Factors related to good death in the Eastern Mediterranean Region: a systematic review

Abstract

Background: Considerations for palliative care and quality of death has significantly increased over the past 10 years in the Eastern Mediterranean Region (EMR). Recent trends in ageing and increasing chronic disease burden have drawn attention to the need to pay attention to the concept of good death and related factors from the perspective of the local population. Aims: To assess the factors related to good death in the EMR. Methods: We searched PubMed, Embase, Scopus, Web of Science, and ProQuest on 22 October 2021 for English language articles, with no time limit, using keywords “quality of death”, “good death”, “quality of dying”, “good dying”, “Middle Eastern”, and countries in the Region. The quality of articles was evaluated using the Hawker criterion and based on the PRISMA guidelines. From the thematic analysis, the factors influencing good death were extracted. EndNote X8 software was used for data management. Results: The search yielded 55 articles, and 14 were included in the study, with a total of 3589 participants. Factors related to good death were classified into 2 main categories: patient preferences and end-of-life care. The former was divided into 4 groups: symptom management, psychological support, social support, and spiritual care. The second category included 2 subcategories: death control and patient autonomy, and end-of-life care. Conclusion: Although patients’ beliefs about good death are personal, unique, and different, perception about good death in the EMR depends on the extent to which patients’ preferences are met and end-of-life care is provided. More research on good death is recommended in the context of Islamic countries in EMR, and to empower patients and their families to better manage the dying process and create educational programmes.