Factors That Impact End-of-Life Decision Making in African Americans with Advanced Cancer (710)

Abstract

Significance African Americans with cancer are less likely to use hospice services and more likely to die in the hospital than white patients with the same diagnosis. However, there is much that is not understood about the factors that lead African Americans to choose options for end-of-life care. Design A qualitative, descriptive design was used in this pilot study. Methods Interviews were conducted with two groups of African Americans with advanced-stage cancer (people enrolled in hospice and those who were not under hospice care). Findings End-of-life decisions were primarily guided by clinical factors, the patient-related physical, emotional, and cognitive symptoms that are sequelae of the underlying disease or medical treatments. The physician was the healthcare provider most likely to be involved in decision making with patients, family members, and caregivers. Individual factors, such as personal beliefs, influenced end-of-life decision making. Religion and spirituality were a topic in many interviews, but they did not consistently influence decision making. Discussion Future studies should include interviews with family members, caregivers, and healthcare professionals so that factors that impact end-of-life decision making can be fully described. Strategies to facilitate recruitment will need to be added to future protocols.

Introducing Psychoeconomics of Healthcare Decisions: Understanding the Why behind Our Choices

“…Traditional economic models, which assume perfect rationality (the idea that people make perfectly logical decisions based on all available information), fall short in explaining these intricacies (Camerer et al, 2003). These models often fail to account for the emotional considerations, cognitive limitations, and socio-economic factors that significantly influence how we approach healthcare decisions (Campbell et al, 2011). Limited access to preventive care due to financial constraints can lead to poorer health outcomes, while treatment adherence relies not only on medical advice but also on the ability to afford medications and manage potential financial burdens.…”