Hispanic access to hospice services in a predominantly Hispanic community

Adams, Carolyn E.; Horn, Kathryn; Bader, Julia

doi:10.1177/104990910602300103

Cited by 18 publications

(23 citation statements)

References 4 publications

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“…6,42 Since only 35% of our Latino sample would have recommended hospice services in the hypothetical scenario depicting a cancer patient at the end of life, there may indeed be an ethnicity gap in hospice use. Since education attainment was associated with intention to use hospice care, it is possible that the low educational levels among Latinos, especially immigrant Latinos, may contribute to this gap.…”

Section: Discussionmentioning

confidence: 99%

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Selsky

Kreling

Luta

et al. 2012

Journal of Palliative Medicine

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Background: Hospice use is low in Latinos but we know little about explanations for this pattern. Objective: To describe factors associated with knowledge of and intention to use hospice for cancer care. Methods: We conducted a Spanish-language, interviewer-administered cross-sectional survey of 331 Latino immigrants from Central and South America in safety-net clinics. Hospice intentions were measured using a hypothetical scenario. We used logistic regression and multiple imputations to test associations between cultural values, social acculturation, and other variables and knowledge and intentions. Results: Only 29% knew about hospice and 35% would choose hospice care (once it was defined). Collectivist (group-focused) views (odds ratio [OR] 1.06 per 1-point increase, 95% confidence interval [CI] 1.01-1.12, p = .05), endorsing family-centric values (OR 1.03 per 1-point increase, 95% CI 1.01-1.04, p = .004), and higher education were associated with greater hospice knowledge after considering covariates. Greater social ties were also independently associated with greater knowledge, but knowledge was not related to hospice intentions. Individuals who believed in maintaining secrecy about prognosis were 19% less likely to choose hospice than those who did not endorse secrecy (OR 0.81, 95% CI 0.67-0.99, p = .038). The most socially acculturated individuals were significantly more likely to choose hospice than those with less acculturation (OR 1.19 for each 1-unit increase, 95% CI 10.6-1.34, p = .004). Conclusions: Hospice knowledge may be necessary but is not sufficient to increase hospice use among immigrant Latinos. Latino social networks and organizations may provide a natural leverage point for interventions. Interventions to increase hospice use may need to consider culturally related values.

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Section: Discussionmentioning

confidence: 99%

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Selsky

Kreling

Luta

et al. 2012

Journal of Palliative Medicine

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“…In terms of maintaining their families, minority caregivers live more often than Whites with family members other than the patient (Adams et al 2006; Hinojosa et al 2009). Other researchers report that African American spouse caregivers request the assistance of family members most often (Feld et al 2004), suggesting a stronger communal view of caregiving than other ethnic groups.…”

Section: Culture and Caregiving Familiesmentioning

confidence: 99%

Patterns of Caregiving of Cuban, Other Hispanic, Caribbean Black, and White Elders in South Florida

Friedemann

Buckwalter

Newman

et al. 2013

J Cross Cult Gerontol

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Caregivers in Miami, Florida (185 Cubans, 108 other Hispanics, 229 non-Hispanic Whites, and 73 Caribbean Blacks) were described and compared along demographic and health variables, cultural attitudes, and caregiving behaviors. Participants were recruited at random through Home Health Services (61 %) and convenience sampling in the community (39 %), and interviewed at their home. Standardized instruments and measures constructed for this study were pretested. Multivariate analyses showed that the ethnic groups differed in age, education, income, and number of persons giving care, while caregiver health and patient functioning were similar. Controlling for demographics, differences in cultural variables were small. The sense of obligation, emotional attachment, openness about who should give care, spirituality, use of family help or community services were comparable in all groups. Commitment to caregiving was high, driven mainly by patient needs. Cubans had the greatest family stability, and worked the hardest, with the lowest sense of burden. Caribbean Black caregivers lived in bigger families, were youngest, and their patients had the lowest cognitive status. Burden was felt most by White caregivers who were older than the others. Professionals need to understand complex belief systems and behavior patterns to assist caregivers in mobilizing appropriate resources.

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“…(10) It has also been reported that ethnicity had no bearing on timing of access, while other findings are that palliative care services have been disproportionately accessed by Caucasians. (10) While these contradictions are probably related to the social contexts of the studies, (14) comparative research might help identify the underlying factors that contribute to these superficial differences.…”

Section: Patient and Family-related Issuesmentioning

confidence: 99%

Barriers to accessing palliative care: A review of the literature

Love

Liversage

2013

Progress in Palliative Care

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The aim was to review factors affecting patients' access to palliative care. First, the benefits of palliative care for comprehensive care of patients and their families are identified. Despite these benefits, universal standards for access are lacking and referral typically occurs later than is recommended, limiting access to best practice care. Factors relating to access are reviewed in detail. They are grouped conceptually, combining those related to organisational factors, patient and family-related issues, which include characteristics of patients, preferences for curative care, and willingness to discuss and participate in palliative care, and factors attributed to physicians and health professionals, such as communication styles, sense of efficacy, perceptions of patient readiness, and knowledge of palliative care. Despite the accumulated evidence, the existing studies share methodological weaknesses, which are (1) Yet referrals to PC can still be untimely, poorly managed, or delayed. An earlier review of the literature has identified the problems and issues associated with accessing PC.(2) The aim of this paper is to review the literature published in the decade since, addressing factors associated with access to PC services and to suggest aspects of access to PC requiring further investigation. Referral to palliative careMany studies have demonstrated that earlier access to palliative care may have positive benefits, addressing issues such as anticipatory grief and loss throughout the trajectory, facilitating improved symptom management, improved mood, and overall quality of life. (3,4) Despite the demonstrated benefits, PC use is often less than optimal and opportunities are frequently missed. Table 1.Insert Table 1 about here Factors affecting access to palliative care servicesIn order to conceptualise the many interrelated factors that have been identified as affecting access to PC services, a theoretical model was devised (Figure 1). Patients are considered as part of a family system, including carers and other family members. Health care teams are spearheaded by treating physicians and are part of health organisations.Communication factors between patients and families and health care teams create the foundation on which relationships are formed. There is a broader context: the wider health care system and social and cultural factors are important influences on access to PC services.

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Hispanic access to hospice services in a predominantly Hispanic community

Cited by 18 publications

References 4 publications

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Patterns of Caregiving of Cuban, Other Hispanic, Caribbean Black, and White Elders in South Florida

Barriers to accessing palliative care: A review of the literature

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