Application of social ecological model to Taiwanese end-of-life communication and healthcare planning

Article

Huang, Ya-Ling, Yates, Patsy, Thorberg, Fred Arne and Wu, Chiung-Jung (Jo). 2020. "Application of social ecological model to Taiwanese end-of-life communication and healthcare planning." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 27 (5), pp. 477-486. https://doi.org/10.1016/j.colegn.2020.04.008
Article Title

Application of social ecological model to Taiwanese end-of-life communication and healthcare planning

ERA Journal ID14073
Article CategoryArticle
AuthorsHuang, Ya-Ling, Yates, Patsy, Thorberg, Fred Arne and Wu, Chiung-Jung (Jo)
Journal TitleCollegian: The Australian Journal of Nursing Practice, Scholarship and Research
Journal Citation27 (5), pp. 477-486
Number of Pages10
Year2020
PublisherElsevier
Place of PublicationNetherlands
ISSN1322-7696
1876-7575
Digital Object Identifier (DOI)https://doi.org/10.1016/j.colegn.2020.04.008
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S1322769620300561
Abstract

Background
Cultural and social backgrounds shape how people regard health, illness and death, and also play a significant role in end-of-life (EOL) decision-making in the face of uncertainty and distress. EOL communication and planning can be complex in a society where families play an important role in decision-making for EOL care in Taiwan.
Aim
This study aimed to identify the significance of cultural, community, interpersonal and individual determinants of EOL communication and healthcare planning.
Methods
A social ecological model was applied to underpin the study. A random sample of 2000 adults aged 20 years or above was selected from the electoral roll in a metropolitan area in southern Taiwan. Adults were told that if they did not wish to participate in the study, they could either return a non-participation form or not complete the questionnaires. Hierarchical multiple regression analyses were used to determine the significance of different societal levels of factors on EOL communication and healthcare planning.
Findings
Four hundred and seventy-four valid questionnaires were returned. Hierarchical multiple regression analyses revealed that the models of modified Measures of Public Preferences (p < .0001) were significant, with 22.7% of variance in facilitation, 81.9% of variance in content and 22.9% of variance in support being explained by variables at cultural, community, interpersonal and intrapersonal levels. The model of Advance Directives Attitude Survey (p < .0001) was significant with 25.6% of variance being explained by variables at cultural, community, interpersonal and intrapersonal levels.
Discussion
This study offers empirical evidence embedded within a social ecological perspective of the significance of cultural, social and contextual factors on individuals’ preferences for EOL communication and healthcare planning.
Conclusion
Such information is important to enable health professionals to prepare individuals and their families for dealing with challenges related to EOL communication and healthcare.

KeywordsCulture; Social norms; Social environment; Advance care planning; Health communication
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420316. Palliative care
420506. Sub-acute care
420699. Public health not elsewhere classified
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Byline AffiliationsGold Coast Hospital and Health Service, Australia
Queensland University of Technology
Bond University
University of Queensland
University of California Los Angeles, United States
University of the Sunshine Coast
Royal Brisbane and Women’s Hospital, Australia
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