Promoting signing of advance directives in faith communities

Medvene, Louis J.; Wescott, Jo Veta; Huckstadt, Alicia; Ludlum, Joseph; Langel, Sondra; Mick, Katherine A.; Patrick, Renee B.; Base, Michelle

doi:10.1046/j.1525-1497.2003.20351.x

Cited by 23 publications

(13 citation statements)

References 23 publications

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“…Medvene et al achieved an increase in AD completion of 23% in 17 of their faith communities [31]. While studies among African Americans [32, 44] found that spiritual beliefs facilitated end-of-life decision-making, in our study, spiritual beliefs were not significantly associated with either AD completions or proxy conversations.…”

Section: Discussioncontrasting

confidence: 70%

“…In previous studies, perceived higher social support from their religious community was associated with higher odds of AD completion [31, 32, 44]. Other studies suggest that older church attendees look to their churches for social and spiritual support and guidance on end-of-life issues [21, 45, 46].…”

Section: Discussionmentioning

confidence: 97%

“…Promotion of AD completion has been successful in White and African American churches [31, 32]. This study is the first to examine a church-based, culturally-targeted program to promote AD completion among Asian Americans.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans

Sun

Bui

Tsoh

et al. 2016

J Immigrant Minority Health

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Background Having an Advance Directive (AD) can help to guide medical decision-making. Asian Americans (AA) are less likely than White Americans to complete an AD. This pilot study investigated the feasibility and efficacy of a church-based intervention to increase knowledge and behavior change related to AD among Chinese and Vietnamese Americans. Methods This study utilized a single group pre- and post-intervention design with 174 participants from 4 churches. Domain assessed: demographics; AD-related knowledge, beliefs, attitudes, and intentions; AD completion; and conversations with a healthcare proxy. Data were analyzed using chi-square and multiple logistic regression techniques. Results We observed significant increases in participants' AD-related knowledge, intentions, and a gain in supportive beliefs and attitudes about AD, resulting in 71.8% AD completion, and 25.0% having had a proxy conversation. Discussion Providing culturally-tailored intervention and step-by-step guidance can help to achieve significant changes in AD related knowledge and behavior in AA church goers.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 97%

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Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans

Sun

Bui

Tsoh

et al. 2016

J Immigrant Minority Health

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“…A similar pattern was found in one study of buffering against fear of death, which may be associated with having a DNR order (29). Some educational groups have reached out to religious congregations in an effort to encourage end-of-life planning (30-32), perhaps influencing the most religious or spiritual patients. Alternatively, the religious patients in our sample may have been part of religious communities that encourage such planning.…”

Section: Discussionmentioning

confidence: 99%

Religiosity, Spirituality, and End-of-Life Planning: A Single-Site Survey of Medical Inpatients

Karches

Chung

Arora

et al. 2012

Journal of Pain and Symptom Management

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Context Prior studies suggest that terminally ill patients who use religious coping are less likely to have advance directives and more likely to opt for heroic end-of-life measures. Yet, no study to date has examined whether end-of-life practices are associated with measures of religiosity and spirituality. Objectives To assess the relationship between general measures of patient religiosity and spirituality and patients’ preferences for care at the end of life. Methods We examined data from the University of Chicago Hospitalist Study, which gathers sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center. Primary outcomes were whether the patient had an advance directive, a do-not-resuscitate (DNR) order, a durable power of attorney for health care, and an informally designated decision maker. Primary predictors were religious attendance, intrinsic religiosity, and self-rated spirituality. Results The sample population (n=8,308) was predominantly African American (73%) and female (60%). In this population, 1.5% had advance directives and 10.4% had DNR orders. Half (51%) of patients had specified a decision maker. White patients were more likely than African-American patients to have an advance directive (adjusted odds ratio [OR] 2.1; 95% confidence interval [CI] 1.1, 4.0) and a DNR order (OR 1.7; 95% CI 1.0, 2.9). Patients reporting high intrinsic religiosity were more likely to have specified a decision maker than those with low intrinsic religiosity (OR 1.3; CI 1.1, 1.6). The same was true for those with high compared to low spirituality (OR 1.3; CI 1.1, 1.5). Religious characteristics were not significantly associated with having an advance directive or DNR order. Conclusion Among general medicine inpatients at an urban academic medical center, those who were highly religious and/or spiritual were more likely to have a designated decision-maker to help with end-of-life decisions, but did not differ from other patients in their likelihood of having an advance directive or DNR order.

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“…Thirty-six percent of the 248 participants that completed the program either revised an existing AD or completed one for the first time. Thirty-five percent of those who completed the program signed an AD for the first time 27.…”

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confidence: 99%

Promoting completion of advance directives in a Hispanic religious congregation: An evidence-based practice project

Miguel¹,

Clark²

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Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than non-Hispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) in a Hispanic population through culturally appropriate interventions. Intervention: The project was implemented with a Hispanic religious congregation. Two group sessions were held at the congregation's meetinghouse. Informational handouts and exercises were provided to each participant along with an initial knowledge and attitudes questionnaire. Individual reflections and group exercises were used to explore personal views, ways to talk to loved ones about ACP, and how to make difficult healthcare decisions. At the conclusion of the second group session, the same knowledge and attitude questionnaire was completed. Participants then scheduled a one-on-one session to complete an AD. Results: Of the 21 eligible participants, 13 attended both group sessions and scheduled a one-on-one visit. Mean scores for knowledge increased from 71% to 91%; mean attitude and comfort scores increased from 61% to 80%; and 100% of participants who attended both group sessions completed an AD. Conclusion: Increasing AD completion among Hispanics can be achieved through culturally appropriate interventions that increase knowledge about, attitudes toward, and comfort with end-oflife decisions. Promoting completion of ADs can improve care outcomes and decrease 6 costs. More studies are needed among Hispanics that focus on effective interventions to complete ADs, rather than Hispanic end-of-life cultural preferences alone.

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Promoting signing of advance directives in faith communities

Cited by 23 publications

References 23 publications

Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans

Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans

Religiosity, Spirituality, and End-of-Life Planning: A Single-Site Survey of Medical Inpatients

Promoting completion of advance directives in a Hispanic religious congregation: An evidence-based practice project

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