Objectives: With the rapidly aging population worldwide, the demand for palliative care is increasing. Palliative care publicity and education must be further developed globally, especially for the elderly. It is essential to perform targeted promotion by understanding the awareness and needs of palliative care of the elderly. This study aimed to investigate elderly people's awareness of palliative care and their own views on and needs for palliative care, which could provide a basis for the popularization of palliative care among them. Methods: A total of 20 elderly people were recruited to participate in the semi-structured, and in-depth interviews. Participants were from communities and nursing homes in Chongqing, China. The interview transcripts were coded using the method of thematic analysis. Results: Finally, 4 themes and 10 subthemes were identified, that is: unawareness of the concept of palliative care (never heard of palliative care, confusion between euthanasia and palliative care), motivations for accepting palliative care (personal perspective: less suffering; family perspective: relieving the burden), factors influencing palliative care decision (cost of palliative care, knowledge of palliative care, opinion of decision-making agents), and necessity and preferences for publicizing palliative care (eagerness to know more about palliative care, focusing on policy and charges, preference for Electronic Media Advertising). Conclusions: Palliative care publicity among the elderly is important and necessary. Findings in this study could provide some insights into how to popularize palliative care among the elderly. Considering the preference of the elderly for access to palliative care information, simultaneous publicity through TV and online channels is suggested. Since the elderly would like to choose their doctors and adult children as decision-making agents, more communication between community, health professionals and family is advocated.
StephenRCMariaCSB. Global Atlas of Palliative Care at the End of Life. Worldwide Hospice Palliative Care Alliance: Hospice House, 34–44 Britannia Street, London WC1X 9JG, England, 2014; pp.10–12.
2.
HuiDHannonBLZimmermannCBrueraE. Improving patient and caregiver outcomes in oncology: team-based, timely, and targeted palliative care. CA Cancer J Clin. 2018;68(5):356‐376. doi:10.3322/caac.21490
3.
MounseyLFerresMEastmanP. Palliative care for the patient without cancer. Aust J Gen Pract. 2018;47(11):765‐769. doi:10.31128/AJGP-07-18-4625
4.
StephenRC. Global Atlas of Palliative Care 2nd Edition. Worldwide Hospice Palliative Care Alliance: Hospice House, 34-44 Britannia Street, London WC1X 9JG, England, 2020; pp12.
5.
CarrascoJMInbadasHWhitelawAClarkD. Early impact of the 2014 world health assembly resolution on palliative care: a qualitative study using semistructured interviews with key experts. J Palliat Med. 2021;24(1):103‐106. doi:10.1089/jpm.2019.0384
6.
ChungRYDongDChauNNSChauPYYeohEKWongEL. 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. Int J Environ Res Public Health. 2020;17(14):5072. doi:10.3390/ijerph17145072
7.
WantingH. Effect of end-of-life care on dying status of the elderly in China. Mod Bus Trade Ind. 2020;41(07):74‐75. doi: 10.19311/j.cnki.1672-3198
8.
SnowCEVarelaBRPardiDAAdelmanRDSaidSReidMC. Identifying factors affecting utilization of an inpatient palliative care service: a physician survey. J Palliat Med. 2009;12(3):231‐237. doi:10.1089/jpm.2009.9656
9.
GraulAHaggertyAStickleyC, et al.Effect of patient education on palliative care knowledge and acceptability of outpatient palliative care services among gynecologic oncology patients: a randomized controlled trial. Gynecol Oncol. 2020;156(2):482‐487. doi:10.1016/j.ygyno.2019.11.023
10.
TrivediNPetersonEBEllisEMFerrerRAKentEEChouWS. Awareness of palliative care among a nationally representative sample of U.S. adults. J Palliat Med. 2019;22(12):1578‐1582. doi:10.1089/jpm.2018.0656
11.
MillerSCLimaJCThompsonSA. End-of-life care in nursing homes with greater versus less palliative care knowledge and practice. J Palliat Med. 2015;18(6):527‐534. doi:10.1089/jpm.2014.0393
BluckSDirkJMackayMMHuxA. Life experience with death: relation to death attitudes and to the use of death-related memories. Death Stud. 2008;32(6):524‐549. doi:10.1080/07481180802138860
15.
DuryR. Social isolation and loneliness in the elderly: an exploration of some of the issues. Br J Community Nurs. 2014;19(3):125‐128. doi:10.12968/bjcn.2014.19.3.125
16.
DouglasHGeorgiouAWestbrookJ. Social participation as an indicator of successful aging: an overview of concepts and their associations with health. Aust Health Rev. 2017;41(4):455‐462. doi:10.1071/AH16038
17.
AalamiOOFangTDSongHMNacamuliRP. Physiological features of aging persons. Arch Surg. 2003;138(10):1068‐1076. doi:10.1001/archsurg.138.10.1068
18.
McGiltonKSVellaniSYeungL, et al.Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review. BMC Geriatr. 2018;18(1):231. doi:10.1186/s12877-018-0925-x
19.
HanrattyBLowsonEGrandeG, et al.Transitions at the end of life for older adults – patient, carer and professional perspectives: a mixed-methods study. Health Serv Deliv Res. 2014;2(17):101‐102. doi: 10.3310/hsdr02170
20.
VaismoradiMTurunenHBondasT. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398‐405. doi:10.1111/nhs.12048
21.
KigerMEVarpioL. Thematic analysis of qualitative data: AMEE Guide No. 131. Med Teach. 2020;42(8):846‐854. doi:10.1080/0142159X.2020.1755030
22.
TongASainsburyPCraigJ. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349‐357. doi: 10.1093/intqhc/mzm042
GivenLM, ed. The SAGE Encyclopedia of Qualitative Research Methods. SAGE Publications, Inc; 2008.
25.
PadgettD. Qualitative Methods in Social Work Research: Challenges and Rewards. Sage Publications; 1998:178.
26.
HawleyP. Barriers to access to palliative care. Palliat Care. 2017;10:1178224216688887. doi:10.1177/1178224216688887
27.
CheungJTKAuDIpAHF, et al.Barriers to advance care planning: a qualitative study of seriously ill Chinese patients and their families. BMC Palliat Care. 2020;19(1):80. doi:10.1186/s12904-020-00587-0
28.
ZhangQXieCXieSLiuQ. The attitudes of Chinese cancer patients and family caregivers toward advance directives. Int J Environ Res Public Health. 2016;13(8):816. doi:10.3390/ijerph13080816
YanYZhangHGaoW, et al.Current awareness of palliative care in China. Lancet Glob Health. 2020;8(3):e333‐e335. doi:10.1016/S2214-109X(20)30006-1
33.
SeymourJ. The impact of public health awareness campaigns on the awareness and quality of palliative care. J Palliat Med. 2018;21(S1):S30‐S36. doi:10.1089/jpm.2017.0391
CesariMCalvaniRMarzettiE. Frailty in older persons. Clin Geriatr Med. 2017;33(3):293‐303. doi:10.1016/j.cger.2017.02.002
36.
WangLMChenZHZhangM, et al.Study of the prevalence and disease burden of chronic disease in the elderly in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2019;40(3):277‐283. doi: 10.3760/cma.j.issn.0254-6450.2019.03.005
37.
MaresovaPJavanmardiEBarakovicS, et al.Consequences of chronic diseases and other limitations associated with old age - a scoping review. BMC Public Health. 2019;19(1):1431. doi:10.1186/s12889-019-7762-5
38.
ShalevAPhongtankuelVKozlovEShenMJAdelmanRDReidMC. Awareness and misperceptions of hospice and palliative care: a population-based survey study. Am J Hosp Palliat Care. 2018;35(3):431‐439. doi:10.1177/1049909117715215
39.
TamKICheSLZhuMLeongSM. Knowledge of palliative care and preference of end of life care: a cross-sectional survey of residents in the Chinese socio-cultural background of Macao. BMC Palliat Care. 2021;20(1):87. doi:10.1186/s12904-021-00798-z
40.
XieYXuYYangSYanJJinXQLiuC. Investigation of the awareness of and demand for hospice care and attitudes towards life-sustaining treatment at the end of life among community residents in Hangzhou. BMC Palliat Care. 2020;19(1):128. doi:10.1186/s12904-020-00628-8
41.
GalliGSirotaMGruberMJ, et al.Learning facts during aging: the benefits of curiosity. Exp Aging Res. 2018;44(4):311‐328. doi:10.1080/0361073X.2018.1477355
42.
LaabarTDAuretKSaundersCNgoHJohnsonCE. Support needs for bhutanese family members taking care of loved ones diagnosed with advanced illness [published online ahead of print, 2021 Dec 13]. J Palliat Care. 2021:8258597211066248. doi:10.1177/08258597211066248
43.
LiHJiYChenT. The roles of different sources of social support on emotional well-being among Chinese elderly. Plos One. 2014;9(3):e90051. doi:10.1371/journal.pone.0090051
44.
GilbertSMNemethLAmellaEEdlundBBurggrafV. Adult children and the transition of aging parents. Issues Ment Health Nurs. 2018;39(5):374‐381. doi:10.1080/01612840.2018.1434842
45.
ZhangZMinX. The ethical dilemma of truth-telling in healthcare in China. J Bioeth Inq. 2020;17(3):337‐344. doi:10.1007/s11673-020-09979-6
46.
SheuSJHuangSHTangFIHuangSL. Ethical decision making on truth telling in terminal cancer: medical students’ choices between patient autonomy and family paternalism. Med Educ. 2006;40(6):590‐598. doi:10.1111/j.1365-2929.2006.02477.x
47.
NingXH. Hospice and palliative care in mainland China: history, current status and challenges. Chin Med Sci J. 2018;33(4):199‐203. doi:10.24920/003524
NingX. Hospice and palliative care research in mainland China: current status and future direction. Palliat Med. 2019;33(9):1127‐1128. doi:10.1177/0269216319857495
50.
TorensmaMOnwuteaka-PhilipsenBDde VoogdXWillemsDLSuurmondJL. The role of research in improving responsiveness of palliative care to migrants and other underserved populations in the Netherlands: a qualitative interview study. BMC Palliat Care. 2021;20(1):5. doi:10.1186/s12904-020-00701-2
51.
PentarisPChristodoulouP. Qualities of culturally and religiously sensitive practice: a cross-sectional study [published online ahead of print, 2021 Nov 29]. J Palliat Care. 2021:8258597211050742. doi:10.1177/08258597211050742
52.
ChenQFlahertyJHGuoJHZhouYZhangXMHuXY. Attitudes of older Chinese patients toward death and dying. J Palliat Med. 2017;20(12):1389‐1394. doi:10.1089/jpm.2017.0014
53.
ChengHBShekPKManCW, et al.Dealing With death taboo: discussion of do-not-resuscitate directives with Chinese patients with noncancer life-limiting illnesses. Am J Hosp Palliat Care. 2019;36(9):760‐766. doi:10.1177/1049909119828116
54.
BolligGBrandtFCiurlionisMKnopfB. Last aid course. An education for all citizens and an ingredient of compassionate communities. Healthcare (Basel). 2019;7(1):19. doi:10.3390/healthcare7010019
55.
WangTMolassiotisAChungBTanJY. Current research status of palliative care in mainland China. J Palliat Care. 2018;33(4):215‐241. doi:10.1177/0825859718773949
56.
GardnerDSParikhNSVillanuevaCH, et al.Assessing the palliative care needs and service use of diverse older adults in an urban medically-underserved community. Ann Palliat Med. 2019;8(5):769‐774. doi:10.21037/apm.2019.11.22
57.
IsaacsonMJ. Addressing palliative and end-of-life care needs with Native American elders. Int J Palliat Nurs. 2018;24(4):160‐168. doi:10.12968/ijpn.2018.24.4.160
58.
KozlovEMcDarbyMReidMCCarpenterBD. Knowledge of palliative care among community-dwelling adults. Am J Hosp Palliat Care. 2018;35(4):647‐651. doi:10.1177/1049909117725725
59.
GrantMSBackALDettmarNS. Public perceptions of advance care planning, palliative care, and hospice: a scoping review. J Palliat Med. 2021;24(1):46‐52. doi:10.1089/jpm.2020.0111
60.
PatelPLyonsL. Examining the knowledge, awareness, and perceptions of palliative care in the general public over time: a scoping literature review. Am J Hosp Palliat Care. 2020;37(6):481‐487. doi:10.1177/1049909119885899
61.
ZhangLMYuH. Comparison of the quality of life and the cost of home palliative care in patients with advanced cancer. Modern Instrumentation and Medicine. 2016;22(006):84‐86. doi: 10.11876/mimt201606032
62.
LeeVHFLamTCJingHM, et al.Integrative palliative cancer care in Hong Kong: an overview and an example from the east. Clin Oncol (R Coll Radiol). 2019;31(8):589‐594. doi:10.1016/j.clon.2019.06.001
63.
KeYXHuSHTakemuraNLinCC. Perceived quality of palliative care in intensive care units among doctors and nurses in Taiwan. Int J Qual Health Care. 2019;31(10):741‐747. doi:10.1093/intqhc/mzz003
64.
YijinWLinziLHangSXueliYWenM. Hospice and palliative care: development and challenges in China. Clin J Oncol Nurs. 2016;20(1):E16‐E19. doi:10.1188/16.CJON.E16-E19
65.
WashingtonKTDemirisGWhitePMathisHCForsytheJEParker OliverD. A goal-directed model of collaborative decision making in hospice and palliative care [published online ahead of print, 2021 Nov 17]. J Palliat Care. 2021:8258597211049138. doi:10.1177/08258597211049138
