Psychosocial Oncology and Palliative Care in Hong Kong

Psychosocial Oncology and Palliative Care in Hong Kong: The First Decade

Richard Fielding
Cecilia Lai-wan Chan
Copyright Date: 2000
Pages: 312
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  • Book Info
    Psychosocial Oncology and Palliative Care in Hong Kong
    Book Description:

    As the evidence-base for clinical practice in the management of life-threatening diseases and care at the end of life increases, it is apparent that psychosocial factors play a most profound role, influencing outcomes at every level from quality of life and satisfaction with clinical services through to duration of survival and mortality. This book documents some, but by no means all, of the developments that have occurred in the past decade in the area of psychosocial oncology and palliative care in Hong Kong. Contributions describing interventions by practitioners involved in service development in nursing, social work and clinical psychology, are complemented by chapters describing academic research and theoretical perspectives. The unique cultural mix of Hong Kong is given rich emphasis in the adaptations made by practitioners and academics to the interventions and theoretical issues outlined. As both a documentation of the efforts of some of those who helped psychosocial oncology and palliative care evolve in Hong Kong, and as a reflection of the need to more critically evaluate the impact of intervention efforts in health care, this volume provides a valuable resource. Nurses, social workers, psychologists and doctors involved in delivering or planning cancer treatment or palliative care will find this book useful. This book challenges many attitudes prevalent in Hong Kong and will, we hope, begin to break some of the taboos that continue to generate unnecessary suffering among the people cared for by our health care systems. The valuable experience documented in these pages can help others build the next generation of services to those with life-threatening illness and those at the end of life.

    eISBN: 978-988-220-259-7
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Preface
    (pp. vii-x)
    Richard Fielding and Cecilia Lai-wan Chan
  4. Contributors
    (pp. xi-xii)
  5. 1 Psychosocial and Palliative Care in the Chinese Context: The Challenges Ahead
    (pp. 1-12)
    Cecilia Lai-wan Chan and Richard Fielding

    We learn about cancer, death and bereavement from our patients. Their stories of courage and perseverance have given us the energy to put this book together. Their experiences, time and, in some cases, even money to support research have been given with a generosity that is hard to match. We become knowledgeable about the cancer experience because patients and their family members so willingly share their stories, pain and joy with us. We have learnt about their strength in the face of adversity and of their sometimes amazing capacities to cope with what, to most of us, would be overwhelming...

  6. 2 The Wider Philosophy of Palliative Care: How It Is Applicable in the General Ward
    (pp. 13-28)
    Katherine Thompson

    The modern hospice movement was founded in England by Dame Cicely Saunders as the result of her vision for dying patients. As long ago as 1930 she recognized that dying patients were not receiving care suitable for their condition, often receiving aggressive and traumatic treatments, being left in pain and with no one to talk with them about their anguish. This distressing image she called the ‘total pain’ of the dying, a suffering so great that it encompassed the whole being, body, mind and soul (Saunders, 1967). Her dream of developing a place where people could die in peace was...

  7. 3 Psychological Care in Oncology
    (pp. 29-54)
    Peter Wing-ho Lee, Lina Yuen-fan Wu and Amy Shuk-man Fung

    The multifarious interventions which have been proposed and claimed to be effective in helping cancer patients ride the stormy course of their illness can sometimes be both dazzling and misleading. A critical evaluation of the efficacy of the treatments proposed is therefore mandatory. In this chapter, the nature and efficacy of psychological care for cancer patients is reviewed and a survey of the psychological care provisions in oncology offered in local Hong Kong hospital settings is reported. Lastly, the common therapeutic components of psychological care advocated and evidenced in the local and international literature are reviewed. The efficacy of psychological...

  8. 4 The Quality of Life of Cancer Patients Receiving Chemotherapy
    (pp. 55-74)
    Camila Suk-yi Li

    Cancer is the number-one killer in Hong Kong, with almost one in three (9,675 deaths or 31.4%) dying from cancer (Hong Kong Government, 1996b). Cancer patients can now live longer, can have better control of the disease with fewer side-effects from treatment, and can enjoy a better quality of life (QoL). Many treatment programmes now include QoL objectives. However, studies have documented that most recent achievements in cancer care have been due as much to increased understanding of the psychosocial aspects of cancer as they have to developments in medical science (Richards and Martinson, 1987). In research and in the...

  9. 5 Psychosocial Support for Parents of Children With Cancer
    (pp. 75-104)
    Ida M. Martinson and Hau-yee Kuan

    In 1997, among Hong Kong’s population of 6.3 million people, there were 379 deaths due to non-accidental causes in children aged below sixteen years old, of which 45 were due to cancer (Hong Kong Government, Census and Statistics Department). When it is no longer a reasonable expectation that the cure-orientated treatment for a chronically ill child is effective and the child will die, the decision can be made as to where the child will die. Does the child need to be in hospital? Are the services that a family needs to care for their dying child available in the home?...

  10. 6 Coping Strategies of NPC Patients in Hong Kong and Their Effects on Short-term Adjustment
    (pp. 105-124)
    Joyce Lai-chong Ma, Damon Tak-kong Choy and Jonathan Shun-tong Sham

    This chapter describes a longitudinal study conducted in Hong Kong from September 1992 to May 1994 and reports the results. Its objectives were to investigate the coping strategies of patients suffering from nasopharyngeal carcinoma (NPC) and to find out if coping accounts for their differing success in short-term adjustment at different phases of the illness. There are four parts in this chapter: the literature review, the research questions and hypothetical predictions, methodology of the study, and discussion and implications for practice.

    NPC is a prevalent cancer commonly afflicting the southern Chinese. Its incidence is high at 27.5 per 100,000 per...

  11. 7 The Illness Experience of Patients With Nasopharyngeal Carcinoma (NPC): Psychosocial Support Services
    (pp. 125-142)
    Josephine Yuk-yi Cheng

    Nasopharyngeal carcinoma (NPC) is common among southern Chinese people (Table 1) both locally and overseas. NPC ranks fifth among all new cancers diagnosed in Hong Kong, with about a thousand newly diagnosed cases in a year reported. The male-to-female ratio is approximately 2.7 to 1 (Hong Kong Cancer Registry, 1998).

    Hong Kong is renowned for its treatment of NPC. More than 50% of patients diagnosed with NPC survive for five years or more, and most of them show no clinical evidence of disease at this time (Huang et al., 1991). With therapeutic advances, mortality from NPC has dropped from 13.3...

  12. 8 Lost for Words — Improving Care for Dying People Through Communication
    (pp. 143-166)
    Richard Fielding

    Hospice care is based on the principle of minimizing patient discomfort and symptoms and maximizing quality of life (QoL) or wellness for patients who are terminally ill. Hospice care has become the standard for patients with cancer in particular, but may also be provided for patients with AIDS, motor neurone disease and, less frequently, other progressive diseases in their later stages when cure is no longer a therapeutic goal (see Chapter 2 in this book).

    The switch from cure-oriented treatment to supportive symptom control and deciding when and under what circumstances treatment is or is not to be given often...

  13. 9 An Empowerment Group for Chinese Cancer Patients in Hong Kong
    (pp. 167-188)
    Cecilia Lai-wan Chan, Maria Yuen-yee Law and Pamela Piu-yiu Leung

    As with patients in other parts of the world, Chinese cancer patients suffer from physical discomfort, emotional stress, death anxiety and worry about the future. However, most Chinese are not trained to express their emotions. There is a poverty of vocabulary describing feelings in the Chinese language. Despite the difficulty in verbal expression, Chinese have strong family support as well as traditional forms of bodily and spiritual expression through tai chi and qi gong. A culturally-sensitive empowerment package for cancer patients, the ‘Cancer Fighters’ Training Course’, with a combination of Western psycho-educational group counselling together with Eastern techniques of qi...

  14. 10 From Expression to Empowerment: Using Creative Arts as Self-healing Media for Cancer Patients
    (pp. 189-212)
    Fiona Man-yan Chang and Sandra Kit-man Tsang

    Cancer patients face many challenges arising from their illness which affect the physical, psychosocial, emotional and spiritual aspects of their lives. They worry about their bodies being weakened by disease progression and have to make many adaptations in order to survive. Their psychosocial well-being may be hampered by feelings of helplessness, loneliness and worthlessness. Some find verbal communication inadequate in conveying their complex emotions. Many feel that nobody can understand their misery, so they hesitate to reach out for friendship or support. Unfortunately, in our experience, the more they are unable or reluctant to express themselves, the more ineffective the...

  15. 11 Death Awareness and Palliative Care
    (pp. 213-232)
    Cecilia Lai-wan Chan

    In Chinese culture, death is taken as a taboo that should never be mentioned, is not to be discussed in public, nor even be thought about (Chan et al., 1998). Even the thought of death is believed to bring bad luck, while discussion of this taboo word might hurry death or invite evil spirits into the family (Chow and Chan, 1998). When a person attends a traditional Chinese funeral, none of the gifts should be taken home. Instead, the gifts, usually a sweet to be eaten after the funeral and a coin to be spent on travelling home, are used...

  16. 12 Turning Grief Into Good Separation: Bereavement Services in Hong Kong
    (pp. 233-254)
    Amy Yin-man Chow, Brenda Wing-sze Koo, Elaine Wai-kwan Koo and Anna Yan-yan Lam

    Traditionally, Chinese people describe the four most significant events in life as ‘birth, ageing, illness and death’. ‘Death’ is always associated with sorrow, grief and pain. The Jessie and Thomas Tam Centre (for bereavement counselling, education and resource provision) of the Society for the Promotion of Hospice Care was opened on 31 October 1997. As bereavement care team members, we are dedicated to serving bereaved family members who suffer from the loss of their loved ones through death. We believe that early intervention can turn ‘grief’ into a ‘good separation’. This chapter will share the practical wisdom gained through the...

  17. 13 Benefits and Drawbacks of Chinese Rituals Surrounding Care for the Dying
    (pp. 255-270)
    Cecilia Lai-wan Chan and June Mui-hing Mak

    Our conceptions of death and dying, illness and health are related to our culture, social norms, religion and belief systems (Manderson, 1981; Braun and Nichols, 1997). Rituals are associated with ceremonial occasions characterized by a synchronization of behaviour, emotion and thought (Sheehy, 1994; Hawkes, Pawsey and Shepherdso, 1988). Death rituals usually comprise rites of separation, rites of transition and rites of incorporation into the new state. The secularization of society and the weakening of organized religion have not changed the importance and performance of death rituals. They reflect an underlying cultural philosophy in which death is given meaning through the...

  18. 14 Conclusion: The Next Decade or a New Millenium?
    (pp. 271-276)
    Richard Fielding

    The contributors to this book have all been involved in some aspect of developing and researching care for people with cancer, some of whom may be at the end of life, and their family members and care-providers. One clear message emerging from these pages is that psychosocial care in life-threatening illness is a growing philosophy of care practice. It is a philosophy that can be, and is being, adapted to suit the particular Chinese cultural context in Hong Kong. It extends to fit the cultural values and practices of the people it seeks to serve.

    Palliative care used to be...

  19. Index
    (pp. 277-300)