Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-05T12:11:54.918Z Has data issue: false hasContentIssue false
  • English
  • Français

Cultural implications for disclosure of diagnosis and prognosis toward terminally ill cancer patients in China: A literature review

Published online by Cambridge University Press:  05 May 2021

Stephanie Stocklassa Open the ORCID record for Stephanie Stocklassa [Opens in a new window] ,
Silja Zhang ,
Stephen Mason  and
Frank Elsner
Stephanie Stocklassa*
Affiliation:
Faculty of Medicine, Department of Palliative Care, RWTH Aachen University, Aachen, Germany
Silja Zhang
Affiliation:
Tongji Hospital Huazhong University of Science and Technology, Wuhan, China
Stephen Mason
Affiliation:
Palliative Care Institute Liverpool, University of Liverpool, Liverpool, UK
Frank Elsner
Affiliation:
Faculty of Medicine, Department of Palliative Care, RWTH Aachen University, Aachen, Germany
*
Author for correspondence: Stephanie Stocklassa, Department of Palliative Care, RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Health professionals in China tend to avoid open communication with terminally ill cancer patients concerning their diagnosis and prognosis. This review aims to explore Chinese cultural beliefs and attitudes concerning disclosure and death among health professionals and cancer patients in China and to investigate preferences of terminally ill cancer patients for a “good death.”

Method

A narrative literature review was conducted in May 2020 on MEDLINE, EMBASE, and WEB OF SCIENCE to include all studies with clear study design which presented its own study data or referred to data within underlying studies, published between January 2000 and May 2020, having cancer patients and/or healthcare professionals as participants, conducted in Mainland China, Hong Kong, or Taiwan and containing relevant data concerning “medical disclosure” or “good death.” Quality assessment of publications was conducted using the NIH and CASP checklists.

Results

Primary database search revealed a total of 108 papers of which 9 were ultimately included. The additional hand search led to the inclusion of eight further papers. In total, there were 11 quantitative studies, 4 qualitative studies and 2 literature reviews included in this review. Our findings indicated that most terminally ill cancer patients in China want to know the truth about their diagnosis and prognosis and preferred to be informed by their doctors. Terminally ill cancer patients valued a good relationship with family and medical staff as well as being respected as an individual and wanted to be able to prepare for death.

Significance of results

Terminally ill cancer patients in China often have a substantial need for information about their condition while their preferences are widely consistent with those in Western societies. Training for health professionals needs to focus on communication skills in order to overcome barriers in patient interaction.

Keywords

Chinese cultureDisclosureGood deathLiterature reviewPalliative care
Type
Review Article
Information
Palliative & Supportive Care , Volume 20 , Issue 2 , April 2022 , pp. 283 - 289
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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

Ando, M, Somchit, S, Miyashita, M, et al. (2016) The perception for good death of community dwelling Japanese and Thailand respondents. Asian/Pacific Island Nursing Journal 1(3), 91–96.Google Scholar
Bai, Q, Zhang, Z, Lu, X, et al. (2010) Attitudes towards palliative care among patients and health professionals in Henan, China. Progress in Palliative Care 18(6), 341–345.CrossRefGoogle Scholar
Bengtsson, M (2016) How to plan and perform a qualitative study using content analysis. NursingPlus Open 2, 8–14.CrossRefGoogle Scholar
Chan, WCH (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(9), 997–1003.CrossRefGoogle ScholarPubMed
Chen, W, Sun, K, Zheng, R, et al. (2018) Cancer incidence and mortality in China, 2014. Chinese Journal of Cancer Research 30(1), 1.CrossRefGoogle Scholar
Cheng, HWB (2018) Advance care planning in Chinese seniors: Cultural perspectives. Journal of Palliative Care 33(4), 242–246.CrossRefGoogle ScholarPubMed
Critical Appraisal Skills Programme (2018) CASP checklist. Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf.Google Scholar
Dong, F, Zheng, R, Chen, X, et al. (2016) Caring for dying cancer patients in the Chinese cultural context: A qualitative study from the perspectives of physicians and nurses. European Journal of Oncology Nursing 21, 189–196.CrossRefGoogle ScholarPubMed
Gong, N, Zhou, Y, Cheng, Y, et al. (2018) Practice of informed consent in Guangdong, China: A qualitative study from the perspective of in-hospital patients. BMJ Open 8, 10.CrossRefGoogle Scholar
Hou, X, Lu, Y, Yang, H, et al. (2019) Preferences for a good death: A cross-sectional survey in advanced cancer patients. BMJ Supportive & Palliative Care, 1–8. doi:10.1136/bmjspcare-2018-001750Google Scholar
Hu, K and Feng, D (2016) Barriers in palliative care in China. The Lancet 387(10025), 1272.CrossRefGoogle ScholarPubMed
Huang, H, Liu, H, Zeng, T, et al. (2015) Preference of Chinese general public and healthcare providers for a good death. Nursing Ethics 22(2), 217–227.Google Scholar
Huang, H, Zeng, T, Mao, J, et al. (2018) The understanding of death in terminally ill cancer patients in China: An initial study. Cambridge Quarterly of Healthcare Ethics 27(3), 421–430.CrossRefGoogle Scholar
Jiang, Y, Li, J, Liu, C, et al. (2006) Different attitudes of oncology clinicians toward truth telling of different stages of cancer. Supportive Care in Cancer 14(11), 1119–1125.CrossRefGoogle ScholarPubMed
Jiang, Y, Liu, C, Li, JY, et al. (2007) Different attitudes of Chinese patients and their families toward truth telling of different stages of cancer. Psycho-Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer 16(10), 928–936.CrossRefGoogle ScholarPubMed
Li, JY, Liu, C, Zou, LQ, et al. (2008) To tell or not to tell: Attitudes of Chinese oncology nurses towards truth telling of cancer diagnosis. Journal of Clinical Nursing 17(18), 2463–2470.CrossRefGoogle ScholarPubMed
Li, J, Yuan, XL, Gao, XH, et al. (2012) Whether, when, and who to disclose bad news to patients with cancer: A survey in 150 pairs of hospitalized patients with cancer and family members in China. Psycho-Oncology 21(7), 778–784.CrossRefGoogle Scholar
Li, X, Xing, YF, Chen, ZH, et al. (2013) Palliative care in urban areas of China. The Lancet Oncology 14(9), 339.CrossRefGoogle ScholarPubMed
Lin, CC (1999) Disclosure of the cancer diagnosis as it relates to the quality of pain management among patients with cancer pain in Taiwan. Journal of Pain and Symptom Management 18(5), 331–337.CrossRefGoogle Scholar
Lio, J, Ning, X, Wu, L, et al. (2018) Exploring palliative care competency standards for medical education in China: A survey of national hospice service program providers. Journal of Palliative Medicine 21(1), 6–8.CrossRefGoogle Scholar
Lu, Y, Gu, Y and Yu, W (2018) Hospice and palliative care in China: Development and challenges. Asia-Pacific Journal of Oncology Nursing 5(1), 26–32.CrossRefGoogle Scholar
Miyashita, M, Morita, T, Sato, K, et al. (2008) Good death inventory: A measure for evaluating good death from the bereaved family member's perspective. Journal of Pain and Symptom Management 35(5), 486–498.CrossRefGoogle ScholarPubMed
National Heart, Lung and Blood Institute (2019) Study Quality Assessment Tools. Available at: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.Google Scholar
Ning, X (2018) Hospice and palliative care in Mainland China: History, current status and challenges. Chinese Medical Sciences Journal 33(4), 199–203.Google ScholarPubMed
Qu, X, Jiang, N, Ge, N, et al. (2018) Physicians’ perception of palliative care consultation service in a major general hospital in China. Chinese Medical Sciences Journal 33(4), 228–233.Google Scholar
Shih, FJ, Gau, ML, Lin, YS, et al. (2006) Death and help expected from nurses when dying. Nursing Ethics 13(4), 360–375.CrossRefGoogle ScholarPubMed
Tang, ST and Lee, SYC (2004) Cancer diagnosis and prognosis in Taiwan: Patient preferences versus experiences. Psycho-Oncology 13(1), 1–13.CrossRefGoogle ScholarPubMed
Tang, ST, Liu, TW, Lai, MS, et al. (2006) Congruence of knowledge, experiences, and preferences for disclosure of diagnosis and prognosis between terminally-ill cancer patients and their family caregivers in Taiwan. Cancer Investigation 24(4), 360–366.CrossRefGoogle ScholarPubMed
The Economist Intelligence Unit (2015) The 2015 Quality of Death Index Ranking palliative care across the world. Available at: https://eiuperspectives.economist.com/sites/default/files/2015%20EIU%20Quality%20of%20Death%20Index%20Oct%2029%20FINAL.pdf.Google Scholar
Tse, CY, Chong, A and Fok, SY (2003) Breaking bad news: A Chinese perspective. Palliative Medicine 17(4), 339–343.CrossRefGoogle ScholarPubMed
Tseng, LH (2013) The Bereaved Family Member's Grief and Hospice Palliative Care Patients’ Good Death From the Familie's Perspective. Kaohsiung: Fooyin University.Google Scholar
Wang, XS, Di, LJ, Reyes-Gibby, CC, et al. (2004) End-of-life care in urban areas of China: A survey of 60 oncology clinicians. Journal of Pain and Symptom Management 27(2), 125–132.CrossRefGoogle Scholar
Wang, T, Molassiotis, A, Chung, BPM, et al. (2018) Current research status of palliative care in Mainland China. Journal of Palliative Care 33(4), 215–241.CrossRefGoogle ScholarPubMed
Wu, Y, Li, L, Su, H, et al. (2016) Hospice and palliative care: Development and challenges in China. Clinical Journal of Oncology Nursing 20, 1.CrossRefGoogle ScholarPubMed
Yang, FM, Ye, ZH, Tang, LW, et al. (2017) Factors associated with the attitudes of oncology nurses toward hospice care in China. Patient Preference and Adherence 11, 853–860.CrossRefGoogle ScholarPubMed
Yang, H, Lu, Y, Hou, X, et al. (2019) Nurse-rated good death of Chinese terminally ill patients with cancer: A cross-sectional study. European Journal of Cancer Care 28(6), 1–9.CrossRefGoogle ScholarPubMed
Zeng, T, Huang, H, Zhao, M, et al. (2011) Health professionals’ attitude towards information disclosure to cancer patients in China. Nursing Ethics 18(3), 356–363.Google Scholar
Zheng, RS, Guo, QH, Dong, FQ, et al. (2015) Chinese oncology nurses’ experience on caring for dying patients who are on their final days: A qualitative study. International Journal of Nursing Studies 52(1), 288–296.CrossRefGoogle ScholarPubMed
Zou, M, O'Connor, M, Peters, L, et al. (2013) Palliative care in Mainland China. Asia Pacific Journal of Health Management 8(1), 9.Google Scholar