Treatment preferences and advance care planning at end of life: The role of ethnicity and spiritual coping in cancer patients

True, Gala; Phipps, Etienne; Braitman, Leonard E.; Harralson, Tina L.; Harris, Diana; Tester, William J.

doi:10.1207/s15324796abm3002_10

Cited by 182 publications

(177 citation statements)

References 40 publications

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“…[14][15][16][17][18][19][20] Formal evaluation of these proposed mediators is important because finding a significant mediator could provide a starting point for a targeted intervention to reduce racial/ethnic differences in ACP, whereas finding a lack of mediation would encourage researchers to search for other potential mediating factors.…”

Section: Journal Of Clinical Oncology O R I G I N a L R E P O R T V Omentioning

confidence: 99%

Racial and Ethnic Differences in Advance Care Planning Among Patients With Cancer: Impact of Terminal Illness Acknowledgment, Religiousness, and Treatment Preferences

Smith

McCarthy

Paulk

et al. 2008

JCO

236

214

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A B S T R A C T PurposeDespite well-documented racial and ethnic differences in advance care planning (ACP), we know little about why these differences exist. This study tested proposed mediators of racial/ethnic differences in ACP. Patients and MethodsWe studied 312 non-Hispanic white, 83 non-Hispanic black, and 73 Hispanic patients with advanced cancer in the Coping with Cancer study, a federally funded multisite prospective cohort study designed to examine racial/ethnic disparities in ACP and end-of-life care. We assessed the impact of terminal illness acknowledgment, religiousness, and treatment preferences on racial/ethnic differences in ACP. ResultsCompared with white patients, black and Hispanic patients were less likely to have an ACP (white patients, 80%; black patients, 47%; Hispanic patients, 47%) and more likely to want life-prolonging care even if he or she had only a few days left to live (white patients, 14%; black patients, 45%; Hispanic patients, 34%) and to consider religion very important (white patients, 44%; black patients, 88%; Hispanic patients, 73%; all P Ͻ .001, comparison of black or Hispanic patients with white patients). Hispanic patients were less likely and black patients marginally less likely to acknowledge their terminally ill status (white patients, 39% v Hispanic patients, 11%; P Ͻ .001; white v black patients, 27%; P ϭ .05). Racial/ethnic differences in ACP persisted after adjustment for clinical and demographic factors, terminal illness acknowledgment, religiousness, and treatment preferences (has ACP, black v white patients, adjusted relative risk, 0.64 [95% CI, 0.49 to 0.83]; Hispanic v white patients, 0.65 [95% CI, 0.47 to 0.89]). ConclusionAlthough black and Hispanic patients are less likely to consider themselves terminally ill and more likely to want intensive treatment, these factors did not explain observed disparities in ACP.

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Section: Journal Of Clinical Oncology O R I G I N a L R E P O R T V Omentioning

confidence: 99%

Racial and Ethnic Differences in Advance Care Planning Among Patients With Cancer: Impact of Terminal Illness Acknowledgment, Religiousness, and Treatment Preferences

Smith

McCarthy

Paulk

et al. 2008

JCO

236

214

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“…Primary barriers indeed include greater mistrust of the health care system, as well as lower knowledge about advance care planning, greater valuation of communal decision making over individual autonomy, and specific spiritual beliefs in African Americans compared to other groups. 1,2 Informed by the knowledge of these known barriers and recognizing that the church is a critical social and valueconveying nexus within the African American community, I assembled a team of community and academic partners, and designed a study that aims to develop and pilot an advance care planning guideline for elderly, churchgoing African Americans in Los Angeles, California. This communitypartnered participatory research project engages pastors and church leaders and trains them in effective techniques to facilitate discussions on advance care planning options within their congregations.…”

mentioning

confidence: 99%

Helping African Americans of Faith Embrace End-of-Life Discussions

Robinson

2016

Journal of Palliative Medicine

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“…5 Prior studies showing ethnic cultural differences over advance care planning, life support, and other aspects of dying further supported our assumption. 3,8,[10][11][12] Our interview study revealed occasional beliefs that may characterize Americans in general, some beliefs that may characterize only certain ethnic groups or genders, and many beliefs that may characterize only particular individuals.…”

Section: Discussionmentioning

confidence: 89%

“…We assumed that culture-the values a group uses to interpret shared experiences and transmits across generations 2,3 -influences those beliefs. 1,[4][5][6][7][8][9][10] We reasoned that, because death is a universal human experience, every culture must address its meaning. 5 Prior studies showing ethnic cultural differences over advance care planning, life support, and other aspects of dying further supported our assumption.…”

Section: Discussionmentioning

confidence: 99%

Patients' diverse beliefs about what happens at the time of death

Perkins

Cortez²,

Hazuda

2011

Journal of Hospital Medicine

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BACKGROUND:Beliefs about what happens at the time of death surely affect a patient's whole dying experience and could help guide end‐of‐life care. Yet virtually no research describes those beliefs. This exploratory study begins the descriptive process.METHODS:Assuming culture is key, we interviewed 26 Mexican‐American (MA), 18 Euro‐American (EA), and 14 African‐American (AA) inpatients about their beliefs concerning what happens at the time of death.RESULTS:One belief, that death separates the dead from the living, was widespread. Majorities of all 3 ethnic group samples and of 5 of the 6 gender subsamples expressed this belief, saying the dead “go” or “leave” from this life. Other beliefs differed by ethnic group or gender. For example, more EAs (50%) than others said death is a momentary event, and more MAs (35%) than others said death involves “being taken” by an external force (always God or Jesus). Furthermore, considerably more EA women (45%) than others said some senses persist after death. In contrast, the physiologic signs that participants cited as defining the exact time of death varied from individual to individual with no ethnic or gender pattern, and no one sign predominated.CONCLUSIONS:A few beliefs about what happens at the time of death may characterize Americans in general; many other beliefs may characterize only certain ethnic groups, genders, or individuals. To identify such beliefs and to use them to guide end‐of‐life care, hospitalists and other health professionals may have to elicit them directly from patients or survivors. Journal of Hospital Medicine 2012. © 2011 Society of Hospital Medicine

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Treatment preferences and advance care planning at end of life: The role of ethnicity and spiritual coping in cancer patients

Cited by 182 publications

References 40 publications

Racial and Ethnic Differences in Advance Care Planning Among Patients With Cancer: Impact of Terminal Illness Acknowledgment, Religiousness, and Treatment Preferences

Racial and Ethnic Differences in Advance Care Planning Among Patients With Cancer: Impact of Terminal Illness Acknowledgment, Religiousness, and Treatment Preferences

Helping African Americans of Faith Embrace End-of-Life Discussions

Patients' diverse beliefs about what happens at the time of death

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