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4th Edition of

Singapore Nursing Research Conference

March 21-23, 2024 | Singapore

Nursing 2023

Carmen WH Chan

Speaker at Singapore Nursing Research Conference 2023 - Carmen WH Chan
The Nethersole School of Nursing, China

Title: Cultural adaptation of a health manual to promote advance directives among the South Asian ethnic population in Hong Kong


Hong Kong is a multi-ethnic society with an increasing number and a large proportion (14.5 %) of South Asians currently living here. Anecdotal data shows that people of ethnic minorities in Hong Kong rarely receive specialized palliative care or engage in advance directive discussions. Language or cultural barriers may hinder these individuals’ knowledge of and motivation to receive palliative care. Therefore, there is a need to tackle these barriers and enable ethnic minority people to benefit from palliative care services and advance directive.

This research project aims to promote an awareness and appreciation of the benefits and engagement of palliative care and AD among South Asian ethnic minority groups (Indians, Nepali and Pakistani) through culturally-adapted and language-sensitive health manuals, training of lay volunteers, conduct radio talk show, organize community roadshows and health talks in collaboration with local ethnic minority support centres that currently provide services to South Asians in Hong Kong.

Phase 1 of the project focused on the development of a  health manual in English language on palliative care and cultural adaptation for the South Asian communities, including the Indian (English speaking), Nepali and Pakistani in Hong Kong. Phase 2 involved training of native speaking community volunteers to deliver radio talk shows, conduct community roadshows, organize exhibitions and health talks, and to disseminate the translated health manual (hard copy and e-copy) among South Asians in Hong Kong. Through in-depth interviews and expert review of Phase 1, this presentation will describe the experiences and processes of the cultural adaptation of the health manual.

A convenience sample of 30 South Asian participants recruited from community centres were invited to participate in individual interviews. The interviews were conducted at the community centres or other venues convenient to the participants. Based on the input received from the qualitative interview, the health manuals were modified (e.g. by changing the scenarios or wordings) to respect the cultural differences, while preserving the core elements and essential message of the material. The pre-final version was examined for the validity and clarity of the content by a panel of six members including health care providers, academics, and native speakers of English, Nepali and Urdu. The researcher then modified the material after receiving the members’ responses. The modified manual with an anonymous summary of all responses were sent to the panel members to repeat the consensus survey process until a final version was obtained.


Professor Carmen Chan is Alice Ho Miu Ling Nethersole Charity Foundation Endowed Professor of Nursing, and Vice Director (Education) of the Nethersole School of Nursing at the Chinese University of Hong Kong.  She is a fellow of American Academy of Nursing and Hong Kong Academy of Nursing.

Professor Chan has 30 years of academic experience.  She demonstrated integrated scholarship in cancer and palliative care research which has broadly impacted on the profession, patients, families, community and nursing education. Her research expertise includes symptom management, psychosocial care, and advance care planning.