1
|
Leung DYP, Wan Z, Chan HYL, Chiu PKC, Lo RSK, Tang FWK. 124 Perceived Quality of End-Of-Life Communication Provided by Healthcare Professionals Among Frail Older Chinese Patients. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Better communications among the patient, their family, and healthcare providers can enable a shared understanding on patient’s end-of-life (EOL) care preferences. Discussion about death-related issue however has been thought to be taboo among Chinese people. This study aims to explore perceived quality of EOL communication provided by healthcare professionals (HCPs) among frail older Chinese patients.
Method
Frail older patients were recruited from a medical ward of a public hospital for a randomized controlled trial of the effectiveness of a nurse-led advance care planning. Participants completed a baseline questionnaire including the 7-item Quality of Communication (QOC) Questionnaire which measures perceived quality of EOL communication provided by HCPs (0 “The worst or none happened” to 10 “The best”). Bivariate analyses examined associated factors of QOC.
Results
Between December 2018 and January 2020, 105 participants were recruited and have completed the QOC. Their mean age was 80 years old (SD = 7.1), and 74% (n = 78) reported had received some formal education. A total of 95 participants (91%) responded “0” to all the 7 items in QOC (poor QOC group). For individual QOC item, all participants scored “0” in 4 items, 99 scored “0” in Item 1 “Talking about details if you got sicker”, 104 scored “0” in Item 2 “Talking about how long you might have to live”, and 101 scored “0” in Item 7 “Respecting your spiritual or religious beliefs”. Participants with “0” score in QOC reported a significant lower mean level in certainty regarding decision-making in EOL preferences (1.2 ± 1.6 vs. 2.3 ± 1.8, p = 0.039).
Conclusion
Occurrence of talking about EOL care with frail older Chinese patients by HCPs was rare, and the quality of EOL communication associated with decision-making certainty regarding EOL preferences. Training of initiation of EOL discussions and improve communication skills for HCPs is essential. Funding: RGC, HKSAR, China (PolyU14162617H).
Collapse
Affiliation(s)
- D Y P Leung
- School of Nursing, The Hong Kong Polytechnic University; School of Nursing, The Hong Kong Polytechnic University; Nethersole School of Nursing, The Chinese University of Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Department of Palliative Medicine, Shatin Hospital; Nethersole School of Nursing, The Chinese Univeristy of Hong Kong
| | - Z Wan
- School of Nursing, The Hong Kong Polytechnic University; School of Nursing, The Hong Kong Polytechnic University; Nethersole School of Nursing, The Chinese University of Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Department of Palliative Medicine, Shatin Hospital; Nethersole School of Nursing, The Chinese Univeristy of Hong Kong
| | - H Y L Chan
- School of Nursing, The Hong Kong Polytechnic University; School of Nursing, The Hong Kong Polytechnic University; Nethersole School of Nursing, The Chinese University of Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Department of Palliative Medicine, Shatin Hospital; Nethersole School of Nursing, The Chinese Univeristy of Hong Kong
| | - P K C Chiu
- School of Nursing, The Hong Kong Polytechnic University; School of Nursing, The Hong Kong Polytechnic University; Nethersole School of Nursing, The Chinese University of Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Department of Palliative Medicine, Shatin Hospital; Nethersole School of Nursing, The Chinese Univeristy of Hong Kong
| | - R S K Lo
- School of Nursing, The Hong Kong Polytechnic University; School of Nursing, The Hong Kong Polytechnic University; Nethersole School of Nursing, The Chinese University of Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Department of Palliative Medicine, Shatin Hospital; Nethersole School of Nursing, The Chinese Univeristy of Hong Kong
| | - F W K Tang
- School of Nursing, The Hong Kong Polytechnic University; School of Nursing, The Hong Kong Polytechnic University; Nethersole School of Nursing, The Chinese University of Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong; Department of Palliative Medicine, Shatin Hospital; Nethersole School of Nursing, The Chinese Univeristy of Hong Kong
| |
Collapse
|
2
|
Kwok T, Jin X, Yeung F, Cheng J, Lo RSK, Lam CLK, Yuan HJ, Woo J. A Comparison of the Long-term Health Related Quality of Life and Handicap of Stroke Patients in Mainland China and Hong Kong. Health Serv Insights 2010. [DOI: 10.1177/117863291000300001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose To compare health related quality of life (HRQOL) and handicap of stroke survivors in Hong Kong (HK) and Chengdu (CD) in Mainland China. Method Fifty-four pairs of first ever stroke patients in CD and in HK matched by age, sex and Modified Barthel Index (MBI) were interviewed using a structured questionnaire at 16–36 months after stroke. HRQOL and handicap outcomes were evaluated by the Chinese version of the Short-Form Health Survey (SF-36) and London Handicap Scale (LHS) respectively. Results Compared to stroke patients in CD, HK subjects reported significantly greater handicap, especially in the occupation domain. HK subjects also had significantly lower HRQOL Z scores in domains of role limitations due to emotional or physical problems, and bodily pain. CD subjects had more social support, but had more difficulties in meeting medical costs, and were less likely to have regular medical follow-up and dysphagia symptom. After adjusting for social and health related factors, the site differences in handicap and the role limitation (physical) domain of SF36 became insignificant. Conclusions CD stroke survivors had better scores in HRQOL and fewer handicaps than their counterparts in HK, because of social and health related factors.
Collapse
Affiliation(s)
- T Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong
| | - X Jin
- Department of Geriatrics, Renji Hospital, Shanghai
| | - F Yeung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong
| | - J Cheng
- Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong
| | - RSK Lo
- Department of Geriatrics and Medicine, Shatin Hospital, Hong Kong
| | - CLK Lam
- Family Medicine Unit, Department of Medicine, University of Hong Kong
| | - HJ Yuan
- West China Health Promotion and Training Center on Ageing of 4th Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - J Woo
- Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong
| |
Collapse
|