Abstract
BackgroundSince the establishment of a hospice in the year 2000 and the development of a palliative care ward in 2019, there is no study examining public’s knowledge of palliative care, nor preference of end of life care in Macao.AimTargeting Chinese residents of Macao, the current study has 3 goals: i) to understand the level of knowledge of palliative care, ii) to explore the preference of end of life treatments, and iii) to identify the associated factors of the preference of end of life treatments.MethodsA cross-sectional questionnaire survey was conducted using a structured questionnaire. The study employed non-probability quota sampling through which Macao residents aged 18 and above were recruited between July and September 2020.ResultsA total of 737 responses were valid. The average correct rate of palliative care knowledge ranged from 40.4% to 85.5%. Pertaining to end of life treatments, 62.0% of the respondents chose comfort care. However, almost half of the respondents agreed that life-sustaining treatments should not be stopped under any circumstances. Respondents who scored higher in palliative care knowledge and those with secondary and tertiary education were associated factors of choosing comfort care rather than life-sustaining treatments. In addition, respondents who agreed that futile life-sustaining treatments should be stopped were also associated with preference for comfort care.ConclusionThe understanding of palliative care amongst Macao residents is inadequate. Despite the public’s inclination towards comfort care, it is generally believed that life-sustaining treatments should not be stopped at the end of life. The study results suggest that not only the knowledge of palliative care should be enhanced amongst the general public in Macao, but information about life-sustaining treatments should also be offered to patients and families by healthcare professionals, in aiding end of life treatment decision making.
Highlights
Since the establishment of a hospice in the year 2000 and the development of a palliative care ward in 2019, there is no study examining public’s knowledge of palliative care, nor preference of end of life care in Macao
The study results suggest that the knowledge of palliative care should be enhanced amongst the general public in Macao, but information about life-sustaining treatments should be offered to patients and families by healthcare professionals, in aiding end of life treatment decision making
The public of Macao gravitated towards comfort care over futile life prolongation, there was still a significant number of people who did not want life-sustaining treatments (LST) to stop at the end of their lives
Summary
Since the establishment of a hospice in the year 2000 and the development of a palliative care ward in 2019, there is no study examining public’s knowledge of palliative care, nor preference of end of life care in Macao. Macao’s earliest implementation of palliative and end of life (EoL) care began when the first hospice was established in the year 2000. While there is a limited extent of home visit offered by the hospice, the main focus of palliative care in Macao has remained on the inpatient service. Regarding legislations on EoL issues, there is no advance directives legislation in Macao. Patients and their families can decide to sign an agreement stating the decision to reject resuscitation or other life-sustaining treatments (LST). The agreement is based primarily on hospital’s internal policy whose nature is conceptually different from advance directives, and the agreement is not legally binding
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