Attitudes and Preferences of Korean‐American Older Adults and Caregivers on End‐of‐Life Care

Kwak, Jung; Salmon, Jennifer R.

doi:10.1111/j.1532-5415.2007.01394.x

Cited by 114 publications

(151 citation statements)

References 25 publications

Supporting

Mentioning

141

Contrasting

Order By: Relevance

“…First, our fi ndings showing that nonwhite patients were less likely to have advance directives are congruent with studies from non-ICU settings. 11,[25][26][27][28][29][30][31][32][33][34] Previous research suggests multifactorial causes for this difference, including diverse cultural beliefs and values, geographic variation in advance directive use, 32,[35][36][37] and disparities in patient-clinician communication about advance care planning. 12,14,15,26,34 Recent data support the potential value of advance directives in assuring that patients receive the care they would want.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Race/Ethnicity and Socioeconomic Status on End-of-Life Care in the ICU

Muni

Engelberg

Treece

et al. 2011

Chest

172

130

View full text Add to dashboard Cite

A growing body of evidence demonstrates the existence of important racial and ethnic differences in health care. Although many studies report on disparities in health care for acute and chronic conditions, 1-5 relatively few address racial disparities in the ICU, and those report confl icting fi ndings. Some have reported that black patients receive fewer medical interventions, 6,7 have shorter lengths of stay, and use fewer resources. 7 In contrast, others have found increased resource utilization, including larger numbers of ICU admissions and higher numbers of medical interventions for minority than for white patients. 8,9 Background: There is confl icting evidence about the infl uence of race/ethnicity on the use of intensive care at the end of life, and little is known about the infl uence of socioeconomic status. Methods: We examined patients who died in the ICU in 15 hospitals. Race/ethnicity was assessed as white and nonwhite. Socioeconomic status included patient education, health insurance, and income by zip code. To explore differences in end-of-life care, we examined the use of (1) advance directives, (2) life-sustaining therapies, (3) symptom management, (4) communication, and (5) support services. Results: Medical charts were abstracted for 3,138/3,400 patients of whom 2,479 (79%) were white and 659 (21%) were nonwhite (or Hispanic). In logistic regressions adjusted for patient demographics, socioeconomic factors, and site, nonwhite patients were less likely to have living wills (OR, 0.41; 95% CI, 0.32-0.54) and more likely to die with full support (OR, 1.59; 95% CI, 1.30-1.94). In documentation of family conferences, nonwhite patients were more likely to have documentation that prognosis was discussed (OR, 1.47; 95% CI, 1.21-1.77) and that physicians recommended withdrawal of life support (OR, 1.57; 95% CI, 1.11-2.21). Nonwhite patients also were more likely to have discord documented among family members or with clinicians (OR, 1.49; 95% CI, 1.04-2.15). Socioeconomic status did not modify these associations and was not a consistent predictor of end-of-life care. Conclusions: We found numerous racial/ethnic differences in end-of-life care in the ICU that were not infl uenced by socioeconomic status. These differences could be due to treatment preferences, disparities, or both. Improving ICU end-of-life care for all patients and families will require a better understanding of these issues.

show abstract

Section: Discussionmentioning

confidence: 99%

The Influence of Race/Ethnicity and Socioeconomic Status on End-of-Life Care in the ICU

Muni

Engelberg

Treece

et al. 2011

Chest

172

130

View full text Add to dashboard Cite

show abstract

“…Others have noted cultural differences between decision-making approaches of whites compared to Asian-American 33,34 and Asian versus AsianAmerican physicians 35 that may affect decision making. Physicians who self-identified as Asian in this study were diverse and included both South Asian and East Asian physicians, and native and non-native English speakers.…”

Section: Discussionmentioning

confidence: 99%

Physicians’ Experience with Surrogate Decision Making for Hospitalized Adults

et al. 2009

View full text Add to dashboard Cite

show abstract

“…For parents of the only-child generation, the small family size and adult children's work stresses have strained the ability to provide family support and maintain intergenerational and parent care relationships (Mui 1996). Concerns about accessing a host country's healthcare system (Chappell and Funk 2011;Rawl 1992) and fears of dying in a foreign land (Kwak and Salmon 2007) are also major concerns for Chinese aging parents and their only children living overseas.…”

Section: Challenges and Dilemmas For Transnational Familiesmentioning

confidence: 99%

“I Am the Only Child of my Parents:” Perspectives on Future Elder Care for Parents among Chinese only-Children Living overseas

Gui

Koropeckyj‐Cox

2016

J Cross Cult Gerontol

View full text Add to dashboard Cite

The 1979 One-Child Policy in China created a generation of only children, leading to increased elder care dilemmas for this generation and its aging parents, particularly for young adults studying or working abroad. The current study used in-depth, semi-structured interviews with Chinese young adults who were currently studying or working in Montreal, Canada (N = 20), whose parents still lived in China. The interviews focused on the following topics: elder care patterns of respondents' grandparents; family values and expectations; perceptions of professional long-term care institutions (in China and Canada); and future plans for taking care of aging parents. Respondents described their grandparents' care as following traditional elder care patterns with multiple familial caregivers, which they appreciated as a positive model that defined their own obligations towards parents. Respondents reported being very close to their parents. Some planned to settle down in Canada and bring their parents, others planned to go back to China. Citing the tradition of filial piety, they expected to take care of their parents in the future, but they also considered the dilemmas involved in caring for aging parents without siblings to share the task, potentially requiring them to find compromises between their personal lives and caring for older parents. Those who planned to settle in Canada raised additional concerns about the challenges of bringing over their parents, including acculturation and access to and communication with health and long-term care providers. The results are discussed in the context of contemporary demographic, economic, and policy concerns about aging, family care, and immigration.

show abstract

Attitudes and Preferences of Korean‐American Older Adults and Caregivers on End‐of‐Life Care

Cited by 114 publications

References 25 publications

The Influence of Race/Ethnicity and Socioeconomic Status on End-of-Life Care in the ICU

The Influence of Race/Ethnicity and Socioeconomic Status on End-of-Life Care in the ICU

Physicians’ Experience with Surrogate Decision Making for Hospitalized Adults

“I Am the Only Child of my Parents:” Perspectives on Future Elder Care for Parents among Chinese only-Children Living overseas

Contact Info

Product

Resources

About