• Keyuan Jiao, Amy Ym Chow, Juan Wang, and Iris Ik Chan.
• Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China.
• Palliat Med. 2021 Jun 1; 35 (6): 1181-1190.

BackgroundDelivery of community-based end-of-life care for patients and family members has been recognized as an important public health care approach. Despite differences in different healthcare settings and the significance of a person-centered approach, little research has investigated facilitators of community-based end-of-life care from the perspective of service recipients. In particular, there has been limited exploration of strategies to ensure positive outcomes at an operational level.AimTo explore factors facilitating positive end-of-life care provision in community-based settings and how these are achieved in practice, from the perspectives of patients and family caregivers.DesignA qualitative cross-sectional descriptive study was undertaken through semi-structured interviews with patients and family caregivers subjected to thematic analysis.Setting/ParticipantsTen patients and 16 family caregivers were recruited from an end-of-life community care program provided by four non-governmental organizations in Hong Kong.ResultsSeven core themes were identified: positive emotions about the relationship, positive appraisals of the relationship, care through inquiring about recipients' circumstances, instrumentality of care (i.e. information, coaching on care, practical help, psychological support, multiple activities), comprehensiveness of care (i.e. diversity, post-death care, family-level wellbeing), structure of care (i.e. timely follow-up, well-developed system), and qualities of workers.ConclusionsImprovement in service quality might be achieved through alternating the perceptions or emotional reactions of care recipients toward care providers and increased use of sensitive inquiry. Comprehensive care and positive outcomes might be facilitated by addressing the dualities of care by providing diverse choices in pre-death and post-death care.

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