title: Dignity amidst liminality: healing within suffering among Chinese terminal cancer patients.
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.
authors: Centre on Behavioral Health and Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China.
authors: Andy H Y
authors: AH
authors: Ho
authors: Centre on Behavioral Health and Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China.
authors: Pamela P Y
authors: PP
authors: Leung
authors: Department of Medicine & Geriatrics & ICU, Caritas Medical Centre, Hong Kong, Hong Kong, China.
authors: Doris M W
authors: DM
authors: Tse
authors: School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
authors: Samantha M C
authors: SM
authors: Pang
authors: Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, Canada.
authors: Harvey M
authors: HM
authors: Chochinov
authors: Department of Psychology, University of Memphis, Memphis, Tennessee, USA.
authors: Robert A
authors: RA
authors: Neimeyer
authors: Centre on Behavioral Health and Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China.
authors: Cecilia L W
authors: CL
authors: Chan
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology*; D001293:Attitude to Death / Q000208:ethnology*; D005195:Family Relations / Q000208:ethnology; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D029181:Spirituality; D019452:Terminally Ill / Q000523:psychology*