Knowledge, Attitudes, and Preferences of Advance Decisions, End-of-Life Care, and Place of Care and Death in Hong Kong. A Population-Based Telephone Survey of 1067 Adults

Chung, Roger Yat‐Nork; Wong, Eliza Lai-Yi; Kiang, Nicole; Chau, Patsy Yuen-Kwan; Lau, Janice Y.C.; Wong, Samuel Yeung‐Shan; Yeoh, Eng‐Kiong; Woo, Jean

doi:10.1016/j.jamda.2016.12.066

Cited by 90 publications

(118 citation statements)

References 13 publications

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“…To our knowledge, this is the first study to investigate preferences for place of death among older people living in Brazil. Preferences for place of death have been investigated in countries such as the United States, United Kingdom, Canada, Australia, Japan and China 3,[12][13][14]26 . In the European Union population-based survey among seven European countries showed that 51-84% of participants preferred to die at home along with 51.1% in Kenya (Nairobi) if they were to die with advanced disease and if circumstances allowed them choose 12,13 .…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies that associate self-rated health and preference of the place of death 14 . A population-Based Survey in Hong Kong found an associated poor self-rated health with lower preference to die at home 26 . A study about preferences for the place of death among Japanese older people, found that good self-rated health was significantly associated with a home death preference 14 .…”

Section: Discussionmentioning

confidence: 99%

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Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

Jorge

Calanzani

Freitas

et al. 2019

Ciênc. saúde coletiva

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We examined people’s preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: very good health) and selecting “choosing who makes decisions about your care” as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

Jorge

Calanzani

Freitas

et al. 2019

Ciênc. saúde coletiva

View full text Add to dashboard Cite

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“…It is also often more challenging for clinicians to undertake prognostic care planning and make decisions to initiate EOL care for these patients in acute hospital settings (Australian Commission on Safety & Quality in Health Care, 2013). Comparing across regions, hospital remains the most common place of death ranging from 40%, 48%, 61% and 90% in Taiwan, the UK, Singapore and Hong Kong, respectively (Chung et al, 2017;Wang & Chan, 2015 It is well recognised that the practice style of healthcare providers has an important impact on the provision of high-quality EOL care. Gaps in priority of EOL care practice exist not only among physicians and nurses, but also among nurses across practice settings in hospitals.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Nurses’ perceptions of and barriers to the optimal end‐of‐life care in hospitals: A cross‐sectional study

Chan

Chow

Chan

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To assess nurses’ perceptions of what constitutes optimal end‐of‐life (EOL) care in hospital and evaluate nurses’ perceived barriers to EOL care delivery. Background Care of dying patients is common in hospitals. However, little is known about the important elements of and barriers to optimal EOL care from key service providers’ perspective, which is crucial for quality EOL care in hospital settings. Method This is a cross‐sectional survey. Nurses practising in hospitals recruited by convenience sampling completed self‐report survey questionnaires. STROBE checklist was used in study reporting. Results One hundred and‐seventy‐five nurses participated in the survey. The majority (70%) had experience in caring for dying patients. The five most highly perceived factors constituting optimal EOL care included the following: “families know and follow patient's EOL wishes”; “patients emotional concerns identified and managed well”; “patients participating in decision‐making”; “EOL care documents stored well and easily accessed”; and “provide private rooms and unlimited visiting hours for families of dying patients”. Top five barriers were “doctors are too busy”; “nurses are too busy”; “insufficient private room/space”; “nurses have limited training in EOL care”; and “families have unrealistic expectations of patient's prognosis.” Multivariate regression analysis identified that nurses without experience in caring for dying patients reported a significantly higher number of perceived barriers towards EOL care (p = .012). Those with postgraduate degree training reported significantly fewer perceived barriers (p = .007). Conclusion Findings identified essential elements for optimal hospital EOL care not only involving patients and families in EOL decision and care, but also documentation and environmental issues in the healthcare system level and the needs for strengthening manpower and expertise at palliative care policy level. Relevance to clinical practice This study revealed quantitative data to inform health service managers and policy makers in terms of training and service development/ re‐design for EOL care in hospital settings.

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“…Only 14%-19% of patients treated in palliative care prefer home deaths (Lam,5 2013; Woo et al, 2013), while dying at home is considered as 'contaminating' the property and making it a 'haunted house'. A public survey though finds 30.8% of Hong Kong Chinese participants would like to die at home, 51.8% still prefer dying in the hospital (Chung, 2016). Nonetheless, Lam (2013) also contemplated that the preference of dying of home is obscured by the micro living space, such as small-size apartment homes and subdivided rooms, in Hong Kong.…”

Section: Sustaining the Dying Older Adults' Relational Personhood In mentioning

confidence: 99%

Organizational capacities for ‘residential care homes for the elderly’ to provide culturally appropriate end-of-life care for Chinese elders and their families

Kong

Fang

Lou

2017

Journal of Aging Studies

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Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care. We conducted two phases of research, a questionnaire survey and a qualitative study, which respectively aims at (1) understanding the EoL care service demand and provision in RCHEs, including death facts and perceived barriers and challenges in providing quality end-of-life care in care homes, and (2) identifying the necessary organizational capacities for the 'relational personhood' to be sustained in the process of ageing and dying in residential care homes. Findings shed light on how to empower residential care homes with necessary environmental, structural and cultural-resource-related capacity for providing quality end-of-life care for Chinese elders and their families.

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Knowledge, Attitudes, and Preferences of Advance Decisions, End-of-Life Care, and Place of Care and Death in Hong Kong. A Population-Based Telephone Survey of 1067 Adults

Cited by 90 publications

References 13 publications

Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

Nurses’ perceptions of and barriers to the optimal end‐of‐life care in hospitals: A cross‐sectional study

Organizational capacities for ‘residential care homes for the elderly’ to provide culturally appropriate end-of-life care for Chinese elders and their families

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