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Abstract
This study critically examines the concepts of dignity and liminality at the end-of-life, in an effort to better understand the processes of healing within suffering among Chinese terminal cancer patients receiving palliative care services in Hong Kong. Meaning-oriented interviews were conducted with 18 Chinese terminal patients, aged 44 to 98, to elicit the narratives and stories of their illness experience. All interviews were analyzed using grounded theory and supplemented by ethnographic observations and field notes. Two major themes and eight subprocesses of healing adopted by patients to achieve and maintain dignity were identified: (a) personal autonomy, which encompasses the need to (i) regain control over living environments, (ii) maintain self-sufficiency despite institutional care, (ii) make informed care decisions to reduce sense of burden, and (iv) engage in future planning to create a lasting legacy; and (b) family connectedness, which encompasses the need to (i) maintain close ties with family members to express appreciation, (ii) achieve reconciliation, (iii) fulfill family obligations, and (iv) establish a continuing bond that transcends generations. Implications of these themes for advanced care planning and life review interventions were discussed with the goal of enhancing patient autonomy and family connectedness, and thereby providing structure and meaning for Chinese terminal patients and their families at the end of life.
Acknowledgments
This study was funded by the General Research Fund, Research Grant Council, Hong Kong SAR Government (Ref no. HKU 740909H). Our funders had no role in the design, execution, analysis, and interpretation of the data or writing of the study. We express our deepest appreciation and gratitude to all of our participants for sharing their stories on life's most precious moments; this has truly been a rewarding and humbling experience. We extend our thanks to Ms. Yammi Yuen, Ms. Candy Fong, and Ms. Pearl Tse for their assistance in the fieldwork stage of the study, as well as Dr. Jordan Potash for his helpful comments on an early version of this manuscript.