Advance Directive Completion and Its Associated Factors Among Older Chinese Americans

Wang, Kaipeng; Liu, Yanqin; Sun, Fei; Kong, Dexia; Jiang, Lin; Wu, Bei

doi:10.1016/j.jamda.2020.06.049

Cited by 18 publications

(29 citation statements)

References 26 publications

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“…Advance care planning (ACP) is defined as the process of deciding medical treatment preferences ahead of time when patients have life-threatening diseases and are not able to speak for themselves (Weathers et al, 2016). While the completion of an advance directive (AD), defined as legal documents that allow individuals to communicate medical decisions about end-of-life (EOL) care in advance (Wang et al, 2021), is considered the optimal ACP outcome, discussing EOL care plans with significant others has become increasingly important before completing an AD (Volandes & Volandes, 2015). Successful communication of EOL care plans has been associated with improved quality of life among patients (Wright et al, 2008), less aggressive medical care (Mack et al, 2012), and lower stress and anxiety of family members (Detering et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…There are approximately five million Chinese Americans in the United States (Pew Research Center, 2017), many of whom have not been actively involved in ACP. Research shows that the completion rate of AD is only 14% among older Chinese Americans (Wang et al, 2021). Despite the strong evidence of benefits, older Chinese Americans tend to refrain from discussing EOL care plans with their family members (X.…”

Section: Introductionmentioning

confidence: 99%

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Attitude Toward Family Involvement in End-of-Life Care Among Older Chinese Americans: How Do Family Relationships Matter?

Wang

Sun

et al. 2021

J Appl Gerontol

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Family involvement is critical to end-of-life (EOL) care among older adults. This study aims to examine the association and pathways between family relationships and older Chinese Americans’ attitude toward family involvement in EOL care discussions. Data were collected from 260 Chinese Americans aged 55 years and above. Structural equation modeling was used to examine the total and indirect effects of family relationships on attitude toward family involvement in discussing EOL care plans. Family relationships had a significant positive total effect on attitude toward family involvement in EOL care. Indirect effects of family relationships on attitude toward family involvement in EOL care through self-efficacy, perceived benefits, and perceived barriers of discussing EOL care with family members were all significant. Findings provide empirical evidence of how family relationships affect older Chinese Americans’ attitude toward family involvement in EOL care and underline the need for family-centered EOL interventions for this population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitude Toward Family Involvement in End-of-Life Care Among Older Chinese Americans: How Do Family Relationships Matter?

Wang

Sun

et al. 2021

J Appl Gerontol

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“…A nivel investigativo, el conocimiento alrededor de las tasas de diligenciamiento de los dva por parte de las personas en diferentes escenarios de manejo de la enfermedad ha empezado a cobrar mucha más importancia (50). Al respecto, Graw (51) identificó que solo el 12.8% de las personas que asistieron a una sala de emergencias por trauma en Alemania tenían elaborado y firmado un Documento de Voluntad Anticipada.…”

Section: Discussionunclassified

Voluntades anticipadas como referente ético de conocimiento en los enfermeros que laboran en servicios de oncología

Castellar

Castaño

2022

Rev. latinoam. bioet

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El propósito del presente artículo es identificar los conocimientos sobre la Voluntad Anticipada (VA) en enfermeros que laboran en servicios de oncología. Para ello, se utilizó como metodología un estudio observacional con intención analítica que midió el nivel de conocimiento a través de un cuestionario autodiligenciado. En él participaron 50 enfermeros, seleccionados por muestreo no probabilístico. Así, se analizaron las variables cualitativas con distribuciones de frecuencia, y las cuantitativas con estadística descriptiva y análisis bivariado. El nivel de conocimiento se categorizó así: 0 a 10 puntos (nivel bajo), 11 a 20 puntos (nivel medio), 21 a 30 puntos (nivel alto). Los resultados de la investigación arrojaron como dato que, para un grupo donde el 86 % eran mujeres, con promedio de edad de 37 años, el promedio de años de experiencia como enfermeros fue de 11.5 años. Por otra parte, el promedio de años de experiencia en el área de oncología fue de 6.2 años. De los que hacían parte de este último promedio, el 48 % tenían diplomado en oncología y el 46 % especialización. El 70 % de los participantes tenía un conocimiento medio, el 26 % un conocimiento alto, y el 4 %un nivel bajo. Cabe mencionar que solo el nivel de formación de postgrado se relacionó de manera significativa con el nivel de conocimientos. Como conclusión, se encontró que los profesionales en enfermería poseen un nivel de conocimiento medio sobre la legislación que aborda las voluntades anticipadas en Colombia y esto está relacionado con el nivel de formación.

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“…may assist in clarifying goals and expectations surrounding food intake at the EOL. Third, Chinese Americans' low awareness and knowledge of ACP 35,36 led CACCC to incorporate ACP-specific items (e.g. advance directives, life sustaining treatment, and disease progression) as prompts for further education and discussion.…”

Section: Culturally Tailored Content Of the Hth Cardsmentioning

confidence: 99%

“…These preliminary results highlight HTH Café's potential for promoting ACP engagement among Chinese Americans, especially when compared with prior literature demonstrating low completion of advance directives and ACP contemplation. 35,36 A unique element of the HTH Café that may have facilitated the high levels of engagement is its group-based format. Existing literature demonstrates that group visits may improve self-efficacy in ACP through high-quality education, and facilitator and peer-supported discussions.…”

Section: Hth Cafés' Role In Promoting Acp Engagement and Educationmentioning

confidence: 99%

Heart to Heart Cards: A Novel, Culturally Tailored, Community-Based Advance Care Planning Tool for Chinese Americans

Jia

Stokes

Pan

et al. 2021

Am J Hosp Palliat Care

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Context: A paucity of literature describes the growing Chinese American community’s end-of-life (EOL) priorities and preferences. Objective: Develop a culturally-tailored advance care planning (ACP) tool to understand the EOL preferences of this underserved minority group. Methods: Informed by the Cultural Appropriateness Theory, the Chinese American Coalition for Compassionate Care (CACCC) developed Heart to Heart (HTH) Cards using a 3-step approach. First, CACCC created and refined a list of bilingual, culturally relevant EOL issues. Next, CACCC organized the EOL issues into a card deck. Finally, CACCC developed a unique playstyle of the cards—the HTH Café. From 2014-2019, CACCC recruited Chinese American volunteers and participants for HTH Cafés. Following each Café, participants completed an anonymous survey describing their sociodemographics, top 3 cards, and café evaluation. Results: The 54 HTH Cards were organized into 4 suits (spiritual, physical, financial/legal, and social). Each card displayed a culturally-tailored EOL issue in English and Chinese. Playstyles included one-on-one and group formats (ie. HTH Café). CACCC volunteers conducted 316 HTH Cafés for 2,267 Chinese American adults. Most participants were female (61.6%), between 18-50 years old (56.7%), lived in California (80.2%) and born in Asia (74.3%). The top priority (25.5%) was “If I’m going to die anyway, I don’t want to be kept alive by machines.” Participants thought the session was pleasant (99.5%) and expressed intent to complete advance directives (86.5%). Conclusion: HTH Cards represents the first, theory-driven, culturally-tailored ACP tool for Chinese Americans. More research is needed to establish its impact on ACP conversations and outcomes.

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Advance Directive Completion and Its Associated Factors Among Older Chinese Americans

Cited by 18 publications

References 26 publications

Attitude Toward Family Involvement in End-of-Life Care Among Older Chinese Americans: How Do Family Relationships Matter?

Attitude Toward Family Involvement in End-of-Life Care Among Older Chinese Americans: How Do Family Relationships Matter?

Voluntades anticipadas como referente ético de conocimiento en los enfermeros que laboran en servicios de oncología

Heart to Heart Cards: A Novel, Culturally Tailored, Community-Based Advance Care Planning Tool for Chinese Americans

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