Abstract
Abstract
Background Quality of death (QoD) in palliative care is a critical yet understudied area of healthcare in China, shaped
by complex cultural, familial, and clinical factors. As an emerging medical specialty, palliative care in China increasingly
emphasises holistic and person-centred approaches. The understanding of what constitutes a good death in clinical
settings however, remains largely Western-centric and is often implicitly defined within unique Chinese sociocultural
contexts.
Methods In-depth, semi-structured interviews were collected from 27 multidisciplinary end-of-life care practitioners
across China, including doctors, nurses and social workers. Inductive thematic analysis was conducted to explore
the key components of good QoD and the factors influencing it within Chinese hospice and palliative care settings.
The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) to ensure rigour and
transparency.
Results Three themes emerged: (1) providing care with dignity through relationships, balancing respect for patients
with cultural expectations and medical realities; (2) enhancing communication within family dynamics, involving
indirect communication styles, managing family conflicts, and balancing transparency with cultural norms; and (3)
negotiating intergenerational dilemmas, where generational differences in attitudes toward death and dying create
tensions in care decisions. These findings reveal the challenges that practitioners may face in respecting patient
autonomy while addressing family-centred values and medicalised norms.
Conclusion The study highlights the importance of improving communication about death and dying, promoting
public education on end-of-life care, and tailoring palliative services to integrate Western clinical approaches with
traditional Chinese family-centric values to enhance QoD.
Background Quality of death (QoD) in palliative care is a critical yet understudied area of healthcare in China, shaped
by complex cultural, familial, and clinical factors. As an emerging medical specialty, palliative care in China increasingly
emphasises holistic and person-centred approaches. The understanding of what constitutes a good death in clinical
settings however, remains largely Western-centric and is often implicitly defined within unique Chinese sociocultural
contexts.
Methods In-depth, semi-structured interviews were collected from 27 multidisciplinary end-of-life care practitioners
across China, including doctors, nurses and social workers. Inductive thematic analysis was conducted to explore
the key components of good QoD and the factors influencing it within Chinese hospice and palliative care settings.
The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) to ensure rigour and
transparency.
Results Three themes emerged: (1) providing care with dignity through relationships, balancing respect for patients
with cultural expectations and medical realities; (2) enhancing communication within family dynamics, involving
indirect communication styles, managing family conflicts, and balancing transparency with cultural norms; and (3)
negotiating intergenerational dilemmas, where generational differences in attitudes toward death and dying create
tensions in care decisions. These findings reveal the challenges that practitioners may face in respecting patient
autonomy while addressing family-centred values and medicalised norms.
Conclusion The study highlights the importance of improving communication about death and dying, promoting
public education on end-of-life care, and tailoring palliative services to integrate Western clinical approaches with
traditional Chinese family-centric values to enhance QoD.
| Original language | English |
|---|---|
| Number of pages | 12 |
| Journal | BMC Palliative Care |
| Volume | 24 |
| Issue number | 297 (2025) |
| Early online date | 28 Nov 2025 |
| DOIs | |
| Publication status | Published - 28 Nov 2025 |
Data Availability Statement
No datasets were generated or analysed during the current study.Acknowledgements
We would like to express our heartfelt gratitude to all the participants in this study, including the healthcare and social care professionals, for sharing their invaluable insights and experiences. We gratefully acknowledge the Fushouyuan Development Foundation in Shanghai for their contribution to the overall design of the project and the conceptualisation of this article, as well as the practical assistance provided by Jisheng Wang, Mandi Huang, Hongyi Li, Xindi Xu and others in this study.Funding
Not applicable.
Keywords
- Care culture
- Familism
- healthcare practitioners
- Quality of death
- Qualitative
- Hospice
- palliative care