Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-29T13:05:08.792Z Has data issue: false hasContentIssue false
  • English
  • Français

End-of-life care research in Hong Kong: A systematic review of peer-reviewed publications

Published online by Cambridge University Press:  15 June 2015

Chong-Wen Wang  and
Cecilia L.W. Chan
Chong-Wen Wang*
Affiliation:
Centre on Behavioral Health, The University of Hong Kong, Hong Kong
Cecilia L.W. Chan
Affiliation:
Centre on Behavioral Health, The University of Hong Kong, Hong Kong
*
Address correspondence and reprint requests to: Chong-Wen Wang, Centre on Behavioral Health, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This systematic review aimed to examine end-of-life (EoL) care research undertaken in an Eastern cultural context—Hong Kong—with the hope of better informing EoL care professionals and policy makers and providing lessons for other countries or areas that share similar EoL care challenges.

Method:

Eight databases were searched from their respective inception through to August of 2014. All of the resulting studies conducted in Hong Kong and relevant to EoL care or palliative care were examined. The included studies were assessed with respect to study design, care settings, participants, research themes, and major findings.

Results:

Some 107 publications published between 1991 and 2014 were identified. These studies were undertaken at a range of places by different professionals. Of the total, 44 were led by physicians, 36 by nurses, 17 by social workers, and 10 by other professionals. Participants included both inpatients and outpatients with different illnesses, nursing home residents, older community-dwelling adults, deceased individuals, care staff, and informal caregivers. A total of 13 research themes were identified: (1) attitudes to or perceptions of death and dying; (2) utilization of healthcare services, (3) physical symptoms or medical problems; (4) death anxiety or mental health issues; (5) quality of life; (6) advance directives or advance care planning; (7) supportive care needs, (8) decision making; (9) spirituality; (10) cost-effectiveness or utility studies; (11) care professionals' education and training; (12) informal caregivers' perceptions and experience; and (13) scale development or validation.

Significance of results:

While there has been a wide and diverse range of research activities in Hong Kong, EoL care services at primary care settings should be strengthened. Some priority areas for further research are recommended.

Keywords

End of lifePalliative careResearchSystematic reviewHong Kong
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1711 - 1720
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Broad, J.B., Gott, M., Kim, H., et al. (2013). Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential aged care settings in 45 populations, using published and available statistics. International Journal of Public Health, 58, 257–267.CrossRefGoogle ScholarPubMed
Carlson, J. (2010). Not finished yet: Coalition wants end-of-life care to be a priority. Modern Healthcare, 40, 17.Google Scholar
Census and Statistics Department (2014). Hong Kong monthly digest of statistics. Hong Kong: The Government of the Hong Kong Special Administrative Region.Google Scholar
Census and Statistics Department (2009). Thematic household survey. Report No. 40. Hong Kong: The Government of the Hong Kong Special Administrative Region.Google Scholar
Chan, C.L., Ho, A.H., Leung, P.P., et al. (2012). The blessings and the curses of filial piety on dignity at the end of life: Lived experience of Hong Kong Chinese adult children caregivers. Journal of Ethnic and Cultural Diversity in Social Work, 21, 277–296.Google Scholar
Chan, C.W. & Chang, A.M. (2000). Experience of palliative home care according to caregivers’ and patients’ ages in Hong Kong Chinese people. Oncology Nursing Forum, 27, 1601–1605.Google Scholar
Chan, H.Y. & Pang, S.M. (2007). Quality-of-life concerns and end-of-life care preferences of aged persons in long-term care facilities. Journal of Clinical Nursing, 16, 2158–2166.Google Scholar
Chan, W.C. (2011). Being aware of the prognosis: How does it relate to palliative care patients’ anxiety and communication difficulty with family members in the Hong Kong Chinese context? Journal of Palliative Medicine, 14, 997–1003.Google Scholar
Chan, W.C., Epstein, I., Reese, D., et al. (2009). Family predictors of psychosocial outcomes among Hong Kong Chinese cancer patients in palliative care: Living and dying with the “support paradox.” Social Work in Health Care, 48, 519–532.Google Scholar
Cheng, H.W.B., Chan, K.Y., Sham, M.K.M., et al. (2014 a). Symptom burden, depression, and suicidality in Chinese elderly patients suffering from advanced cancer. Journal of Palliative Medicine, 17, 10.Google Scholar
Cheng, H.W., Li, C.W., Chan, K.Y., et al. (2014 b). Bringing palliative care into geriatrics in a Chinese culture society: Results of a collaborative model between palliative medicine and geriatrics unit in Hong Kong. Journal of the American Geriatrics Society, 62, 779–781.Google Scholar
Cheng, S.T., Lum, T., Lam, L.C., et al. (2013). Hong Kong: Embracing a fast aging society with limited welfare. The Gerontologist, 53, 527–533.Google Scholar
Chu, L. (2012). One step forward for advance directives in Hong Kong. Hong Kong Medical Journal, 18, 176.Google Scholar
Chu, L.W., Luk, J.K., Hui, E., et al. (2011 a). Advance directive and end-of-life care preferences among Chinese nursing home residents in Hong Kong. Journal of the American Medical Directors Association, 12, 143–152.CrossRefGoogle ScholarPubMed
Chu, L.W., McGhee, S.M., Luk, J.K., et al. (2011 b). Advance directives and preference of old age home residents for community model of end-of-life care in Hong Kong. Hong Kong Medical Journal, 17(Suppl. 3), 13–15.Google Scholar
Chu, L.W., So, J.C., Wong, L.C., et al. (2014). Community end-of-life care among Chinese older adults living in nursing homes. Geriatrics & Gerontology International, 14(2), 273–284.Google Scholar
Chu, W.W. & Christine, Y. (2013). Evaluation of end-of-life care service in a nursing home in Hong Kong, 2000–2013: The clinical profile and hospital utilization. Asia Pacific Regional Conference on End-of-Life and Palliative Care in Long-Term Care Settings.Google Scholar
Department of Health (2008). End-of-life care strategy: Promoting high-quality care for all adults at the end of life. London: Department of Health.Google Scholar
Department of Health and Ageing (2011). Supporting Australians to live well at the end of life: National Palliative Care Strategy 2010. Canberra: Department of Health and Ageing.Google Scholar
Economist Intelligence Unit (2010). The quality of death: Ranking end-of-life care across the world. Singapore: Lien Foundation.Google Scholar
Giovanni, L.A. (2012). End-of-life care in the United States: Current reality and future promise: A policy review. Nursing Economics, 30, 127–135.Google Scholar
Ho, S.M.Y. & Shiu, W.C.T. (1995). Death anxiety and coping mechanism of Chinese cancer patients. Omega, 31, 59–65.Google Scholar
Hsu, C.-Y., O'Connor, M., & Lee, S. (2009). Understanding of death and dying for people of Chinese origin. Death Studies, 33, 153–174.Google Scholar
Hui, E., Ma, H.M., Tang, W.H., et al. (2014). A new model for end-of-life care in nursing homes. Journal of the American Medical Directors Association, 15, 287–289.Google Scholar
Lau, K.S., Tse, D.M., Tsan Chen, T.W., et al. (2010). Comparing noncancer and cancer deaths in Hong Kong: A retrospective review. Journal of Pain and Symptom Management, 40, 704–714.Google Scholar
Lam, P.T., Ma, S.Y., Ng, H.Y., et al. (2011). Service outcomes six years after implementing strategies in optimizing bed utilization at a palliative care unit. Progress in Palliative Care, 19, 109–113.Google Scholar
Lee, J., Cheng, J., Au, K.-M., et al. (2013). Improving the quality of end-of-life care in long-term care institutions. Journal of Palliative Medicine, 16, 1268–1274.Google Scholar
Lo, R.S., Woo, J., Zhoc, K.C., et al. (2002). Quality of life of palliative care patients in the last two weeks of life. Journal of Pain and Symptom Management, 24, 388–397.Google Scholar
Lo, R.S., Kwan, B.H., Lau, K.P., et al. (2010). The needs, current knowledge, and attitudes of care staff toward the implementation of palliative care in old age homes. The American Journal of Hospice & Palliative Care, 27, 266–271.Google Scholar
Lo, S.H., Chan, C.Y., Chan, C.H., et al. (2009). The implementation of an end-of-life integrated care pathway in a Chinese population. International Journal of Palliative Nursing, 15, 384–388.Google Scholar
Loke, A.Y., Liu, C.F. & Szeto, Y. (2003). The difficulties faced by informal caregivers of patients with terminal cancer in Hong Kong and the available social support. Cancer Nursing, 26, 276–283.Google Scholar
Luk, J.K.H., Liu, A., Beh, P. & Chan, F.H.W. (2011). End-of-life care in Hong Kong. Asian Journal of Gerontology & Geriatrics, 6, 103–106.Google Scholar
Mak, Y.W., Chiang, V.C. & Chui, W.T. (2013). Experiences and perceptions of nurses caring for dying patients and families in the acute medical admission setting. International Journal of Palliative Nursing, 19, 423–431.Google Scholar
McIlfatrick, S.J. & Murphy, T. (2013). Palliative care research on the island of Ireland over the last decade: A systematic review and thematic analysis of peer-reviewed publications. BMC Palliative Care, 12, 33.CrossRefGoogle ScholarPubMed
Murray, S.A., Firth, A., Schneider, N., et al. (2015). Promoting palliative care in the community: Production of the primary palliative care toolkit by the European Association of Palliative Care Taskforce in primary palliative care. Palliative Medicine, 29, 101–111.Google Scholar
National Council for Palliative Care (2013). National survey of patient activity data for specialist palliative care services: MDS full report for the year 2011–2012. Available from http://www.endoflifecare-intelligence.org.uk/resources/publications/patient_activity_data.Google Scholar
National Hospice and Palliative Care Organization (2013). NHPCO facts and figures: Hospice care in America. Available from http://www.nhpco.org/sites/default/files/public/Statistics_Research/2013_Facts_Figures.pdf.Google Scholar
Hospital Authority of Hong Kong (2013). Hospital authority statistical report 2011–2012. Available from http://www.ha.org.hk/upload/publication_15/471.pdf.Google Scholar
Sigurdardottir, K.R., Haugen, D.F., van der Rijt, C.C., et al. (2010). Clinical priorities, barriers and solutions in end-of-life cancer care research across Europe: Report from a workshop. European Journal of Cancer, 46, 1815–1822.CrossRefGoogle ScholarPubMed
Silveira, M.J., Wiitala, W. & Piette, J. (2014). Advance directive completion by elderly Americans: A decade of change. Journal of the American Geriatrics Society, 62, 706–710.CrossRefGoogle ScholarPubMed
Siu, M.W., Cheung, T.Y., Chiu, M.M., et al. (2010). The preparedness of Hong Kong medical students towards advance directives and end-of-life issues. East Asian Archives of Psychiatry, 20(4), 155–162.Google ScholarPubMed
Siu, S.W., Liu, R.K., Cheung, K.W., et al. (2011). End-of-life care for Chinese patients in an acute care ward setting: Experience in an oncology ward and report on a pilot project on the use of an integrated care pathway. Palliative Medicine, 25, 664–665.Google Scholar
Social Work Department (2013). Overview of residential care services for elders. Available from http://www.swd.gov.hk/en/index/site_pubsvc/page_elderly/sub_residentia/id_overviewon/.Google Scholar
Ting, F.H. & Mok, E. (2011). Advance directives and life-sustaining treatment: Attitudes of Hong Kong Chinese elders with chronic. Hong Kong Medical Journal, 17(2), 105–111.Google Scholar
Tong, K.-W. (2014). Good death through control over place of death? A snapshot in Hong Kong . In Community care in Hong Kong: Current practices. Research studies and future directions. Tong, K.-W. & Fong, K.N. (eds.), pp. 169–208. Hong Kong: City University of Hong Kong Press.Google Scholar
Tsang, M., Yeung, K., Wong, K., et al. (2013). Cross-sectional survey on advance care planning acceptance and end-of-life care preferences among community-dwelling elderly with complex medical problems and their carers. BMJ Supportive & Palliative Care, 3, 258–259.CrossRefGoogle Scholar
Tse, D.M., Chan, K.S., Lam, W.M., et al. (2007). The impact of palliative care on cancer deaths in Hong Kong: A retrospective study of 494 cancer deaths. Palliative Medicine, 21, 425–433.Google Scholar
Williams, A.M., Crooks, V.A., Whitfield, K., et al. (2010). Tracking the evolution of hospice palliative care in Canada: A comparative case study analysis of seven provinces. BMC Health Services Research, 10, 147.CrossRefGoogle Scholar
Wong, F.K., Liu, C.F., Szeto, Y., et al. (2004). Health problems encountered by dying patients receiving palliative home care until death. Cancer Nursing, 27, 244–251.CrossRefGoogle ScholarPubMed
Wong, S., Lo, S., Chan, C., et al. (2012). Is it feasible to discuss an advance directive with a Chinese patient with advanced malignancy? A prospective cohort study. Hong Kong Medical Journal, 18(3), 178–185.Google Scholar
Woo, J. & Chau, P.P. (2009). Aging in Hong Kong: The institutional population. Journal of the American Medical Directors Association, 10, 478–485.Google Scholar
Woo, J., Cheng, J.O., Lee, J., et al. (2011 a). Evaluation of a continuous quality improvement initiative for end-of-life care for older noncancer patients. Journal of the American Medical Directors Association, 12(2), 105–113.Google Scholar
Woo, J., Lo, R., Cheng, J.O., et al. (2011 b). Quality of end-of-life care for non-cancer patients in a non-acute hospital. Journal of Clinical Nursing, 20, 1834–1841.Google Scholar
World Health Organization (WHO) (2002). Innovative care for chronic conditions: Building blocks for action. Global report on noncommunicable diseases and mental health. Geneva: WHO Press.Google Scholar
Wu, A.M., Tang, C.S. & Kwok, T.C. (2002). Death anxiety among Chinese elderly people in Hong Kong. Journal of Aging and Health, 14, 42–56.Google Scholar
Xu, Y. (2007). Death and dying in the Chinese Culture: Implications for health care practice. Home Health Care Management & Practice, 19, 412–414.Google Scholar
Yan, S. & Cheng, K.F. (2006). Quality of life of patients with terminal cancer receiving palliative home care. Journal of Palliative Care, 22, 261–266.Google Scholar