Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

BMC Nursing

Research

Sei-Ven Leu¹  Wen-Yu Hu²  Hsin-Tzu Sophie Lee³  Chia-Ling Yang⁴ 

[1] Department of Computer Center, Tzu Chi University, 97071, Hualien City, Hualien County, Taiwan, Republic of China;Department of Nursing, National Taiwan University, Taipei City, Taiwan, Republic of China;Department of Nursing, Tzu Chi University of Science and Technology, 97005, Hualien City, Taiwan, Republic of China;Mackay Junior College of Medicine, Nursing and Management, 11260, Taipei City, Taiwan, Republic of China;

关键词: Culture;    End-of-life;    Nursing home;    Advance care planning;    Advance directives;    Making decisions;   

DOI  :  10.1186/s12912-022-01143-2

 received in 2022-06-16, accepted in 2022-12-09,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundWhen older nursing home residents and their families are faced with end-of-life care decisions in Taiwan, they make them in the context of traditional cultural norms and socioeconomic changes. Both parties (residents and their family members) are often unwilling to broach the topic, leading to a decisional impasse. The aim of this study was to understand difficult-to-raise issues related to end-of-life care by investigating the perspectives of older nursing home residents and their family members.MethodsThis qualitative descriptive study was conducted using content analysis based on the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to select the participants, and sampling continued until data saturation. Data were collected using semi structured interviews, and related analyses were conducted using an inductive approach.ResultsTen residents and twelve family members were interviewed individually. Six main themes were identified: (1) the inevitability of a goodbye; (2) a good death; (3) going with or against traditional culture; (4) better a good death than a bad life; (5) abiding by the residents’ decisions; and (6) being willing but unable to take care of residents.ConclusionNursing home residents and their family members’ thoughts on end-of-life care shifted toward the concept of a good death, and they even regarded death as a form of liberation. Health care providers may serve as mediators to counsel a resident and their family members separately, enabling them to speak up and understand each other’s thoughts on end-of-life care before a decision is made so that neither party has regrets.

【 授权许可】

CC BY   
© The Author(s) 2022