Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study

Abstract

ObjectivesThis study aimed to investigate the knowledge and attitudes of patients with cancer of palliative care and their preferences regarding end-of-life care in mainland China.DesignA cross-sectional study.SettingThis study was conducted in a tertiary cancer hospital.ParticipantsTwo hundred forty-seven patients with cancer were recruited and consented to fill out the questionnaires.Outcome measuresThe participants’ knowledge and attitudes of palliative care and their preferences of end-of-life care involving place of care, place of death, truth disclosure and treatments during end-of-life were measured.ResultsIn total, 239 questionnaires were valid. The vast majority of patients with cancer (81.2%) had never heard about palliative care or related policies, and only a few of them (5.8%) had somewhat or totally understanding of palliative care. Most participants (75.3%) had supportive attitudes towards palliative care. In terms of preferences for end-of-life care, most patients with cancer preferred to be cared for at home at the end of their life and to die at home. The majority of patients with cancer (65.7%) wanted to know their diagnosis or prognosis of the disease, regardless of the type of disease. More than half of the participants (54%) wished to improve their quality of life rather than prolong their life expectancy. More than a third of the patients with cancer preferred to entrust a family member or agent to sign medical decision agreements for them.ConclusionsIt is essential for healthcare providers to improve the understanding of patients with cancer of palliative care and be aware of the end-of-life care preferences of patients with cancer, in order to provide support that enables patients with cancer to receive end-of-life care that is accordant with their wishes.

Willingness of patients with cancer pain to participate in end-of-life decisions: a multi-center cross-sectional study from three coastal provinces in southern China

“…Simultaneously, medical staffs don’t fully understand the patients’ intention to participate in EOLD due to inadequate communication with patients [ 27 ]. All of these may result in patients in China mainland to have little opportunity to understand EOLD related knowledge and to participate in discussion on EOLD, which has been confirmed in recent studies from China mainland [ 14 – 16 ]. More importantly, the true willingness of patients in China mainland to participate in EOLD discussions remains elusive.…”

“…On the contrary, very few patients with cancer (2.8 to 18.8%) participated in the process of EOLD in China mainland [ 14 , 15 ]. Such heavily contrast may be attributed to policy and cultural differences between Western countries and China mainland.…”

“…Although some studies focused on the preference of EOL care and cancer patients’ and caregivers’ decision-making practices in China mainland [ 14 – 16 ], little was known about the true thoughts of patients with cancer pain to participate in EOLD. The aim of this study was to investigate the willingness of such patients to participate in EOLD, preference of EOL care and associated factors in three coastal provinces in southern China.…”

Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China

“…Hospice care in China is relatively nascent compared to some Western countries (e.g., United States, Canada, England, Australia), yet growing steadily [ 12 , 13 , 14 ]. Since hospice care was introduced in 1988 [ 15 ], it has made great progress, and by 2017, there were 2343 medical institutions with hospice care departments in China [ 16 ].…”

“…For example, a recent study with community residents in Hangzhou, China, found that only 50.3% of adult populations aged 40 and above in China were aware of hospice care [ 28 ], as compared to 86% and 76% of the general population in the United States [ 33 ] and Northern Ireland [ 34 ], respectively. Awareness of hospice care is even lower among cancer patients (5.8%) [ 14 ] and oncologists in China [ 35 ]. Hospice care is often perceived as appropriate only for those facing imminent death in China.…”