Bringing Palliative Care into Geriatrics in a <scp>C</scp>hinese Culture Society—Results of a Collaborative Model between Palliative Medicine and Geriatrics Unit in <scp>H</scp>ong <scp>K</scp>ong

Cheng, Hon Wai Benjamin; Li, Cho‐Wing; Chan, Kwok Ying; Ho, Rebecca; Sham, Mau‐Kwong

doi:10.1111/jgs.12760

Cited by 25 publications

(22 citation statements)

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“…Cultural influences were also identified in a study of dying patients in Hong Kong, many of whom desire to die at home [ 58 ]. Only 2.7 % of patients died at home, however, largely due to the influence of social and culture barriers including limited housing, crowded living environments, and perceived threat of devaluing real estate property should a death occur at home [ 58 ]. The same study identified social and cultural taboos (e.g.…”

Section: Resultsmentioning

confidence: 99%

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A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

et al. 2016

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BackgroundMultiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool.MethodsTo explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June–August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004–2014.ResultsThe search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making.ConclusionsThis review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0282-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…The same study identified social and cultural taboos (e.g. idea that speaking about death may bring upon death) has significant influencers on perceptions of ‘a good death’ [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

et al. 2016

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“…Despite increases in the use of palliative and hospice care in elderly patients with terminal illness, ethnic disparities persist [ 33 ]. Therefore, hospice care teams who understand cultural differences between Chinese and Western societies might improve EOL quality care.…”

Section: Discussionmentioning

confidence: 99%

Effect of hospice care on quality indicators of end-of-life care among patients with liver cancer: a national longitudinal population-based study in Taiwan 2000–2011

Kao

Chiang

2015

BMC Palliat Care

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BackgroundQuality of near end-of-life (EOL) care is typically evaluated using six accepted quality indicators (QIs). Research has yet to evaluate the quality of EOL care for liver cancer patients in Taiwan. We evaluated the effect of hospice care on the quality of EOL care for patients with advanced liver cancer.MethodsUsing claims data obtained from the Taiwan National Health Insurance Research Database, we analyzed the QIs of EOL care for patients who died between 2000 and 2011. Logistic regression was performed to identify predictors for QIs of EOL care.ResultsA total of 3092 adult patients died of liver cancer during the study period. The patients were divided into those who received hospice care for a period longer than 1 month (long-H group), shorter than 1 month (short-H group), and not at all (non-H group). There was no significant difference in survival probability among the three groups (p = 0.212). Compared with the non-H group, the long- and short-H groups exhibited a significantly lower risk of being admitted to an intensive care unit (ICU) (odds ratios [ORs] = 0.25 and 0.26, respectively, p < 0.001) and requiring cardiopulmonary resuscitation (CPR) during the final month of life (ORs = 0.21 and 0.09, respectively, p < 0.001). Compared with the non-H group, the short-H group had a higher risk of more than one emergency room (ER) visit, and more than one hospital admission (OR = 1.97, p = 0.003; and OR = 1.56, p = 0.001, respectively), but the long-H group did not differed significantly from the non-H group on these measures.ConclusionsPatients with liver cancer who received hospice care were less likely to be admitted to ICUs or require CPR compared with those who received no hospice care. A longer duration of hospice care was associated with reduced risks of more than one ER visit and more than one hospital admission. We conclude that EOL cancer care in Taiwan might be improved by implementing policies encouraging early hospice referral programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-015-0036-9) contains supplementary material, which is available to authorized users.

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“…In Hong Kong, given the crowded living arrangements, and the perception that deaths in the home will lower the value of the real estate in a country where housing is extremely expensive (H. W. Cheng, Li, Chan, Ho, & Sham, 2014), only 31% of the surveyed Hong Kong public opted to die at home (R. Y. Chung et al, 2017).…”

Section: Preferences In Asian Countriesmentioning

confidence: 99%

“…W. Cheng et al, 2014), Shifting care from the hospital to the home requires the home space to be large enough to accommodate medical technologies and services to support home-based care. In certain urban environments such as Hong Kong (Tse, Chan, Lam, Leu, & Lam, 2007),, home deaths may not be practical due to space limitations.…”

Section: The Hong Kong Experiencementioning

confidence: 99%

Eliciting and honouring end-of-life care preferences : a multiple methods study on place of death

Tan¹

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This chapter describes the value of "home" as the place of death and discusses the differences that exist across high-income countries in having this preference. The experiences of selected Asian, European, and North American countries are contrasted. Other than individual and clinical factors, sociodemographic changes also act in concert with shifts in caregiving and death culture to influence the organisation and operationalisation of health and social care services over time. Legal means are used in some countries to sanction the idea of self-determination in end-of-life care decision-making; and since the late 1990s, ACP has become a significant non-legalistic mechanism, through which end-of-life care preferences are made known. In some countries, changes to end-of-life care service delivery and financing have supported the shifts in deaths from inpatient to out-of-hospital care facilities. These forces shape, and act jointly with the availability of formal and informal care, to support the individual living at home. The research objective, and specific research questions to be addressed in this dissertation, are outlined in this chapter. Yoshiuchi, Fujita, Sawai, & Watanabe, 2011; Ishikawa et al., 2013), was instead sparse. Therefore, the current discourse about home deaths is, to a great extent The Canadian experience On the other hand, the case of Canada was not supported by deliberate policy changes specific to palliative care delivery. Between 1994 and 2004, there were rapid declines in hospital deaths from 78% to 61% and a corresponding increase in home deaths from 19% to 30% (Wilson et al., 2009). Although community-based palliative

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Bringing Palliative Care into Geriatrics in a Chinese Culture Society—Results of a Collaborative Model between Palliative Medicine and Geriatrics Unit in Hong Kong

Cited by 25 publications

References 7 publications

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

Effect of hospice care on quality indicators of end-of-life care among patients with liver cancer: a national longitudinal population-based study in Taiwan 2000–2011

Eliciting and honouring end-of-life care preferences : a multiple methods study on place of death

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