Attitudes toward end-of-life care and preferred death locations: A latent profile analysis

Older adults' attitudes toward end-of-life (EOL) care significantly affect its utilization. This study explored latent profiles of EOL care attitudes, their characteristics, and relations to prefer death locations among 498 Chinese community-dwelling adults aged 50 and above. Exploratory factor analysis identified four distinct dimensions of EOL care attitudes: "life reflection and legacy," "physical comfort and pain management," "autonomy and decision-making," and "spiritual and religious comfort." Latent profile analysis revealed four latent profiles: "holistic preparers" (40.04%), "physical comfort-focused individuals" (36.11%), "passive respondents" (14.66%), and "autonomy and spiritual-comfort seekers" (9.19%). Factors such as religious belief, education, chronic disease, exposure to cancer death, and caregiving experience predicted latent profile membership. Participants in different latent profiles showed significant differences in preferred death locations, with home and hospital being the most favored places. These findings highlight the diverse attitudes and preferences toward EOL care, providing insights for individualized EOL care planning and resource allocation.