Practitioner accounts of end-of-life communication in Hong Kong, Mainland China and Taiwan : a systematic review

Abstract

Objective: Communication at the end-of-life (EOL) is complex and multidimensional. Although culture is acknowledged as a key influence, there remains a gap in knowledge about intracultural aspects of EOL communication in the Chinese context. This review presents a synthesis of practitioners’ accounts of communication at the EOL in Hong Kong, Mainland China and Taiwan. Methods: This review was registered prospectively on PROSPERO (CRD42021297052). Five databases were systematically searched using the terms ‘communication’, ‘End-of-Life’, ‘Hong Kong’, ‘China’ and ‘Taiwan’. Empirical research published between 2015 and 2021 was downloaded and appraised. Fifteen articles were included in the review. Results: Findings highlight the influence of Chinese culture and philosophy, inadequate communication skills training and psychological support for practitioners and legislative and organisational factors. Conclusion: Education and training for practitioners and public education about the EOL needs strengthening. Enhanced understanding of how culture influences EOL communication will strengthen service delivery and enhance awareness in multicultural communities. Practice implications: EOL workers need practical and workplace-based support to engage in meaningful communication practices. The influence of culture and the readiness of patients and families to engage in communication are also important considerations.