Living and dying with dignity in Chinese society: perspectives of older palliative care patients in Hong Kong

the empirical Dignity Model has profoundly influenced the provision of palliative care for older terminally ill patients in the West, as it provides practical guidance and intervention strategies for promoting dignity and reducing distress at the end-of-life. to examine the concept of 'living a...

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Bibliographic Details
Published in:Age and ageing 2013-07, Vol.42 (4), p.455-461
Main Authors: Ho, Andy Hau Yan, Chan, Cecilia Lai Wan, Leung, Pamela Pui Yu, Chochinov, Harvey Max, Neimeyer, Robert A, Pang, Samantha Mei Che, Tse, Doris Man Wah
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Age Factors
Aged
Aged, 80 and over
Aging - ethnology
Aging - psychology
Asian Continental Ancestry Group - ethnology
Asian people
Attitude to Death - ethnology
Awareness
Cancer
Care and treatment
Chinese people
Comparative analysis
Competence
Cost of Illness
Cultural Characteristics
Demographic aspects
Dignity
Dying
Elder care
Ethics
Family Relations - ethnology
Female
Health Knowledge, Attitudes, Practice - ethnology
Health Services for the Aged
Hong Kong
Hong Kong - epidemiology
Human Dignity
Humans
Intervention
Interviews as Topic
Male
Middle Aged
Neoplasms - ethnology
Neoplasms - mortality
Neoplasms - psychology
Neoplasms - therapy
Older people
Palliative Care
Palliative treatment
Patients
Personhood
Psychological distress
Resilience
Right to Die
Social aspects
Spirituality
Terminal Care
Terminal illnesses
Terminally ill people
Terminally ill persons
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Summary:the empirical Dignity Model has profoundly influenced the provision of palliative care for older terminally ill patients in the West, as it provides practical guidance and intervention strategies for promoting dignity and reducing distress at the end-of-life. to examine the concept of 'living and dying with dignity' in the Chinese context, and explore the generalisability of the Dignity Model to older terminal patients in Hong Kong. using qualitative interviews, the concept of dignity was explored among 16 older Chinese palliative care patients with terminal cancer. Framework analysis with both deductive and inductive methods was employed. the three major categories of themes of the Dignity Model were broadly supported. However, the subtheme of death anxiety was not supported, while two subthemes of generativity/legacy and resilience/fighting spirit manifested differently in the Chinese context. Furthermore, four new emergent themes have been identified. They include enduring pain, moral transcendence, spiritual surrender and transgenerational unity. these findings highlight both a cultural and a familial dimension in the construct of dignity, underline the paramount importance of cultural awareness and competence for working with ethnically diverse groups, and call for a culturally sensitive and family oriented approach to palliative care interventions with older Chinese terminal patients.
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/aft003