outcomes.

The Functioning of Hospice in the Perception of Family Members of Cancer Surgery and Hospice Patients

Palliative care in Poland is for all dying people and their families to have timely access to quality care services. The study aimed to assess the perception of the role of hospice care by families of patients treated in oncological surgery departments and hospices. The study included 211 family members of cancer patients, comprising 108 family members of cancer surgery patients (Group I) and 103 hospice patients (Group II). The study used a diagnostic survey method with a proprietary questionnaire. 74.9% of people in Group I and 84.6% in Group II experienced positive associations with hospice care. 86% of respondents from Group I believed that hospice is a place where patients can die with dignity, while 68.3% of those from Group II believed it is where patients receive professional care. 56.7% from Group I and 65.4% from Group II did not feel anxious about hospice care. According to 68.6% of people in Group I, informing the patient that he or she is in hospice as well as about his or her disease should depend on the patient's condition. In the opinion of 75% of Group II, the patient should always be informed. In Group I (68.3%) and Group II (91.5%), the dominant opinion was that the family should take part in the care and treatment of the patient. 78.4% of respondents in Group I and 96.4% in Group II recommend hospice to other families. Most families of cancer patients from both the oncological surgery departments (Group I) and hospice (Group II) had positive first associations with hospice care. However, families from Group II had more critical remarks on hospice functioning.

Domestic research trends related to images of fathers: Focusing on perception of father’s image

연구목적: 본 연구는 아버지 상과 관련해 실제 인식을 파악한 국내 연구들을 체계적으로분석하여 연구동향을 살펴봄으로써, 후속연구에 필요한 방향성과 기초정보를 제공하는데 목적을 둔다. 방법: 아버지에 대한 이미지와 인식을 조사한 2000년부터 최근인 2022년까지 국내에서발행된 36편의 학술지 및 학위논문을 선정하여, 시기, 방법, 주제별로 연구 내용과 빈도를체계적으로 분석하였다. 결과: 첫째, 아버지 상은 2000년대 후반부터 연구물의 수가 크게 증가하여, 2010년대 후반까지 활발하게 연구되었지만, 최근 그 수가 크게 줄어드는 추세이다. 둘째, 아버지 상은과반 이상이 설문조사를 통해 연구되었으며, 그 다음으로 면담, 실험, 관찰, 기타 방법순으로 연구방법이 사용되었다. 셋째, 아버지 상은 가정적인 아버지, 경제적 부양, 정서적지원, 모델·교육·훈육, 부정적 이미지의 다섯 가지 차원으로 분석되었으며, 인식의 주체에따라 서로 다른 양상으로 그 빈도와 추이가 다르게 나타났다. 결론: 아버지 상에 대한 연구동향은 시대적 요구와 사회문화 변화에 따라 변화되어 가는아버지 상을 반영하였다. 또한, 아버지에 대한 가족구성원마다의 인식에서 차이가 있으며, 정부의 정책적 기조와 같은 사회적 변동에 의해 연동됨을 알 수 있다. 사회적 지표를통해 아버지의 역할수행이 개선되고 있음이 드러나지만, 여전히 아버지의 역할수행과인식 간에는 간극이 존재하며, 이에 대한 사회적 차원의 노력이 요구된다. 더불어 다각적인 아버지 상 연구를 위해서는 연구수행에 있어 방법론적 다양성을 확보하고, 심화된분석 논의가 요구된다.Objectives: The purpose of this study is to provide direction and basic information necessary for subsequent studies by analyzing trends in research related to images of fathers published in Korea from 2000 to 2022. Methods: The approach used in this study was to analyze the trend associated with images of fathers according to the periods, methods, and subjects of the images. Results: First, the number of studies on the fathers' images has increased significantly since the late 2000s, and this topic was actively studied until the late 2010s, though the number of studies has significantly decreased more recently. Second, more than half of the fathers' images were studied through a survey, followed by interviews, experiments, observations, and then other methods. Third, the fathers' images were analyzed in five dimensions: family father; economic support; emotional support; model[Jim C2], education, and training; and negative images. The frequency and trend differed depending on the subject of perception. Conclusions: The research trend on fathers' images reflected changes in these images according to the needs of the times and changes in the social culture. In addition, it was noted that there were differences in the perceptions of family members of the father and that this was linked to social changes, such as policy stances taken by the government. Although it was revealed that the father's role performance is improving through social indicators, there is still a gap between the father's role performance and perception, and efforts at the social level are required. In addition, for multilateral father-image research, methodological diversity in research performance is secured, and an in-depth analysis discussion is required.

Male family members’ perceptions of COVID-19 vaccination of pregnant and breastfeeding people in kenya

Evidence supports safe and ethical inclusion of pregnant and breastfeeding people (PBFP) in COVID-19 vaccination efforts. We explored potential influences on COVID-19 vaccine decision-making by Kenyan PBFP, including perceptions of male family members.

How do our older adults die? The perception of family members about suffering in the last year of life

Objectives: To characterize the signs and symptoms of suffering, the circumstances of death, and health service use in the 12 months prior to death in a cohort of community-dwelling older adults according to relatives’ perception, as well as to verify the relationships between baseline frailty and signs/symptoms of suffering in the last year of life. Methods: This retrospective cohort study used data from the Frailty in Older Brazilians (FIBRA) Study. Home interviews were carried out with the relatives of deceased older adults. Descriptive statistical analyses were performed, including adjusted prevalence ratios through Poisson regression. Results: A total of 192 family members participated (64.58% women). The mean age of the deceased was 80.59 years (59.90% women; 27.08% with no formal education). In the year before death, 51.34% had fatigue, 43.68% had pain, 42.63% had anorexia, 41.27% had dyspnea, and 41.21% suffered a fall. Most died either at home (52.10%) or in the hospital (41.66%). The most frequent causes of death were circulatory and respiratory system diseases and neoplasms; 29.63% died suddenly, 51.05% were admitted to an intensive care unit, 52.60% were hospitalized, 58.76% used pain medication, and 27.13% received home care. Relative to non-frailty, baseline frailty was associated with dependence (prevalence ratio = 2.52) and pain medication use (prevalence ratio = 1.52) in the last year of life. Conclusions: Signs and symptoms of suffering in the last year of life were high among community-dwelling older adults, highlighting the need to support them and their families through provide palliative care.