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Status of palliative care education in Mainland China: A systematic review

Published online by Cambridge University Press:  25 August 2020

Antonia M. Willemsen Open the ORCID record for Antonia M. Willemsen [Opens in a new window] ,
Stephen Mason ,
Silja Zhang  and
Frank Elsner
Antonia M. Willemsen*
Affiliation:
Faculty of Medicine, Department of Palliative Care, RWTH Aachen University, Aachen, Germany
Stephen Mason
Affiliation:
Palliative Care Institute Liverpool, University of Liverpool, Liverpool, UK
Silja Zhang
Affiliation:
Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
Frank Elsner
Affiliation:
Faculty of Medicine, Department of Palliative Care, RWTH Aachen University, Aachen, Germany
*
Author for correspondence: Antonia M. Willemsen, Department of Palliative Care, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, Aachen52074, Germany. E-mail: [email protected]
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Abstract

Objective

China is home to one-fifth of the world's population. In the setting of a growing and aging population as well as the designation of palliative care access as a human right in 2013, the implementation of palliative care in China gains special importance. Palliative care education is an important precondition to ensure a nationwide access to palliative care. This systematic review details the status of under- and postgraduate palliative care education in China, examining both the students’ and physicians’ perception, knowledge, and skills in palliative care, and the available educational interventions and programs.

Method

Four databases were searched in September 2018, using considered search terms. Titles, abstracts, and, if necessary, full texts were scanned to identify publications matching the inclusion criteria.

Results

Nine publications were included. They revealed six findings: palliative care education is lacking in both under- and postgraduate medical education, only a few programs exist. Palliative care as a concept is well known, detailed knowledge, and practical skills are less developed. Chinese physicians consider palliative care an important field to be developed in cancer care, yet the majority of healthcare professionals are not willing to work in palliative care services. Communication should be a main emphasis in palliative care education, especially in undergraduate training. Finally, there is no highly qualified research on under- or postgraduate palliative care education in Mainland China.

Significance of results

These findings suggest that palliative care education in China is in demand and should be systematically integrated into medical education. Further research on the topic is urgently needed.

Keywords

ChinaEducationGlobal healthPalliative care
Type
Review Article
Information
Palliative & Supportive Care , Volume 19 , Issue 2 , April 2021 , pp. 235 - 245
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

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
Bridge, DT and Lai, ML (2009) East meets West. Spirituality training in palliative care: A Taiwanese-Australian partnership. Journal of Palliative Care 25(2), 137–141.CrossRefGoogle ScholarPubMed
Chang, HH, Hu, WY, Tsai, SS, et al. (2009) Reflections on an end-of-life care course for preclinical medical students. Journal of the Formosan Medical Association 108(8), 636–643.CrossRefGoogle Scholar
EIU, Economist Intelligence Unit (2015) The 2015 Quality of Death Index. Ranking palliative care across the world. London: The Economist Intelligence Unit.15.Google Scholar
Elsner, F, Centeno, C and Ellershaw, JE (2016) Early integration needs early education. Journal of Palliative Medicine 30(9), 805–806.CrossRefGoogle ScholarPubMed
Fitzmaurice, C, Dicker, D, Pain, A, et al. (2015) The Global Burden of Cancer 2013. JAMA Oncology 1(4), 505–527.Google ScholarPubMed
Ge, N, Qu, X, Ning, XH, et al. (2018) Needs of continuing education on hospice and palliative care in China: A questionnaire-based survey. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 40(3), 390–394.Google ScholarPubMed
Gruber, PC, Gomersall, CD, Joynt, GM, et al. (2008) Changes in medical students’ attitudes towards end-of-life decisions across different years of medical training. Journal of General Internal Medicine 23(10), 1608–1614.CrossRefGoogle ScholarPubMed
Gu, X and Cheng, W (2016) Chinese oncologists’ knowledge, attitudes and practice towards palliative care and end of life issues. BMC Medical Education 16, 149.CrossRefGoogle ScholarPubMed
Higgins, JP and Green, S (2011). Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. The Cochrane Collaboration. Available at: https://training.cochrane.org/handbook/current (retrieved from April 26, 2018).Google Scholar
Hirooka, K, Miyashita, M, Morita, T, et al. (2014) Regional medical professionals’ confidence in providing palliative care, associated difficulties and availability of specialized palliative care services in Japan. Japanese Journal of Clinical Oncology 44(3), 249–256.CrossRefGoogle ScholarPubMed
Ilse, B, Alt-Epping, B, Kiesewetter, I, et al. (2015) Undergraduate education in palliative medicine in Germany: A longitudinal perspective on curricular and infrastructural development. BMC Medical Education 15, 151.CrossRefGoogle ScholarPubMed
Jiang, X, Liao, Z, Hao, J, et al. (2011) Palliative care education in China: Insight into one medical university. Journal of Pain and Symptom Management 41(4), 796–800.CrossRefGoogle ScholarPubMed
Kang, J, Koh, SJ, Yoo, YS, et al. (2010) Development of the standard hospice and palliative care education program in Korea: Results from the demonstration project. Journal of Palliative Medicine 13(6), 703–710.CrossRefGoogle ScholarPubMed
Kang, J, Yang, EB, Chang, YJ, et al. (2015) Evaluation of the national train-the-trainer program for hospice and palliative care in Korea. Asian Pacific Journal of Cancer Prevention 16(2), 501–506.CrossRefGoogle ScholarPubMed
Kim, D, Kim, K, Shin, S, et al. (2019 ) Factors That Influence Attitudes Toward End-of-Life Care Among Medical Students: Nationwide Survey for Fourth-Year Korean Medical Students. The American journal of hospice & palliative care. 36 (6), 460–465.Google ScholarPubMed
Kizawa, Y, Tsuneto, S, Tamba, K, et al. (2012) Development of a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan: A modified Delphi method. Palliative Medicine 26(5), 744–752.CrossRefGoogle ScholarPubMed
Kizawa, Y, Morita, T, Miyashita, M, et al. (2015) Improvements in physicians’ knowledge, difficulties, and self-reported practice after a regional palliative care program. Journal of Pain and Symptom Management 50(2), 232–240.CrossRefGoogle ScholarPubMed
Lam, KW, Yeung, KW, Lai, KY, et al. (2015) Changes in the attitude and practice toward end-of-life care: Perspective of Chinese physicians in medical department. American Journal of Hospice and Palliative Care 32(5), 549–554.CrossRefGoogle ScholarPubMed
Lam, PL, Lam, TC, Choi, CW, et al. (2018) The impact of palliative care training for oncologists and integrative palliative service in a public-funded hospital cluster — A retrospective cohort study. Supportive Care in Cancer 26(5), 1393–1399.Google 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. Jounal of Palliative Medicine 21(1), 6–8.CrossRefGoogle ScholarPubMed
Liu, WJ, Hu, WY, Chiu, YF, et al. (2005) Factors that influence physicians in providing palliative care in rural communities in Taiwan. Supportive Care in Cancer 13(10), 781–789.CrossRefGoogle ScholarPubMed
Lyerly, HK, Fawzy, MR, Aziz, Z, et al. (2015) Regional variation in identified cancer care needs of early-career oncologists in China, India, and Pakistan. Oncologist 20(5), 532–538.CrossRefGoogle ScholarPubMed
Lynch, T, Connor, S and Clark, D (2013) Mapping levels of palliative care development: A global update. Journal of Pain and Symptom Management 45(6), 1094–1106.CrossRefGoogle ScholarPubMed
Morita, T, Miyashita, M, Yamagishi, A, et al. (2013) Effects of a programme of interventions on regional comprehensive palliative care for patients with cancer: A mixed-methods study. The Lancet Oncology 14(7), 638–646.CrossRefGoogle ScholarPubMed
Nakamura, Y, Takamiya, Y, Saito, M, et al. (2017) A survey of palliative medicine education in Japan's undergraduate medical curriculum. BMC Palliative Care 16(1), 38.CrossRefGoogle ScholarPubMed
Nakazawa, Y, Kizawa, Y, Hashizume, T, et al. (2014) One-year follow-up of an educational intervention for palliative care consultation teams. Japanese Journal of Clinical Oncology 44(2), 172–179.CrossRefGoogle ScholarPubMed
Nakazawa, Y, Yamamoto, R, Kato, M, et al. (2018) Improved knowledge of and difficulties in palliative care among physicians during 2008 and 2015 in Japan: Association with a nationwide palliative care education program. Cancer 124(3), 626–635.CrossRefGoogle ScholarPubMed
Oya, H, Matoba, M, Murakami, S, et al. (2013) Mandatory palliative care education for surgical residents: Initial focus on teaching pain management. Japanese Journal of Clinical Oncology 43(2), 170–175.CrossRefGoogle ScholarPubMed
Pohl, G, Marosi, C, Dieckmann, K, et al. (2008) Survey of palliative care concepts among medical students and interns in Austria: A comparison of the old and the new curriculum of the Medical University of Vienna. Palliative Care: Research and Treatment 2, 9–17.Google Scholar
Radbruch, L, De Lima, L, Lohmann, D, et al. (2013) The Prague Charter: Urging governments to relieve suffering and ensure the right to palliative care. Palliative Medicine 27(2), 101–102.CrossRefGoogle ScholarPubMed
Shih, CY, Chiu, TY, Lee, LT, et al. (2010) What factors are important in increasing junior doctors’ willingness to provide palliative care in Taiwan? An educational intervention study. Journal of Palliative Medicine 13(10), 1245–1251.CrossRefGoogle ScholarPubMed
Shih, CY, Hu, WY, Lee, LT, et al. (2013) Effect of a compassion-focused training program in palliative care education for medical students. American Journal of Hospice and Palliative Care 30(2), 114–120.CrossRefGoogle ScholarPubMed
Shim, HY, Chang, YJ, Kawk, KS, et al. (2017) Do Korean doctors think a palliative consultation team would be helpful to their terminal cancer patients? Cancer Research and Treatment 49(2), 437–445.CrossRefGoogle ScholarPubMed
Tsai, SS, Hu, WY, Chang, HH, et al. (2008) Effects of a multimodule curriculum of palliative care on medical students. Journal of the Formosan Medical Association 107(4), 326–333.CrossRefGoogle ScholarPubMed
Walker, S, Gibbins, J, Barclay, S, et al. (2016) Progress and divergence in palliative care education for medical students: A comparative survey of UK course structure, content, delivery, contact with patients and assessment of learning. Journal of Palliative Medicine 30(9), 834–842.CrossRefGoogle ScholarPubMed
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 ScholarPubMed
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
WHO, World Health Organazition (2014) Sixty-Seventh World Health Assembly: Resolutions and Decisions. Available at: http://apps.who.int/gb/ebwha/pdf_files/WHA67-REC1/A67_2014_REC1-en.pdf#page=1 (retrieved from April 30, 2018).Google Scholar
Yamaguchi, T, Narita, M, Morita, T, et al. (2012) Recent developments in the management of cancer pain in Japan: Education, clinical guidelines and basic research. Japanese Journal of Clinical Oncology 42(12), 1120–1127.CrossRefGoogle ScholarPubMed
Yin, Z, Li, J, Ma, K, et al. (2017) Development of palliative care in China: A tale of three cities. Oncologist 22(11), 1362–1367.CrossRefGoogle ScholarPubMed
Yun, YH, Kim, KN, Sim, JA, et al. (2018) Comparison of attitudes towards five end-of-life care interventions (active pain control, withdrawal of futile life-sustaining treatment, passive euthanasia, active euthanasia and physician-assisted suicide): A multicentred cross-sectional survey of Korean patients with cancer, their family caregivers, physicians and the general Korean population. BMJ Open 8(9), e020519.CrossRefGoogle ScholarPubMed