A Preliminary Study Comparing Attitudes toward Hospice Referral between African American and White American Primary Care Physicians

Ache, Kevin A.; Shannon, Robert; Heckman, Michael G.; Diehl, Nancy N.; Willis, Floyd B.

doi:10.1089/jpm.2010.0426

Cited by 18 publications

(19 citation statements)

References 20 publications

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“…13 The overall results were consistent with other studies, revealing positive attitudes toward hospice yet low referral numbers.…”

Section: Barrierssupporting

confidence: 91%

“…13,14 By contrast, 2 studies 14 reported a much higher positive response (99%) on a similar survey question. In our project, providers reported caring for a low number of terminally ill patients in the last 6 months (n = 21), typically reporting between 10 and 20 patients.…”

Section: Attitudesmentioning

confidence: 87%

“…13 The survey had 11 questions examining attitudes and knowledge regarding barriers to hospice referral in primary care and addressed various topics regarding hospice, including beliefs, past experiences, patient perceptions, and referral reasons. Responses used a 5-point Likert scale, with response options of strongly agree, agree, neutral, disagree, and strongly disagree.…”

Section: Methodsmentioning

confidence: 99%

“…The findings were limited to 1 academic center in 1 city and may not be generalizable. 13 In addition, the use of a previously designed survey 13 may not be comprehensive regarding all barriers to hospice referral in primary care. 17 Providers with a personal history of positive hospice experiences may also have been more likely to participate, leading to responder bias.…”

Section: Barriersmentioning

confidence: 99%

“…12 The primary care provider's view of and response to referring patients to hospice need to be further explored. 13 The purpose of this study is to explore primary care providers' attitudes, knowledge about, referral practices, and other barriers to hospice care.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Exploring Barriers Among Primary Care Providers in Referring Patients to Hospice

Torres

Lindstrom

Hannah

et al. 2016

Journal of Hospice & Palliative Nursing

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“…13 The overall results were consistent with other studies, revealing positive attitudes toward hospice yet low referral numbers.…”

Section: Barrierssupporting

confidence: 91%

Section: Attitudesmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Barriersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Exploring Barriers Among Primary Care Providers in Referring Patients to Hospice

Torres

Lindstrom

Hannah

et al. 2016

Journal of Hospice & Palliative Nursing

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Reversing Racial Inequities at the End of Life: A Call for Health Systems to Create Culturally Competent Advance Care Planning Programs Within African American Communities

Belisomo

2017

J. Racial and Ethnic Health Disparities

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Racial and cultural barriers inherent in health systems have made the delivery of culturally relevant end of life care that aligns with patient preferences a particular challenge across African American patient populations. The end of life experience has been cited as a public health crisis by the Institute of Medicine (IOM), and this crisis is one felt even more acutely by patients of this minority race. Structural racism has limited access to the planning mechanisms proven to result in quality end of life care; thus, health systems must initiate remedies in the face of dire need, as African Americans face a disproportionate burden of morbidity and mortality from many serious illnesses. Recognizing that education is essential to overcoming barriers to quality care access, the development of new and culturally appropriate models of community engagement surrounding advance care planning is needed to serve and empower African American patients.

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Decisional Control Preferences, Disclosure of Information Preferences, and Satisfaction Among Hispanic Patients With Advanced Cancer

Noguera

Yennurajalingam

Torres-Vigil

et al. 2014

Journal of Pain and Symptom Management

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Context Studies to determine the decisional control preferences (DCPs) in Hispanic patients receiving palliative care are limited. Objectives The aims of this study were to describe DCPs, disclosure of information, and satisfaction with decision making among Hispanics, and to determine the degree of concordance between patients’ DCPs and their self-reported decisions. Methods We surveyed 387 cancer patients referred to outpatient palliative care clinics in Argentina, Chile, Guatemala, and the U.S. DCPs were measured with the Control Preference Scale, disclosure preferences with the Disclosure of Information Preferences questionnaire, and satisfaction with care with the Satisfaction with Decision Scale. Results In this study, 182 patients (47.6%) preferred shared decisional control, 119 (31.2%) active decisional control, and 81 (21.2%) preferred a passive approach. Concerning diagnosis and prognosis, 345 (92%) patients wanted to know their diagnosis, and 355 (94%) wanted to know their prognosis. Three hundred thirty-seven (87%) patients were satisfied with the decision-making process. DCPs were concordant with the self-reported decision-making process in 264 (69%) patients (weighted kappa, 0.55). Patients’ greater satisfaction with the decision-making process was correlated with older age (P≤0.001) and with a preference for enhanced diagnostic disclosure (P≤0.024). Satisfaction did not correlate with concordance in the decision-making process. Conclusion The vast majority preferred a shared or active decision-making process and wanted information about their diagnosis and prognosis. Older patients and those who wanted to know their diagnosis seemed to be more satisfied with the way treatment decisions were made.

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A Preliminary Study Comparing Attitudes toward Hospice Referral between African American and White American Primary Care Physicians

Abstract: The results of our preliminary study suggest that certain attitudes toward hospice referral may differ between African American and white American PCPs. If validated, further insight into this issue could lead to educational programs for PCPs that correct misperceptions.

Cited by 18 publications

References 20 publications

Exploring Barriers Among Primary Care Providers in Referring Patients to Hospice

Exploring Barriers Among Primary Care Providers in Referring Patients to Hospice

Reversing Racial Inequities at the End of Life: A Call for Health Systems to Create Culturally Competent Advance Care Planning Programs Within African American Communities

Decisional Control Preferences, Disclosure of Information Preferences, and Satisfaction Among Hispanic Patients With Advanced Cancer

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