The emotional labor of end-of-life care work : findings of a mixed methods study in Hong Kong

Abstract

Objectives: This study explored how end-of-life (EOL) care practitioners in Hong Kong engaged in emotional labor while fulfilling their professional roles in a Chinese cultural context. Methods: A sequential explanatory mixed-methods design was employed. A quantitative survey (n = 32) using validated scales that measured emotional job demands and emotional labor strategies was followed by in-depth interviews (n = 11) with EOL care practitioners from diverse disciplines. Survey data were analyzed using descriptive statistics, while interview transcripts underwent thematic analysis. Results: EOL care practitioners reported high emotional job demands, with deep acting being their preferred emotional labor strategy over surface acting. Three key themes emerged related to: (1) balancing emotional involvement and professional boundaries; (2) employing strategic emotional engagement; and (3) navigating cultural beliefs and family dynamics. This multidisciplinary workforce developed sophisticated practices to manage their emotions authentically while establishing protective psychological boundaries. These practices integrated the provision of emotional support with the navigation of tensions between Chinese cultural values and professional responsibilities. Significance of results: This study used mixed-methods to explore how traditional values were integrated into the everyday care practices of EOL practitioners in Hong Kong. The findings contribute to an innovative and culturally sensitive framework for exploring emotional labor in EOL care contexts. This is useful in both Chinese and multicultural care contexts.