{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:06:28Z","timestamp":1793196388623,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Noncancer patients with life-limiting diseases often receive more intensive level of care in their final days of life, with more cardiopulmonary resuscitation performed and less do-not-resuscitate (DNR) orders in place. Nevertheless, death is still often a taboo across Chinese culture, and ethnic disparities could negatively affect DNR directives completion rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aim to explore whether Chinese noncancer patients are willing to sign their own DNR directives in a palliative specialist clinic, under a multidisciplinary team approach<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective chart review of all noncancer patients with life-limiting diseases referred to palliative specialist clinic at a tertiary hospital in Hong Kong over a 4-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Over the study period, a total of 566 noncancer patients were seen, 119 of them completed their own DNR directives. Patients had a mean age of 74.9. Top 3 diagnoses were chronic renal failure (37%), congestive heart failure (16%), and motor neuron disease (11%). Forty-two percent of patients signed their DNR directives at first clinic attendance. Most Chinese patients (76.5%) invited family caregivers at DNR decision-making, especially for female gender (84.4% vs 69.1%; P = .047) and older (age &gt;75) age group (86.2% vs 66.7%; P = .012). Of the 40 deceased patients, median time from signed directives to death was 5 months. Vast majority (95%) had their DNR directives being honored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Health-care workers should be sensitive toward the cultural influence during advance care planning. Role of family for ethnic Chinese remains crucial and professionals should respect this family oriented decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1049909119828116","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T14:41:25Z","timestamp":1549982485000},"page":"760-766","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":86,"title":["Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5302-1804","authenticated-orcid":false,"given":"Hon-Wai Benjamin","family":"Cheng","sequence":"first","affiliation":[{"name":"Medical Palliative Medicine (MPM) unit, Department of Medicine &amp; Geriatrics, Tuen Mun Hospital, NT, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pui-Shan Karen","family":"Shek","sequence":"additional","affiliation":[{"name":"Medical Palliative Medicine (MPM) unit, Department of Medicine &amp; Geriatrics, Tuen Mun Hospital, NT, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Wah","family":"Man","sequence":"additional","affiliation":[{"name":"Medical Palliative Medicine (MPM) unit, Department of Medicine &amp; Geriatrics, Tuen Mun Hospital, NT, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oi-Man","family":"Chan","sequence":"additional","affiliation":[{"name":"Medical Palliative Medicine (MPM) unit, Department of Medicine &amp; Geriatrics, Tuen Mun Hospital, NT, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hung","family":"Chan","sequence":"additional","affiliation":[{"name":"Palliative Home Care Nursing Team, Tuen Mun Hospital, NT, Hong 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