Diagnosing Gaps in the Development of Palliative and End-of-Life Care: A Qualitative Exploratory Study

Abstract

A global report found that the quality of dying in Hong Kong lagged behind that of other high-income economies. This study aims to examine the service gaps by conducting a qualitative exploratory study from multiple stakeholders’ perspectives. Purposive and snowball sampling strategies were used to maximize variation in the sample. We interviewed 131 participants, including patients, family members, health care providers, administrators, lawyers, and policy makers. The situation analysis helped identify the facilitators and barriers at individual, organizational, and socio-cultural levels that affect service development. Findings showed that awareness on palliative and end-of-life care is growing, but the existing care is limited in terms of acceptability, coverage, variation in practices, continuity, and sustainability. A number of policy, economic, socio-cultural, environmental, and legal factors were also found to hinder service development. Findings of this study demonstrated that the development of palliative and end-of-life care services involved a paradigm shift relating to society as a whole. The overarching theme is to formulate a government-led policy framework. Furthermore, a public health approach has been advocated to create a supportive environment for service development.

End-of-life care is an integral part of healthcare services

“…Fong et al 5 conducted a survey on speech therapists about palliative care and report that relevant practice guidelines and training are lacking, resulting in inconsistencies in practice and concerns about legal liability. The authors' findings are consistent with those of Chan et al, 6 who found that the overall development of EOL care is influenced by various factors at individual, organisational, legal, and sociocultural levels. Therefore, the recent public consultation is an opportune time for the government to overhaul development of EOL care in terms of policy, legislation, financial support, manpower planning, capacity building, and public education.…”

Palliative Care in the Pre-Hospital Service In Brazil: Experiences of Health Professionals

“…The results of a qualitative research 18 revealed that professionals working in the pre-hospital service were concerned with the patient's manifestations of will, but there was a possibility of contradicting the objectives of the service they perform. They also expressed a feeling of helplessness regarding the will of the family in relation to the Non-Resuscitation Order (NRO), and confessed that there was distrust in accepting the manifestations contained in the document even seeing the signature of the patient's physician.…”

Association Between Training Experience and Attitudes Toward Advance Care Planning Among Healthcare Professionals: A Cross-Sectional Study

“…(3,11) Given this consensus among healthcare professional regardless of the training experience and clinical background, training using an inclusive approach to enhance their preparedness would be the cornerstone of system-wide ACP implementation. (12) Study strengths and limitations This paper addresses the knowledge gap about the association between training and healthcare professionals' attitudes toward ACP. Although the survey included respondents with a wide range of clinical backgrounds, we acknowledged several study limitations when interpreting the study ndings.…”