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From the perspective of hospice care， focusing on the entire process before and after the occurrence of a death event， taking the interpretation of the concept of death value in hospice care as the starting point， this paper explored the value connotation implied in the process of death from the perspectives of the terminal person， caregivers， and social culture， as well as summarized the characteristics of the death value. Meanwhile， in the current social context of the difficulty in achieving good death due to the shallow understanding of death， this paper analyzed the great significance of the construction of the death value concept in hospice care for improving the personal death quality of the terminal person， promoting the quality of end-of-life， and accelerating the formation of a social environment of good death， with a view to stimulating academic attention to the construction of the death value of terminal person， and providing conceptual reference for improving the quality of hospice care services.
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Focusing on the field of palliative care，the Rodgers evolutionary concept analysis method was used to analyze the literature related to good death in the context of Chinese culture.The development history and application，definition and characteristics，influencing factors and their impacts，measuring indicators and tools of the concept of good death were elaborated，and further discussions were conducted.Good death refers to an individual’s peaceful and painless journey towards death，without subjective pain or concern，and calmness under the premise of sufficient longevity，while receiving care and companionship during the process of death from family，especially children and grandchildren，as well as achieving moral fulfilment and transcendence.The characteristics of good death in the context of Chinese traditional culture include the indirect expression of physical and mental pain being “understood” and properly handled，the construction of dying dignity based on virtue rather than autonomy，the emphasis on filial piety and emotional connections in the family，making after-death arrangements and realizing intergenerational inheritance，as well as the emphasis on achieving the integrity of life at the moment of death，which have distinct Chinese cultural characteristics.In the future，the connotation and extension of the concept of good death should be further explored，so as to assist in the development of localized theory and practice systems of good death.
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Objective:To compare the early efficacy of direct anterior approach versus posterolateral approach for total hip arthroplasty in elderly patients.Methods:The 48 elderly patients receiving total hip arthroplasty from September 2017 to September 2019 were divided into two groups: DAA group(n=23, 30 hips)receiving direct anterior approach for total hip arthroplasty, and PLA group(n=25, 33 hips)receiving posterolateral approach for total hip arthroplasty in this retrospective study.The operation time, blood loss, length of hospital stay, acetabular abduction angle, anteversion angle, and intraoperative and postoperative complications were recorded and compared between the two groups.The hip function was compared with Visual Analogue Scale(VAS)and Harris Hip Score(HHS).Results:All the 48 patients were followed up for 7-31 months, with an average of 22.8 months in DAA group, and 24 months in PLA group.The operation time was less in PLA group than in DAA group[(49.3±5.7)min vs.(70.3±6.2)min, t=12.22, P=0.00], while the hospital stay was longer in PLA group than in DAA group, with a statistically significant difference[(7.8±1.5)d vs.(5.6±1.3)d, t=-5.40, P=0.00]. There was no significant difference in intraoperative blood loss between the two groups[(173.1±47.9)ml vs.(189.6±48.7)ml, t=1.18, P=0.24]. The VAS and HHS scores were better at 1 month after operation and at the last follow-up than before operation in both DAA and PLA group(all P<0.05). The VAS and HHS scores were better in DAA than in PLA groups( P<0.05)at 1 month after surgery.However, at the last follow-up, there was no significant difference in VAS and HHS scores between the two groups( P>0.05). Conclusions:The early results of direct anterior approach for total hip arthroplasty are satisfactory in patients aged 85 years and older.It has the advantages of less trauma, faster postoperative recovery and shorter hospital stay.