Quality of Palliative and End-Of-Life Care in Hong Kong: Perspectives of Healthcare Providers

Abstract

Background: In response to population aging, there is a need for health systems to focus on care for chronic disease, specifically palliative care, while focusing on people-centered care. The objective of this study is to explore the healthcare system enablers and barriers to the provision of quality palliative and end-of-life care from the perspective of healthcare professionals. Materials and Methods: Using purposive sampling, fifteen focus group interviews and nine individual interviews involving 72 healthcare providers were conducted. Primary qualitative data were collected between May 2016 and July 2017. All recorded discussions were transcribed verbatim and analyzed. A thematic framework was developed. Results: The provision of quality palliative and end-of-life care is influenced by the interaction and integration of nine sub-themes under four identified themes: (1) political context; (2) organization setting; (3) support to patients, caregivers, and family members, and (4) healthcare workers and the public. Conclusions: Integration of palliative and end-of-life care is an important pillar of healthcare service to improve quality of life by addressing patients’ values, wishes and preference, and assist their family to handle challenges at the end stage of life. Further improvements to the service framework would be required, specifically in the political framework, multidisciplinary approach, and readiness and competence in healthcare workers and community. These were highlighted in our study as key components in service provision to ensure that patients can receive continuous and integrated care between hospitals and the community as well as dignified care at the end stage of life.

Examining the Gaps and Issues of End-of-Life Care among Older Population through the Lens of Socioecological Model—A Multi-Method Qualitative Study of Hong Kong

“…In summary, although there were various practices and providers of EOL care in Hong Kong, as summarized in the Introduction section, there is no overarching policy framework related to EOL care that conceptualizes and clarifies patients’ and their family members’ holistic needs, and how they could be provided with a comprehensive system of care. An advantage of the present study is that it extended from previous works that focused primarily on perspectives from the care providers [ 33 , 34 ]. While there are consistent findings, the present study also encompasses opinions and observations of other major stakeholders of EOL care including the non-care providers.…”

What Intern Nursing Students in Turkey Think About Death and End-of-Life Care? A Qualitative Exploration

“…Moreover, in qualitative studies about end-of-life care in the literature, similar themes such as continuing to have hope, providing spiritual care, adopting a multidisciplinary approach, cooperating with the patient and their family, providing also the family with psychosocial support and preparing the family for the mourning process have come forward (Brooks et al, 2017 ; Dalal & Bruera, 2017 ; Dong et al, 2016 ; Liu & Chiang, 2017 ). Nurses who provided end-of-life care have thought that, to provide good-quality end-of-life care, pain should be alleviated, physical care should be continued properly, effective teamwork should be in place, and the patient and their family should be provided with physical and emotional peace and spiritual comfort (Huang et al, 2016 ; Kisorio & Langley, 2016 ; Wong et al, 2020 ). It was found that one of the points the students underlined most in end-of-life care was the necessity to put the patient’s pain/ache under control.…”

Implementing Advance Care Planning in ‘The Age of Deferred Death' - the Hong Kong Experience over 4 Years

“…The survey showed that there is room for improvement in self-competence in death work among health and social care workers, especially among the younger age group, nurses, and those working in acute hospitals ( 29 ). There were also barriers to advance care planning from the patients’ and families point of view ( 30 ), and implementation of service changes ( 31 , 32 ). These studies showed that improvement in end of life care is needed in promotion and training end of life care conversations for health and social care professionals as well as patients and families, and fit for purpose services in both the institutional and community settings.…”