Challenges to advance care planning among multidisciplinary health professionals in China.

BACKGROUND: Advance care planning (ACP) is a critical component of quality end-of-life care. Little is known regarding the cultural influences on health professionals' attitudes toward the discussion of ACP in China. OBJECTIVE: To better understand attitudes toward ACP among Chinese healthcare professionals in China and the influence of cultural factors such as filial piety, or xiào. METHODS: A mixed methods study was used. This study reports the results of a descriptive cross-sectional survey of physicians, nurses and social workers with experience in palliative and end-of-life care. RESULTS: Some 102 completed surveys were obtained. Most Chinese health professionals had an overall positive attitude toward ACP, acknowledging that these discussions should occur. However, there was a general lack of confidence and sense of reluctance among participants to engage in ACP discussions. CONCLUSION: The lack of statistical difference between the various health professionals suggests that they all faced challenges in participating in ACP discussions. Future research should focus on the influences of cultural factors such as xiào on ACP discussion, and develop culturally sensitive strategies to facilitate these discussions in the Chinese community.