End-of-life Communication From a Chinese Perspective

Objectives: To explore stakeholders' (patients, families and healthcare providers) experiences and perceptions of end-of-life communication in China; and understand culturally appropriate communication strategies.

Design and subjects: This study is a qualitative study. Eligible patients, family caregivers and healthcare providers will be recruited in two hospitals. Purposive sampling methods will be adopted. Semi-structured in-depth interviews with patients and family caregivers will be conducted respectively. Focus group discussions will be arranged with healthcare providers, allowing them to discuss end-of-life communication and generate group interactions and creative thinking.

Data analysis: The data analysis will be an iterative, cyclic and self-reflective process. Using inductive thematic analysis, common themes and categories will be determined through inductive reasoning and constant comparison.

Expected results: The study will fill the gap of no empirical evidence on end-of-life communication strategies from a Chinese perspective and enrich the knowledge about end-of-life communication.

Inclusion criteria

Patients:

• Be aged older than 18 years
• Have a defined incurable life-limiting illness with a likely life expectancy of fewer than 12 months (National Institute for Health and Care Excellence, 2021), according to the consultation with the patient's physician
• Have been informed of disease diagnosis and treatment
• Be able to speak Mandarin and express clearly
• Be able to provide informed consent

Family caregivers:

• Be aged older than 18 years
• One of the terminally ill patient's primary family caregivers who are familiar with patient's situation, which is defined as lived with or visited patients at least twice a week in the past month
• Have been informed of patient's disease diagnosis and treatment
• Be able to speak Mandarin
• Be able to provide informed consent

Healthcare providers:

• Be nurses, physicians or other healthcare professionals
• Be experienced in providing treatment or care to patients with advanced, life-limiting illnesses (whose likely life expectancies of fewer than 12 months) and family caregivers of such patients for at least five years (Koh et al., 2016)
• Consent to participate in the study

Exclusion criteria

Patients and family caregivers:

• Severe auditory impairment
• Cognitive impairment