Journal of Community & Public Health Nursing
Open Access

Abstract

Hospice service and end-of-life planning have been promoted in the mainstream culture by the Taiwanese government and societal efforts in the hope of reducing over or under-treatment and minimize conflicts among patients, family members and health care providers. However, a generally unsatisfactory rate of palliative care usage and understanding remains from official reports. In addition, very little is known about Taiwanese indigenous cancer survivors’ Advance Care Planning (ACP) and their participation in public education. Studies relevant to ACP are scare and based almost entirely on the non-indigenous Taiwanese. A groundbreaking qualitative study was completed to portrait lived illness and health-seeking experiences among indigenous cancer survivors. 18 semi-structured interviews from a diverse indigenous sample have depicted this underrepresented group’s ACP public understanding and behavioral engagement. The result showed that indigenous cancer survivors in Taiwanese were extremely limited in their knowledge for end-of-life decision-making; their low awareness of ACP was affected by incomplete and inadequate information mostly inaccessible and unavailable in the remote areas. The rich qualitative data have contributed a better collective understanding of indigenous cancer survivors’ ACP decisions. Psychological and behavioral factors were identified to offer explanations why some had better readiness to participate in executing advance directives, appoint durable power of attorney, but some had concerns discussing with family and health care providers. Future studies are to seek for interventions that better anticipate indigenous people’s palliative care/hospice usage, foster culturally appropriate public participation in the areas of ACP education and palliative care policy-making.

Biography

Yvonne Hsiung has received her PhD in Palliative Care Nursing in 2011. Being an ethical consultant for terminal patients and family surrogates, her previous research, teaching and clinical experiences mostly focused on the health promotion, community education and cultural advance care planning among minority groups in the Greater Chicago Area. Currently she is at Mackay Medical College teaching courses about Oncology Nursing, Palliative Care, Medical Ethics, Spiritual Nursing Care and Life and Death Education.

E-mail: yvonnebear@mmc.edu.tw