| Author: | Yip, Wing Ki |
| Title: | Exploring experiences of using end-of-life conversation card game amongst Chinese community-dwelling elderly in Hong Kong |
| Advisors: | Chung, Betty (SN) |
| Degree: | DHSc |
| Year: | 2024 |
| Subject: | Death -- Psychological aspects Older people -- China -- Hong Kong -- Psychology Card games Hong Kong Polytechnic University -- Dissertations |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xi, 227 pages : color illustrations |
| Language: | English |
| Abstract: | Background The need for palliative care is increasing annually. The World Health Organization estimated that 56.8 million people, including 25.7 million in the last year of life, are in need of palliative care services. For many of these people, timely and effective end-of-life conversations could help them improve their quality of life. A similar service need has been noted in Hong Kong owing to population ageing. End-of-life conversations are regarded as beneficial in understanding individuals’ end-of-life preferences and wishes. However, different levels of barriers contribute to communication deficiencies in end-of-life conversations. A novel intervention, specifically a card game, may be a feasible way for the elderly to engage in end-of-life conversations. Recent studies have found that the card game enables a fun and enjoyable way to discuss death and dying. Nevertheless, no study has been conducted to explore the use of the card game in end-of-life conversations amongst older persons in Hong Kong. Aim and Significance This study aims to better understand the experiences of using the end-of-life conversation card game amongst Chinese community-dwelling elderly in Hong Kong. By presenting the details of the content and process of end-of-life conversations using the card game, the elderly could have a clear and accurate knowledge of what they should expect and response in these conversations. Accordingly, they are able to have a sense of control over their end-of-life decision-making. Moreover, this study improves healthcare professionals’ understanding of older persons’ needs in end-of-life conversations. Lastly, the current research facilitates the identification and development of necessary and appropriate support in response to patients’ needs. Methods This research adopted the qualitative descriptive study design to fill in the knowledge gap in the process of using the end-of-life conversation card game amongst Chinese community-dwelling elderly. That is, a rich and straight description and summary of informants’ perspectives are desired. Participants were recruited to play the end-of-life conversation card game once and to participate thereafter in individual interviews. Data obtained were transcribed and analysed using inductive thematic analysis. Strategies to ensure trustworthiness were utilised as well. Results A total of 10 participants completed the card game and interviews. The iterative process of data collection and analysis resulted in three sub-themes in this study: (1) Navigating the stormy waters of end-of-life decision-making, (2) Gaining the source of courage to express end-of-life ideas and (3) Getting a sense of connectedness. The sub-themes are crucial structural components in identifying the main theme: Empowerment. The main theme contextualises the experiences of Chinese community-dwelling elderly growing towards engagement in end-of-life conversations. Discussion Findings of this study indicate that playing the end-of-life conversation card game empowered Chinese community-dwelling elderly to be considerably engaged in these conversations in terms of the following aspects: consideration of end-of-life issues, expression of end-of-life wishes and recognition of personal involvement in end-of-life decision-making. End-of-life conversation is a journey of forward and backward passage, in which the Chinese culture discourages the elderly from participating. However, the card game empowered the elderly to actively engage and motivated them to transform their neglect behaviour into engagement in end-of-life conversations. The card game required the elderly to actively participate in end-of-life conversations, enabling them to fulfil their psychological needs (i.e. autonomy, competence and relatedness). Satisfaction of psychological needs promoted internalisation and integration, thereby enhancing the intrinsic motivation for elderly engagement in end-of-life conversations. Therefore, the experiences of using the card game represented a motivation in end-of-life conversations amongst the Chinese elderly. This study provided implications for practice. Given that the card game was found to be applicable for end-of-life conversations amongst the Chinese elderly, its further development for application in such conversations should be promoted. Furthermore, a competent facilitator is essential to facilitate the card game application, and appropriate training should be provided to prepare healthcare professionals providing support to the elderly. This study also highlights the importance of public education to healthcare providers and policy makers. Lastly, further research is recommended to invite diverse participants and to further investigate healthcare professionals’ perceptions of and confidence in using the card game, so as to deepen and expand knowledge of the card game’s application in end-of-life conversations. Conclusions This study reveals a comprehensive understanding of end-of-life conversations using the card game, which is a practical intervention in these conversations for community-dwelling elderly. Moreover, the elderly are empowered in end-of-life conversation engagement, enabling them to gain a sense of control over their end-of-life. Lastly, the elderly’s thoughts and feelings on end-of-life conversations using the card game could assist healthcare professionals to develop appropriate communication skills and interventions to facilitate such conversations. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 7992.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 3.68 MB | Adobe PDF | View/Open |
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