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The blessings and the curses of filial piety on dignity at the end of life: lived experience of Hong Kong Chinese adult children caregivers
- Authors:
- CHAN Cecilia L.W., et al
- Journal article citation:
- Journal of Ethnic and Cultural Diversity in Social Work, 21(4), October 2012, pp.277-296.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The Hong Kong Government bases its policy for older people on the Confucian concept of filial piety. At the same time it has repeatedly stressed the importance to their well-being of elders remaining in the community for as long as possible. This study examines the changing nature of filial piety and the role that it plays in the contemporary experience of “living and dying with dignity” among Hong Kong Chinese families facing the end of life. Meaning-oriented interviews were conducted with a purposive sample of 15 adult-children caregivers (ages 30 to 62, 12 female) to elicit their narratives around caring for a dying elderly parent. Content analysis revealed that, although traditional filial beliefs provided motivation for family caregiving, the regrets of unfulfilled filial responsibilities create emotional distance between parents and adult children, which acts as a cultural barrier for reconciliation and contentment at the end of life. These findings highlight the importance of intergenerational dynamics and interactions in the transformation of filial attitudes and behaviours, highlighting the importance of reciprocal relationships (versus authority relationship), mutual support (versus complete obedience), compassionate duty (versus obligatory duty), emotional connection (versus task fulfilment), and appreciation and forgiveness (versus guilt and shame) in the promotion of dignity at the end of life. Policy and clinical implications of these evolving attitudes are discussed.
Social workers’ involvement in advance care planning: a systematic narrative review
- Authors:
- WANG Chong-Wen, CHAN Cecilia L.W., CHOW Amy Y. M.
- Journal article citation:
- BMC Palliative Care, 17(5), 2018,
- Publisher:
- BioMed Central Ltd
Background: Advance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. Although a number of studies have documented social workers’ attitudes toward, knowledge about, and involvement in advance care planning, the information is fragmented. The purpose of this review was to provide a narrative synthesis of evidence on social workers’ perspectives and experiences regarding implementation of advance care planning. Methods: Six databases were searched for peer-reviewed research papers from their respective inception through December 2016. All of the resulting studies relevant to both advance care planning and social worker were examined. The findings of relevant studies were synthesized thematically. Results: Thirty-one articles met the eligibility criteria. Six research themes were identified: social workers’ attitudes toward advance care planning; social workers’ knowledge, education and training regarding advance care planning; social workers’ involvement in advance care planning; social workers’ perceptions of their roles; ethical issues relevant to advance care planning; and the effect of social work intervention on advance care planning engagement. The findings suggest that there is a consensus among social workers that advance care planning is their duty and responsibility and that social workers play an important role in promoting and implementing advance care planning through an array of activities. Conclusions: This study provides useful knowledge for implementing advance care planning through illustrating social workers’ perspectives and experiences. Further studies are warranted to understand the complexity inherent in social workers’ involvement in advance care planning for different life-limiting illnesses or within different socio-cultural contexts. (Edited publisher abstract)
Survey on death and dying in Hong Kong: attitudes, beliefs, and preferred end-of-life care
- Authors:
- MJELDE-MOSSEY Lee A., CHAN Cecilia L.W.
- Journal article citation:
- Social Work in Health Care, 45(1), 2007, pp.49-65.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The results of a telephone interview survey of 430 Hong Kong Chinese are presented and give information on attitudes and beliefs about death and dying, and preferences for end-of-life care, including hospice care. The results are analysed by gender. Respect for the dying and the dying process is evident, with very little support for views suggesting that talking about death is associated with bad luck or that a painful or early death is the result of past misdeeds. Continued respect for the dead, including compliance with funeral and mourning rituals, is emphasised. A majority gained comfort from the belief that death is a normal part of the life cycle, and that they would live on in the love of their descendants, but belief in reincarnation or an afterlife was not strongly associated with comfort. The respondents were about equally divided in their preference for the relief of pain (and possible shortening of life) or the extension of life as long as possible (even if this means more pain). The implications for social workers, including those in countries such as the USA with significant Hong Kong Chinese communities, are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).