Knowledge of palliative care and preference of end of life care: a cross-sectional survey of residents in the Chinese socio-cultural background of Macao

Abstract

Background Since the establishment of a hospice in the year 2000 and the development of a palliative care ward in 2019, there is no study examining public’s knowledge of palliative care, nor preference of end of life care in Macao. Aim Targeting Chinese residents of Macao, the current study has 3 goals: i) to understand the level of knowledge of palliative care, ii) to explore the preference of end of life treatments, and iii) to identify the associated factors of the preference of end of life treatments. Methods A cross-sectional questionnaire survey was conducted using a structured questionnaire. The study employed non-probability quota sampling through which Macao residents aged 18 and above were recruited between July and September 2020. Results A total of 737 responses were valid. The average correct rate of palliative care knowledge ranged from 40.4% to 85.5%. Pertaining to end of life treatments, 62.0% of the respondents chose comfort care. However, almost half of the respondents agreed that life-sustaining treatments should not be stopped under any circumstances. Respondents who scored higher in palliative care knowledge and those with secondary and tertiary education were associated factors of choosing comfort care rather than life-sustaining treatments. In addition, respondents who agreed that futile life-sustaining treatments should be stopped were also associated with preference for comfort care. Conclusion The understanding of palliative care amongst Macao residents is inadequate. Despite the public’s inclination towards comfort care, it is generally believed that life-sustaining treatments should not be stopped at the end of life. The study results suggest that not only the knowledge of palliative care should be enhanced amongst the general public in Macao, but information about life-sustaining treatments should also be offered to patients and families by healthcare professionals, in aiding end of life treatment decision making.

Awareness and Perceptions of Palliative Care Among the Elderly: A Qualitative Study

“…Elderly individuals have a greater need to be educated about palliative care because of their deteriorated physical conditions. In fact, due to the lack of palliative care education for the elderly, most older people lack awareness of or have never heard of palliative care, 38,39 and they misunderstand that palliative care is only for people with advanced cancer, which is a pessimistic way to wait for death. 40 On the other hand, the elderly are still eager to acquire knowledge about palliative care.…”

Preferences for end‐of‐life care and decision‐making among Chinese community‐dwelling older adults: A comparative cross‐sectional study in Hong Kong and Wuhan in China

“…This finding is not surprising as the view of opting for aggressive treatments when patients' health status is reduced is prevailing in China (Gu et al, 2016). Previous research has found that Chinese patients who had little knowledge of EoL care or did not know or inaccurately understand their prognoses when approaching death were more likely to indicate this preference (Liao et al, 2020; Tam et al, 2021). Furthermore, a recent study in Taiwan showed that the discussion of EoL preferences with patients was associated with the option for less aggressive care (Chan et al, 2022).…”

A Review of Palliative Care Service Delivery Models and Patient Outcomes for Adults with Cancer in Selected East and Southeast Asian Countries

“…However, PC development in Macao is still in its nascent stage, with limited advancements since 2000 when the first hospice was established. 45 Future reviews should aim to include evidence published in other languages if feasible. Searches performed identified papers published in Thailand and Japan, but these were not included because they did not meet the inclusion criteria.…”