Differences between COPD patients and their families regarding willingness toward life-sustaining treatments

Chen, Ting Ru; Hu, Wen-Yu; Chiu, Tai‐Yuan; Kuo, Han Pin

doi:10.1016/j.jfma.2018.06.020

Cited by 5 publications

(14 citation statements)

References 20 publications

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“…Thus, the family members believed that EOL care decisions could wait. This finding is also consistent with the findings of previous research [ 8 , 12 , 17 ]. The withdrawal of treatment may result in a heavy moral burden for family members due to the generational gap between them and the resident.…”

Section: Discussionsupporting

confidence: 94%

“…Interestingly, most family members (n = 10) in this study stated that if they knew that the residents wanted to opt out of emergency care, they would respect their wish to do so. This finding corroborates those of previous studies and indicates that such family members often respect the autonomy of the older adult to choose their EOL care, possibly due to increasing Westernisation and economic development [12,17].…”

Section: Discussionsupporting

confidence: 92%

“…The withdrawal of treatment may result in a heavy moral burden for family members due to the generational gap between them and the resident. The Chinese conception of filial piety is such that children must do all they can to preserve their parents’ lives [ 6 , 12 , 17 ]. Interestingly, most family members ( n = 10) in this study stated that if they knew that the residents wanted to opt out of emergency care, they would respect their wish to do so.…”

Section: Discussionmentioning

confidence: 99%

“…Taiwanese society has become increasingly Westernised, and older adults and their family members wish to communicate their thoughts on EOL care [ 12 , 17 ]. However, discussions about death are regarded as taboo by Chinese people [ 5 , 6 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Westernisation and economic development in Taiwan have resulted in a greater emphasis on autonomy (specifically, the autonomy of the older adult to make decisions about their EOL care) over the traditional Chinese values of filial piety and familism [ 17 ]. Lee et al [ 12 ] reported that among family members of lucid residents, half of them ( n = 6/12) expressed hope that the older adult resident would choose their form of EOL care.…”

Section: Introductionmentioning

confidence: 99%

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Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

et al. 2022

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Background When older nursing home residents and their families are faced with end-of-life care decisions in Taiwan, they make them in the context of traditional cultural norms and socioeconomic changes. Both parties (residents and their family members) are often unwilling to broach the topic, leading to a decisional impasse. The aim of this study was to understand difficult-to-raise issues related to end-of-life care by investigating the perspectives of older nursing home residents and their family members. Methods This qualitative descriptive study was conducted using content analysis based on the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to select the participants, and sampling continued until data saturation. Data were collected using semi structured interviews, and related analyses were conducted using an inductive approach. Results Ten residents and twelve family members were interviewed individually. Six main themes were identified: (1) the inevitability of a goodbye; (2) a good death; (3) going with or against traditional culture; (4) better a good death than a bad life; (5) abiding by the residents’ decisions; and (6) being willing but unable to take care of residents. Conclusion Nursing home residents and their family members’ thoughts on end-of-life care shifted toward the concept of a good death, and they even regarded death as a form of liberation. Health care providers may serve as mediators to counsel a resident and their family members separately, enabling them to speak up and understand each other’s thoughts on end-of-life care before a decision is made so that neither party has regrets.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

et al. 2022

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“We Want to Sign It, But We Can't Do It”

Lee

Yang

Chen

et al. 2021

J Hosp Palliat Nurs

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This study aimed to clarify the experiences of family members of older adult residents regarding the signing of an advance directive in the context of a Chinese culture. Twenty family members of older residents in a long-term care facility participated in face-to-face interviews, and the researchers conducted a thematic analysis of observation field notes and interview transcripts. A content analysis of the interviews revealed 4 themes concerning the refusal to sign advance directives: resident decision, group decision, not entitled to decide, and random decision. Health providers may serve as mediators and pass on the residents' views regarding their end-oflife care to their families after holding discussions with residents and their families separately to ensure that an agreeable decision regarding the modes and objectives of EOL care is reached and that such a decision respects the right of the patient to choose.

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Impediments to Signing Advance Directives in Nursing Home Residents

Lee

Yang

2023

J Hosp Palliat Nurs

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Although public opinion in Taiwan has shifted to favoring self-determination regarding end-of-life care, many nursing home residents still entrust their end-of-life care decision making to family members. This study examined Chinese cultural impediments to nursing home residents signing advance directives. A descriptive qualitative study was conducted using content analysis. In total, 18 nursing home residents participated in face-to-face interviews. Five main themes were identified: (1) bad omens, (2) inability, (3) traditional culture, (4) uncertainty, and (5) unmet needs. The death taboo that is a prominent feature of Chinese culture and the delivery of generic information are primary impediments. Therefore, health care providers should provide tailored information about advance directives, communicate directly with residents, ensure that residents understand the relationship between signing an advance directive and having a good death, and respect the final decisions of residents.

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Differences between COPD patients and their families regarding willingness toward life-sustaining treatments

Abstract: Communication between families and patients on the issue of LST should be facilitated. Adequate information on the patient's condition and possible LSTs should be provided to avoid COPD patients receiving inappropriate LSTs.

Cited by 5 publications

References 20 publications

Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

“We Want to Sign It, But We Can't Do It”

Impediments to Signing Advance Directives in Nursing Home Residents

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