This paper acknowledges the lack of an accepted conceptual framework of existential distress in patients with advanced cancer. It is based on healthcare professionals' views, and further studies from the perspectives of patients and their families are needed.

Hope is considered a coping strategy as well as a factor that enhances quality of life for patients with advanced cancer. Most studies on the meaning of hope are from the patients' perspective. However, the health-care professionals' view is also important since it may affect their practice. This study explored the meaning of hope to patients with advanced cancer from health-care professionals' perspective. This was a qualitative study that used a hermeneutic phenomenological approach. Five focus group interviews were conducted with 23 participants including physicians, nurses, social workers, occupational therapists, chaplains, and a physiotherapist working in the palliative care unit of a hospital in Hong Kong. Data analysis revealed four themes: expected hopelessness, a dynamic process of hope, hope-fostering strategies, and peace as the ultimate hope. It appears that health-care professionals' hopefulness contributes to the hopefulness of patients. Opportunities to reflect on their values, beliefs, and experience may help health-care professionals enhance their ability to foster hope in patients.

mok e, ting fh & lau k‐p (2010)  Journal of Nursing and Healthcare of Chronic Illness2, 313–319
Advance directives and life‐sustaining treatment: informed attitudes of Hong Kong Chinese elders with chronic disease Aim.  The aim of this study was to examine attitudes towards advance directives and life‐sustaining treatment of Chinese older persons with chronic disease in Hong Kong. Background.  The concept of advance directives and related issues are fairly new to people in Hong Kong but they are open to talk about concerns at the end of life rather than treating death as a taboo. Older persons with chronic disease are a group to which end‐of‐life decision making is particularly relevant. Studies on attitudes of Chinese older persons with chronic disease towards advance directives and life‐sustaining treatment will be useful for culturally sensitive practice. Method.  A cross sectional survey was carried out in 2009 in the in‐patient wards of a hospital in Hong Kong. Advance directives and related concepts were explained to participants before they were interviewed to ensure they had sufficient background information to give informed attitudes. Quantitative data regarding their attitudes towards the use of advance directives and limited use of life‐sustaining treatment were collected. Conclusions.  Two hundred and nineteen participants completed the survey. Being informed of the concept of advance directives and related issues, in general they were able to take side regarding their attitudes regarding advance directives and life‐sustaining treatment. They also had a general positive attitude towards the use of advance directives and limited use of life‐sustaining treatment for a good death. To them, family was an indispensable part of end‐of‐life decision making. Relevance to clinical practice.  While concepts such as advance care planning, advance directives and life‐sustaining treatment are fairly new to people in Hong Kong, clinicians should make sure patients are fully informed before they are required to make any life‐and‐death decision. Family members should also be involved in the process of discussion and decision‐making.

No abstract

No abstract