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

Robinson, Maisha T.

doi:10.1089/jpm.2015.0321

Cited by 6 publications

(8 citation statements)

References 5 publications

(4 reference statements)

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“…The Torke et al (2005) study also confirmed AA participants believe EOL is in God’s hands, and making personal EOL care plans ahead of time would be preempting God’s control over life and death. Several other studies documented similar strong spiritual beliefs about EOL and ACP among AAs with similar findings (Carr, 2012; Ko & Lee, 2014; Rhodes et al, 2015; Robinson, 2016; Wicher & Meeker, 2012).…”

Section: Resultssupporting

confidence: 65%

“…Melhado and Bushy (2011) also reported low health literacy among AA patients as a factor affecting EOL planning, finding that participants sometimes perceived ACP questions as addressing euthanasia or assisted suicide, thereby affecting lower rates of AD completion. Many other studies have reported low health literacy as a factor contributing to low AD completions among AAs, finding participants thought having ADs might limit health care options and services (Ko & Lee, 2014; Koss & Baker, 2016; Rhodes et al, 2015; Robinson, 2016; Wicher & Meeker, 2012).…”

Section: Resultsmentioning

confidence: 99%

“…Mistrust has been reported in many studies, most in the context of decreased use of ADs. Findings revealed that AAs discuss EOL care preferences with trusted family and clergy, but often do not have written documents due to fear of receiving too little or lower quality care if preferences are written (Ko & Lee, 2014; Piamjariyakul et al, 2014; Rhodes et al, 2015; Robinson, 2016; Waite et al, 2013; Wicher & Meeker, 2012).…”

Section: Resultsmentioning

confidence: 99%

“…The literature supports that WAs tend to express EOL wishes in formal AD documents, yet AAs are more likely to depend on family members and trusted clergy to communicate preferences at EOL to health care professionals (Giger et al, 2006; Hlubocky, 2014; Piamjariyakul et al, 2014; Volker, 2005; Wicher & Meeker, 2012). The desire for EOL communal decision making with trusted family and clergy has been documented, and is likewise interrelated to mistrust of the health care system by AAs (Robinson, 2016; Torke et al, 2005; Wicher & Meeker, 2012). Communal decision making is also closely related to the ideas of autonomy and self-determination, yet many AAs prefer that these decisions be determined by those individuals closest and dearest to them rather than doing so personally.…”

Section: Resultsmentioning

confidence: 99%

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Cultural Aspects of End-of-Life Care Planning for African Americans: An Integrative Review of Literature

et al. 2018

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Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are affected by demographic variables, cultural distinctives related to patient autonomy, mistrust of the health care system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. An integrative review was conducted to synthesize nursing knowledge regarding cultural perspectives of end-of-life and advance care planning among African Americans. Twenty-four articles were reviewed. Nurses educate patients and families about end-of-life planning as mandated by the Patient Self-Determination Act of 1991. Implementation of advance directives promote patient and family centered care, and should be encouraged. Clinicians must be sensitive and respectful of values and practices of patients of diverse cultures, and initiate conversations with open-ended questions facilitating patient trust and sharing within the context of complex beliefs, traditions, and lifeways.

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Section: Resultssupporting

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cultural Aspects of End-of-Life Care Planning for African Americans: An Integrative Review of Literature

et al. 2018

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“…The difference between informal and formal ACP participation rates among African American women with chronic conditions may be due in part to social and cultural factors, such as mistrust in the healthcare system, to which lower ADs among African Americans have been attributed. In past studies, African Americans have preferred an informal discussion with family members or clergy as opposed to the formal completion of ADs, due to the perception that ADs may lead to receiving too little or a lower quality of care (Wicher and Meeker, 2012; Rhodes et al, 2015; Robinson, 2016). However, the present study did not include or compare the ACP participation of a White group with that of an African American group, nor did it directly assess participants' preferences for treatments at the EOL.…”

Section: Discussionmentioning

confidence: 99%

Factors related to advance care planning among older African American women: Age, medication, and acute care visits

Kwak

Ellis

2019

Pall Supp Care

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Objectives Advance care planning (ACP) is linked with high-quality clinical outcomes at the end of life. However, ACP engagement is lower among African Americans than among Whites. In this study, we sought to identify correlates of ACP among African American women with multiple chronic conditions for two reasons: (1) African American women with multiple chronic conditions have high risks for serious illnesses, more intensive treatments, and circumstances that may require substitutes' decision-making and (2) identifying correlates of ACP among African American women can help us identify important characteristics to inform ACP outreach and interventions for this group. Methods A cross-sectional survey was conducted with 116 African American women aged ≥50 years who were recruited from the central area of a mid-western city. Results On average, participants were 64 years old (SD = 9.42). The majority were not married (78%), had less than a college education (50%), and had an annual income of $15,000 (54%). Their mean numbers of chronic conditions and prescribed medications were 3.31 (SD = 1.25) and 8.75 (SD = 4.42), respectively. Fifty-nine per cent reported having talked with someone about their preferences (informal ACP); only 30% had completed a living will or a power of attorney for healthcare (formal ACP). Logistic regression showed that age, the number of hospitalizations or emergency department visits, and the number of prescription medications were significantly correlated with both informal and formal ACP; other demographic and psychosocial characteristics (the knowledge of ACP, self-efficacy, and trust in the medical system) were not. Significance of results Results of this study suggest a need for targeted, culturally sensitive outpatient ACP education to promote ACP engagement in older African American women, taking into account age, the severity of chronic conditions, and levels of medication management.

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

Cited by 6 publications

References 5 publications

Cultural Aspects of End-of-Life Care Planning for African Americans: An Integrative Review of Literature

Cultural Aspects of End-of-Life Care Planning for African Americans: An Integrative Review of Literature

Factors related to advance care planning among older African American women: Age, medication, and acute care visits

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

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