Chinese Diaspora Communities’ Knowledge of, and Engagement with Advance Care Planning: A Systematic Integrative Review

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Objectives To synthesize evidence regarding Chinese diasporas’ understanding, experience, and factors influencing engagement with advance care planning. Methods: A systematic integrative review using content analysis. Seven electronic databases (Embase, CINAHL, SCOPUS, Web of Science, Medline (OVID), PsycINFo, and The Cochrane Library) and gray resources were searched for studies from January 1990 to March 2022. Study quality appraisal was undertaken.
Results: 27 articles were identified and rated as moderate to good. Two overarching and interrelated themes were identified, “Awareness and knowledge” and “Engagement with advance care planning.” There are low levels of awareness, knowledge and engagement with advance care planning for Chinese diaspora. Findings highlight that this is influenced by two key factors. First, the geographic context and legal, cultural, and social systems within which the Chinese diasporas are living act as a potential catalyst to enhance awareness and engagement with advance care planning. Second, aspects of Chinese diasporas’ original culture, such as filial piety and a taboo surrounding death, were reported to negatively affect the promotion and engagement of advance care planning.
Significance of Results: Chinese diasporas are intermediaries between two divergent cultures that intertwine to strongly influence engagement with advance care planning. Hence, a bespoke culturally tailored approach should be accommodated in future research and practice for Chinese communities in multicultural countries to further advance palliative and end-of-life care awareness among this group.
Original languageEnglish
Pages (from-to)381-397
Number of pages17
JournalJournal of Palliative Care
Issue number3
Early online date27 Feb 2023
Publication statusPublished online - 27 Feb 2023

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by the UK Department of Employment and learning (DEL) awarded to the lead author to undertake this research as part of a PhD.

Publisher Copyright:
© The Author(s) 2023.


  • advance care planning
  • Chinese diaspora
  • Asian continental ancestry group
  • culture
  • knowledge
  • engagement
  • review


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