Caring at the crossroads of culture and emotion: a reflective case study of person-centred end-of-life practices

Person-centred care (PCC) is increasingly emphasised in end-of-life care (EoLC) for its holistic approach to addressing physical, psychological, social, and spiritual needs. However, its implementation in mainland Chinese hospitals remains challenging due to a range of practical, emotional, and cultural barriers. Understanding these real-world barriers is critical for improving compassionate and dignified care delivery. This article explores how emotional, cultural, and organisational factors influence the application of PCC in hospital-based EoLC, through a reflective case study supported by a targeted literature review. A single clinical case involving a 78-year-old woman with advanced lung cancer was analysed using a dual perspective of the patient and the nurse. Three key barriers were identified. First, the emotional burden on nurses delivering EoLC limited their capacity for sustained compassionate engagement. Second, limitations in tailoring dignity therapy to patients' psychological readiness reduced its therapeutic effectiveness and, in some cases, heightened emotional distress. Third, cultural taboos surrounding death and family-led decision-making often restricted open conversations about end-of-life preferences, reducing patient participation. This study underscores the importance of culturally sensitive, emotionally attuned, and systemically supported approaches when applying PCC at the end of life. It offers practice-based insights for improving humanised care delivery in China and other culturally similar settings.