Cultivating mutuality: A qualitative study of community end-of-life care in Hong Kong.

Abstract

In Hong Kong, death and dying are identified as a crucial public health issue, and as the healthcare system has developed, there has been a shift of some care for dying people and their families to cross-disciplinary collaboration in community settings. This shift enhances the salience of social relationships in non-medical forms of community-based end-of-life (EOL) care. The purpose of this paper is to contribute to knowledge about relational development in this regard. Abductive grounded theory methodology was used to examine the complex dynamics and mechanisms involved in cultivating mutuality between dying people (and their families) and volunteers and professionals in two community-based EOL social service agencies in Hong Kong. Qualitative data were collected between June and December 2019 using in-depth interviews with 14 agency practitioners and two theoretically sampled service users. Theoretical coding followed open coding to reach theoretical saturation. Cultivating mutuality was found to entail processes of finding social commonalities (and hiding differences), immersing in routines, supporting actualisation (granting the wishes of dying persons and their families) and engaging with clients' emotions (encouraging emotional release, demonstrating emotional involvement and actively listening). Findings offered a novel symbolic interactive and relational understanding of community EOL care practice. Contributions include theorising social processes in an intermediate stage of social capital and compassionate community development.