Case study analysis of end of life care development: A social movement perspective

Abstract

Background The modern hospice movement is often recognised as a social movement. However, such understanding is primarily based on historic reflection and this approach has lacked theoretical exploration. The modern hospice movement has not been examined by way of any social movement theory. Aim This study addressed the theoretical gap in understanding the end of life care (EoLC) development in Macao China. Focusing on the Chinese socio-cultural context, this study explored the EoLC movement through the social movement theory, the Framing Perspective, as proposed by Snow and Benford in 1988. Methods A case study approach was conducted. Semi-structured interviews were held between 2012 and 2013, with pioneers (n = 11) of the EoLC in Macao. Thematic analysis was adopted to analyse the interviews. Results The EoLC development in Macao can be understood as a social movement. The Framing Perspective analysis illuminated that there was both growth and stagnation of the EoLC movement. Three themes emerged: 1) the suffering of people at the end of their lives was considered as a social problem needed to be addressed urgently, 2) the incoherent EoLC strategies developed by pioneers indicated the lack of internal ideological cohesion within the movement, 3) external constraints contributed to the stagnation of the movement. Conclusions The Framing Perspective provided a theoretical way to understand the emergence of EoLC; offering a novel perspective to conceptualise the modern hospice movement. This sociological and theoretical lens opened up new ways for future research to study the emergence of EoLC in different socio-cultural contexts.