Promoting Advance Care Planning to the General Public and People Suffering from Life-Limiting Disease in Hong Kong

Chan, Carmen W. H.

Thursday, July 14, 2011

Carmen W. H. Chan, PhD¹
Sek Ying Chair, PhD¹
Caroline Y. Y. Chui, PhD, PGD, MN, (Nurse, Ed), BN, RTN, RGN, RMN²
Raymond S. K. Lo, BMBS³
Michael M. K. Sham, BMBS⁴
Cheuk Yin Lai, MA, BSocSc¹
(1)The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
(2)Baptist Hospital, Hong Kong, Hong Kong
(3)Shatin Hospital, Shatin Hospital, Hong Kong, Hong Kong
(4)Grantham Hospital, Grantham Hospital, Hong Kong, Hong Kong

Learning Objective 1: The learner will be able to understand the public knowledge and perception of advance care planning in Hong Kong

Learning Objective 2: The learner will be able to understand the effectivieness of intensive communication intervention on the promotion of advance care planning

Purpose: In Hong Kong, little has been done about advance care planning (ACP) in the health care context. Patients, family members and sometimes health care professionals still refrain from discussing dying and advance directives. This inadequate communication can cause some patients to receive high-cost but unwanted medical treatments rather than their preferred comfort care prior to death.

The launching of a health promotion project in 2009 - 2011 is to promote public awareness of the benefits of advance care planning (ACP) and assess the effectiveness of intensive communication of ACP on patients’ decisions of end-of-life care in Hong Kong.

Methods: Eight community roadshows were conducted to promote the philosophy and services of ACP to general public. Another 100 patients with life-limiting disease were given a 8-week intensive communication intervention as well as a set of the ACP promotional materials (pamphlet, VCD and Health Manual). The effectiveness of the roadshows on increasing public awareness of ACP was assessed by a post-roadshow survey. The effectiveness of the 8-week intervention was evaluated by pre- and post-intervention data of the following:

l patients’ decision on modification of current invasive treatment

l documentation of DNR (do not resuscitation) order

l completion of living will

l hospital readmission and length of each hospital stay.

Preliminary results: Around 4500 citizens participated in the roadshows. 85% of them have not heard of ACP prior to the roadshows and 66% of participants indicated interest to know more about ACP. 86 patients were recruited to the 8-week interventional programme.

Conclusion: The life expectancy for men and women in Hong Kong has increased to 79 & 85, respectively. How can people live the way they prefer until they die is an important health care issue. Preliminary findings on the effectiveness of the 8-week intervention in 86 patients will be reported.

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