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探讨老年澳大利亚华裔对预先医疗指示的认知、态度和需求。

Exploring the knowledge, attitudes and needs of advance care planning in older Chinese Australians.

机构信息

Advance Care Planning Australia, Austin Health, Melbourne, Vic., Australia.

Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic., Australia.

出版信息

J Clin Nurs. 2018 Sep;27(17-18):3298-3306. doi: 10.1111/jocn.13886. Epub 2017 Jul 17.

Abstract

AIMS AND OBJECTIVES

To identify factors that influence the engagement of Chinese Australians with advance care planning.

BACKGROUND

Despite the benefits of advance care planning, there is a low prevalence of advance care planning in the Chinese Australian community. Reasons for this are often cited as cultural considerations and taboos surrounding future medical planning and death; however, other logistical factors may also be important.

DESIGN

This qualitative study used a thematic analysis grounded theory approach to explore facilitators and barriers to engagement in advance care planning.

METHODS

Semistructured interviews were conducted in-language (Mandarin or Cantonese) exploring the views of a purposive sample of 30 community-dwelling older Chinese Australians within Victoria, Australia.

RESULTS

Three key themes were identified: knowledge of, attitudes towards and needs for undertaking advance care planning amongst the Chinese Australians. There was a low awareness of advance care planning amongst the participants and some confusion regarding the concept. Most participants reported positive attitudes towards advance care planning but acknowledged that others may be uncomfortable discussing death-related topics. Participants would want to know the true status of their health and plan ahead in consultation with family members to reduce the burden on the family and suffering for themselves. Language was identified as the largest barrier to overcome to increase advance care planning awareness. In-language materials and key support networks including GPs, family and Chinese community groups were identified as ideal forums for the promotion of advance care planning.

CONCLUSIONS

The participants of this study were open to conversations regarding future medical planning and end-of-life care, suggesting the low uptake of advance care planning amongst Chinese Australians is not culturally motivated but may be due a lack of knowledge relating to advance care planning.

RELEVANCE TO CLINICAL PRACTICE

The results highlight the need to provide access to appropriate in-language advance care planning resources and promotion of advance care planning across the Chinese community.

摘要

目的和目标

确定影响澳大利亚华人参与预先护理计划的因素。

背景

尽管预先护理计划有很多好处,但在澳大利亚华人社区中,该计划的普及率很低。造成这种情况的原因通常被认为是文化方面的考虑因素,以及对未来医疗规划和死亡的禁忌;然而,其他一些实际因素也可能很重要。

设计

本定性研究采用主题分析扎根理论方法,探讨了促进和阻碍澳大利亚华人参与预先护理计划的因素。

方法

以中文(普通话或粤语)进行半结构化访谈,以探索澳大利亚维多利亚州 30 名居住在社区的年长澳大利亚华人的观点。

结果

确定了三个关键主题:澳大利亚华人对预先护理计划的了解、态度和需求。参与者对预先护理计划的认识较低,对该概念有些混淆。大多数参与者对预先护理计划持积极态度,但也承认其他人可能对讨论与死亡相关的话题感到不舒服。参与者希望了解自己的真实健康状况,并与家人一起提前规划,以减轻家庭负担和减轻自己的痛苦。语言被认为是提高预先护理计划意识的最大障碍。中文材料和关键支持网络,包括全科医生、家庭和华人社区团体,被确定为推广预先护理计划的理想论坛。

结论

本研究的参与者对未来医疗规划和临终关怀的讨论持开放态度,这表明澳大利亚华人对预先护理计划的低接受度不是文化因素造成的,而是可能由于缺乏预先护理计划方面的知识。

临床相关性

研究结果强调需要提供适当的中文预先护理计划资源,并在华人社区推广预先护理计划。

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