End-of-life communication experiences within families of people with advanced cancer in China: A qualitative study

Effective communication between people with advanced cancer and their family members on end-of-life issues has a profound impact on meeting needs and improving quality of life of both sides. Several studies have shown that patient-family end-of-life communication is not always adequate and optimal. Little is known about the experiences of end-of-life communication within families of people with advanced cancer in China.The aim of this study was to explore the experiences of end-of-life communication between people with advanced cancer and their family members in China and the factors influencing their communication.A qualitative descriptive study using semi-structured interviews was conducted.This study took place at three tertiary hospitals in Beijing, China from July 2018 to October 2019.Purposive sampling was employed to select participants. Eleven people with advanced cancer and 14 family members were finally interviewed.Audio-recordings were transcribed verbatim and entered into qualitative data analysis software. Qualitative data were analyzed using a content analysis approach.Five themes and associated categories were identified: (1) silence without intention; (2) silence with intention; (3) silence-breaking; (4) openness without restraint; and (5) the influencing factors of end-of-life communication. These four states of end-of-life communication have different essential characteristics and change under the influence of the awareness of disease diagnosis, awareness and acceptance of the incurability of disease, and fear of impending death.Affected by the willingness and ability to communicate about end-of-life issues, people with advanced cancer and their family members present four communication states, namely silence without intention, silence with intention, silence-breaking, and openness without restraint. The study provides an insight into end-of-life communication experiences within families where different communication states are interconnected. The findings enable professionals to evaluate the communication and its influencing factors, so as to provide feasible and effective end-of-life communication support.Not registered.