Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Attitudes toward Death, Perceptions of Hospice Care and Needs for Hospice Care among the LGBT Population

  • Received : 2024.09.13
  • Accepted : 2024.11.04
  • Published : 2024.12.01
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Abstract

Purpose: This study explored the attitudes of lesbian, gay, bisexual, and transgender (LGBT) individuals toward death and their perceptions of hospice and palliative care, as well as their care needs. It also investigated their preferences for alternative decision-making and advance care planning options at the end of life. Methods: A descriptive survey study was conducted with LGBT adults aged 18 and older. Participants were recruited through LGBT organizations and online communities, and data from 207 respondents were analyzed. Questionnaires were utilized to assess attitudes toward death, perceptions of hospice care, and care needs. Statistical analysis was performed using SPSS 20.0, employing the t-test, ANOVA, and Pearson correlation coefficients. Results: LGBT individuals generally had low attitudes toward death and negative perceptions of hospice care. Attitudes toward death varied significantly by sex, age, and education, while perceptions of hospice care differed significantly by sexual orientation and education. Care needs in hospice settings also varied significantly by age, gender identity, and education. Most LGBT participants preferred their biological family members (52%) and partners (39%) as surrogate decision-makers. A significant positive correlation was found between perceptions of hospice care and overall care needs. Conclusion: The findings highlight the need for healthcare services tailored to LGBT individuals' specific needs. It is necessary to promote social understanding, awareness, and policy support to improve the quality of life for LGBT individuals through more inclusive and responsive healthcare services. It also points to the need for healthcare professionals to increase their awareness and understanding of these issues.

Keywords

Acknowledgement

We sincerely thank the Korean Sexual-Minority Culture & Rights Center for their support and assistance with data collection. Their contributions were essential to the success of this research.

References

  1. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: National Academies Press; c2011.
  2. Yi HR, Lee HM, Choo SS, Kim RY, Eom YJ, Kim SS. Importance of collecting sexual orientation and gender identity information in nationally representative surveys of South Korea: a review of current status and measurement development. JCSW 2022;74:175-208.
  3. Lee HM, Park JY, Kim SS. LGBTQI health research in South Korea: a systematic review. Health and Social Science 2014;36:43-76.
  4. OECD. Society at a Glance 2019: OECD SocialIndicators [Internet] Paris; Organisation for Economic Co-operation and Development Publishing:2019.p. 13-50 [cited 2024Jun24] Available from: http://doi.org/10.1787/soc_glance-2019-en.
  5. Ministry ofHealth and Welfare. The 2nd comprehensive planforhospice and life-sustaining treatment (2024-2028). Sejong: Ministryof Health and Welfare;2024.
  6. Tobin J, Rogers A, Winterburn I, Tullie S, Kalyanasundaram A, Kuhn I, et al. Hospice care access inequalities: a systematic review and narrative synthesis. BMJ Support Palliat Care 2022;12:142-51. https://doi.org/10.1136/bmjspcare-2020-002719
  7. Therson JA, Powell FC. Elements of death anxiety and meanings of death. J Clin Psychol 1988;44:691-701.
  8. Park SC. A study on the death orientation of hospice volunteers. J Korean Acad Nurs 1992;22:68-80. https://doi.org/10.4040/jnas.1992.22.1.68
  9. Yoo MS. The influences of death attitudes and emotional intelligence on hospice volunteers’ perception of life as meaningful. J Korean Acad Soc Home Care Nurs 2016;23:90-9
  10. Kim JH. The attitude of medical personal about death and hospice research [master’s thesis]. Seoul: Hanyang Univ.; 1990. Korean.
  11. Lee EJ. A study of spot-survey towards the attitude of hospice [master’s thesis]. Iksan: Wonkwang Univ.; 1998. Korean.
  12. Gwak DY. Hospice palliative care perception and nursing demand of cancer patient’s and families [master’s thesis]. Busan: Graduate School Catholic Univ. of Pusan; 2017. Korean.
  13. Kang KA, Kim SJ, Kim YS. The need for hospice care in families of patients with cancer. Journal of Korean Community Nursing 2004;15:639-47.
  14. Hughes M, Cartwright C. Lesbian, gay, bisexual and transgender people’s attitudes to end-of-life decision-making and advance care planning. Australas J Ageing 2015;34 Suppl 2:39-43. https://doi.org/10.1111/ajag.12268
  15. Lee YE, Choi EA, Lee KE. Spiritual welling-being, attitude to death and perception of hospice care in college students. Korean J Hosp Palliat Care 2015;18:294-305. https://doi.org/10.14475/kjhpc.2015.18.4.294
  16. Oak YH, Kim YS. Attitudes towards death, perceptions of hospice care, and hospice care needs among family members of patients in the intensive care unit. Korean J Hosp Palliat Care 2020;23:172-82. https://doi.org/10.14475/kjhpc.2020.23.4.172
  17. De Vries B, Gutman G, Humble A, Gahagan J, Chamberland L, Aubert P, et al. End-of-life preparations among LGBT older Canadian adults: the missing conversations. Int J Aging Hum Dev 2019;88:358-79. https://doi.org/10.1177/0091415019836738
  18. Jung YM. Factors influencing middle-aged men’s attitude towards death. J Hosp Palliat Care 2023;16:166-74. https://doi.org/10.14475/kjhpc.2013.16.3.166
  19. Rawlings D. End-of-life care considerations for gay, lesbian, bisexual, and transgender individuals. Int J Palliat Nurs 2012;18:29-34. https://doi.org/10.12968/ijpn.2012.18.1.29
  20. Sohn SK. Needs of hospice care in families of the hospitalized terminal patients with cancer. Asian Oncol Nurs 2009;9:1-6.
  21. Son YJ, Park YR. Perception on hospice, attitudes toward death and needs of hospice care between the patients with cancer and family. Korean J Rehabil Nurs 2015;18:11-9. https://doi.org/10.7587/kjrehn.2015.11
  22. Seay J, Mitteldorf D, Yankie A, Pirl WF, Kobetz E, Schlumbrecht M. Survivorship care needs among LGBT cancer survivors. J Psychosoc Oncol 2018;36:393-405. https://doi.org/10.1080/07347332.2018.1447528
  23. Rawlings D. End-of-life care considerations for gay, lesbian, bisexual, and transgender individuals. Int J Palliat Nurs 2012;18:29-34. https://doi.org/10.12968/ijpn.2012.18.1.29
  24. Bristowe K, Hodson M, Wee B, Almack K, Johnson K, Daveson BA, et al. Recommendations to reduce inequalities for LGBT people facing advanced illness: access care national qualitative interview study. Palliat Med 2018;32:23-35. https://doi.org/10.1177/0269216317705102
  25. Candrian C, Cloyes KG. “She’s dying and I can’t say we’re married?”: end-of-life care for LGBT older adults. Gerontologist 2021;61:1197-201. https://doi.org/10.1093/geront/gnaa186
  26. Kang MH, Moon YS, Lee YJ, Kang YS, Kim HG, Lee GW, et al. Physical symptoms and psychiatric, social, spiritual and economical care needs of patients under home-based cancer service. Korean J Hosp Palliat Care 2014;17:216-22. https://doi.org/10.14475/kjhpc.2014.17.4.216
  27. Roberts NJ, Harvey LA, Poulos RG, Ni She E, Dillon Savage I, Rafferty G, et al. lesbian, gay, bisexual, transgender and gender diverse and queer (LGBTQ) community members’ perspectives on palliative care in New South Wales (NSW), Australia. Health Soc Care Community 2022;30:e5926-e5945. https://doi.org/10.1111/hsc.14024
  28. Stein GL, Bonuck KA. Attitudes on end-of-life care and advance care planning in the lesbian and gay community. J Palliat Med 2001;4:173–90.
  29. Hughes M, Cartwright C. LGBT people’s knowledge of and preparedness to discuss end-of-life care planning options. Health Soc Care Community 20 https://doi.org/10.1111/hsc.12113
  30. Cartwright C, Hughes M, Lienert T. End-of-life care for gay, lesbian, bisexual and transgender people. Cult Health Sex 2012;14:537-48. https://doi.org/10.1080/13691058.2012.673639