End-of-life care in rural China: the crucial role and challenges of village doctors

Abstract Objective Quality hospice and palliative care are particularly challenging in rural China. This qualitative study aimed to explore the critical role of village doctors in the end-of-life care of rural China amidst challenges posed by an aging population. Methods Forty-six semistructured int...

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Main Authors: Changhui Song, Min Feng, Hui Xie
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Palliative Care
Subjects:
Online Access:https://doi.org/10.1186/s12904-025-01755-w
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author Changhui Song
Min Feng
Hui Xie
author_facet Changhui Song
Min Feng
Hui Xie
author_sort Changhui Song
collection DOAJ
description Abstract Objective Quality hospice and palliative care are particularly challenging in rural China. This qualitative study aimed to explore the critical role of village doctors in the end-of-life care of rural China amidst challenges posed by an aging population. Methods Forty-six semistructured interviews were conducted in 38 villages across Henan and Shandong Provinces in China. Data were analyzed via thematic analysis. Results Village doctors with at least five years of medical practice were recruited from the student interviewers’ hometowns. Among the 46 village doctors aged 35–78 years, 32 respondents were male (69.6%), with an average duration of professional practice of 29.2 years. Five thematic findings, guided by the multidimensional supportive care needs model, were identified, including symptom management as central to end-of-life care, verbal consolation as ancillary services, the absence of spiritual care, social support and economic assistance, and a lack of informational resources and support. Village doctors have focused primarily on symptom management and basic medical care and have contended with limited resources, strict regulations on narcotic drugs, and cultural taboos against death. Serving as frontline healthcare providers, they navigated complex familial decision-making, offered indirect psychological support, and often avoided direct discussions about terminal prognoses. Conclusion Despite these challenges, village doctors’ deep community roots and trusted relationships ensure continuity and cost-effective end-of-life care. Enhancing their role through improved training and policy support could markedly optimize care quality and accessibility in rural China, addressing disparities and promoting dignified care for patients and their families.
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spelling doaj-art-107da4231bd942efa2adc090e3ab32882025-08-20T03:15:10ZengBMCBMC Palliative Care1472-684X2025-04-012411910.1186/s12904-025-01755-wEnd-of-life care in rural China: the crucial role and challenges of village doctorsChanghui Song0Min Feng1Hui Xie2Research Center on Social Work and Social Governance, Henan Normal UniversityCollege of Social Affairs, Henan Normal UniversityJoseph J. Zilber School of Public Health, University of Wisconsin-MilwaukeeAbstract Objective Quality hospice and palliative care are particularly challenging in rural China. This qualitative study aimed to explore the critical role of village doctors in the end-of-life care of rural China amidst challenges posed by an aging population. Methods Forty-six semistructured interviews were conducted in 38 villages across Henan and Shandong Provinces in China. Data were analyzed via thematic analysis. Results Village doctors with at least five years of medical practice were recruited from the student interviewers’ hometowns. Among the 46 village doctors aged 35–78 years, 32 respondents were male (69.6%), with an average duration of professional practice of 29.2 years. Five thematic findings, guided by the multidimensional supportive care needs model, were identified, including symptom management as central to end-of-life care, verbal consolation as ancillary services, the absence of spiritual care, social support and economic assistance, and a lack of informational resources and support. Village doctors have focused primarily on symptom management and basic medical care and have contended with limited resources, strict regulations on narcotic drugs, and cultural taboos against death. Serving as frontline healthcare providers, they navigated complex familial decision-making, offered indirect psychological support, and often avoided direct discussions about terminal prognoses. Conclusion Despite these challenges, village doctors’ deep community roots and trusted relationships ensure continuity and cost-effective end-of-life care. Enhancing their role through improved training and policy support could markedly optimize care quality and accessibility in rural China, addressing disparities and promoting dignified care for patients and their families.https://doi.org/10.1186/s12904-025-01755-wEnd-of-life carePalliative careVillage DoctorsQualitative studyDeath anxietyRural China
spellingShingle Changhui Song
Min Feng
Hui Xie
End-of-life care in rural China: the crucial role and challenges of village doctors
BMC Palliative Care
End-of-life care
Palliative care
Village Doctors
Qualitative study
Death anxiety
Rural China
title End-of-life care in rural China: the crucial role and challenges of village doctors
title_full End-of-life care in rural China: the crucial role and challenges of village doctors
title_fullStr End-of-life care in rural China: the crucial role and challenges of village doctors
title_full_unstemmed End-of-life care in rural China: the crucial role and challenges of village doctors
title_short End-of-life care in rural China: the crucial role and challenges of village doctors
title_sort end of life care in rural china the crucial role and challenges of village doctors
topic End-of-life care
Palliative care
Village Doctors
Qualitative study
Death anxiety
Rural China
url https://doi.org/10.1186/s12904-025-01755-w
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AT minfeng endoflifecareinruralchinathecrucialroleandchallengesofvillagedoctors
AT huixie endoflifecareinruralchinathecrucialroleandchallengesofvillagedoctors