Family predictors of psychosocial outcomes among Hong Kong Chinese cancer patients in palliative care: living and dying with the "support paradox".

A good death is universally desired. For Chinese patients, the family is believed to play a key role in making this possible. This study aims at exploring the relationship of family-related factors and psychosocial outcomes among Hong Kong Chinese cancer patients in palliative care. Clinical data mining was adopted as the research method. Nurses collected data from clinical interviews with incoming palliative care patients. A total of 935 patients from three years of deceased patient records was included. Stepwise regression analysis demonstrated that "caregivers" support and acceptance" predicted fewer psychosocial symptoms of patients, whereas "depressed family response to patient's illness" and "family anxiety" predicted a greater number of psychosocial symptoms of patients upon their admission to palliative care. The findings suggested two possible pathways toward enhancing the psychosocial experience of dying patients, that is, the 'family support pathway" and the "familial-altruistic pathway." Further reflections on the findings may suggest that these patients may be situated in a "support paradox, "in which they desire family support but also worry about the burden that support places on family members. Implications for practice were discussed in the cultural context.