Mexicans and care for the terminally ill: Family, hospice, and the church

Gelfand, Donald E.; Balcázar, Héctor; Parzuchowski, Jeanne; Lenox, Susana

doi:10.1177/104990910101800608

Cited by 50 publications

(76 citation statements)

References 14 publications

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“…This finding contradicts previous findings by Gelfand et al (2001) and further adds to the speculations of other researchers about Acculturation and Attitudes of Latinos 241 the role of acculturation on the disproportionate use of hospice by Latinos when compared to Whites and African Americans. Furthermore, this finding highlights the importance of addressing the role of socioeconomic factors in studies of Latinos where acculturation is a variable, as suggested by Hunt et al (2004).…”

Section: Discussioncontrasting

confidence: 83%

“…Researchers have theorized that acculturation plays a role in hospice use by Latinos (Colón & Lyke, 2003;Gelfand et al, 2001Gelfand et al, , 2004Noggle, 1995;Topolesky, 1997); however, research in which acculturation is measured directly in relation to attitudes of Latinos toward hospice is limited. Gelfand et al (2001) measured acculturation directly in relation to attitudes of Latinos toward hospice.…”

Section: Literature Reviewmentioning

confidence: 97%

“…Gelfand et al (2001) measured acculturation directly in relation to attitudes of Latinos toward hospice. In their qualitative study with 65 participants, Gelfand et al 230 M. Colo´n (2001) used a unidimensional acculturation scale and found that not all participants were ready to use hospice services.…”

Section: Literature Reviewmentioning

confidence: 99%

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Acculturation and Attitudes of Latinos Toward Hospice

Colón¹

2012

Journal of Social Work in End-Of-Life & Palliative Care

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The relationship between acculturation and attitudes of Latinos toward hospice was examined in a sample of 380 Latinos from southern New Jersey. A survey design, using self-administered questionnaires, including a bi-dimensional acculturation scale, examined attitudes toward hospice. The sample represented a cross-section of socioeconomic groups and various nationalities of Latinos. Findings revealed that education and income were significantly related to attitudes toward hospice but acculturation was not. Findings also revealed that more than one-half of participants were unfamiliar with the word "hospice" prior to the study. Respondents with higher incomes, higher levels of education, and who were older were more familiar and had more positive attitudes. Overall, despite respondents' limited knowledge of hospice, the majority would use it. These findings underscore the need to intensify hospice education in Latino communities taking into account Latinos' socioeconomic status.

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Section: Discussioncontrasting

confidence: 83%

Section: Literature Reviewmentioning

confidence: 97%

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Acculturation and Attitudes of Latinos Toward Hospice

Colón¹

2012

Journal of Social Work in End-Of-Life & Palliative Care

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“…This idea is also consistent with what is known about general Latino cultural preferences for indirect communication. 12,16,20,21 In our sample, 38% felt that the hypothetical cancer patient should maintain treatment with a curative intent. Others have observed that Latinos in the Medicare population prefer lifesustaining therapy more often than whites 10,44 and have higher rates of intensive procedures (and health care costs) in the last six months of life than whites or blacks.…”

Section: Discussionmentioning

confidence: 90%

“…Moreover, despite some research on ethnic and cultural differences in attitudes toward death and dying, [12][13][14][15][16][17][18][19] there are limited quantitative data on how Latino cultural values may affect hospice use, and most of what is known comes from research with Mexican Americans. 12,16,20,21 In this cross-sectional study we evaluate knowledge about and intentions to use hospice among a community sample of immigrant Latinos from Central and South America in safetynet clinics. We hypothesized that greater social acculturation would be associated with greater knowledge about hospice after considering other factors.…”

Section: Introductionmentioning

confidence: 99%

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Selsky

Kreling

Luta

et al. 2012

Journal of Palliative Medicine

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Background: Hospice use is low in Latinos but we know little about explanations for this pattern. Objective: To describe factors associated with knowledge of and intention to use hospice for cancer care. Methods: We conducted a Spanish-language, interviewer-administered cross-sectional survey of 331 Latino immigrants from Central and South America in safety-net clinics. Hospice intentions were measured using a hypothetical scenario. We used logistic regression and multiple imputations to test associations between cultural values, social acculturation, and other variables and knowledge and intentions. Results: Only 29% knew about hospice and 35% would choose hospice care (once it was defined). Collectivist (group-focused) views (odds ratio [OR] 1.06 per 1-point increase, 95% confidence interval [CI] 1.01-1.12, p = .05), endorsing family-centric values (OR 1.03 per 1-point increase, 95% CI 1.01-1.04, p = .004), and higher education were associated with greater hospice knowledge after considering covariates. Greater social ties were also independently associated with greater knowledge, but knowledge was not related to hospice intentions. Individuals who believed in maintaining secrecy about prognosis were 19% less likely to choose hospice than those who did not endorse secrecy (OR 0.81, 95% CI 0.67-0.99, p = .038). The most socially acculturated individuals were significantly more likely to choose hospice than those with less acculturation (OR 1.19 for each 1-unit increase, 95% CI 10.6-1.34, p = .004). Conclusions: Hospice knowledge may be necessary but is not sufficient to increase hospice use among immigrant Latinos. Latino social networks and organizations may provide a natural leverage point for interventions. Interventions to increase hospice use may need to consider culturally related values.

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Palliative Care for Latino Patients and Their Families

Smith

Sudore²,

Pérez‐Stable³

2009

JAMA

123

121

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Latinos account for 15% of the US population, a proportion projected to grow to 30% by the year 2050. Although there is tremendous diversity within this community, commonalities of language, beliefs, attitudes, and behaviors unite Latinos, making them more similar than different. For non-Latino and non-Spanish-speaking clinicians, communication barriers and cultural misunderstandings can impede the care of dying Latino patients and their families. We present the case of a young, pregnant, Spanish-speaking woman from Guatemala diagnosed with a fatal leukemia. As illustrated by this case, Latino immigrants face a number of external challenges to optimal end-of-life care: (1) geographic distance as well as political and economic realities often separate patients from their valued families; (2) undocumented immigrants are frequently uninsured, and fear of deportation may create a barrier to accessing health services; (3) language and literacy barriers; and (4) concerns about discrimination. Other Latino issues that may be more pronounced in end-of-life settings include cultural themes and religious and spiritual influences. We recommend that professional interpreters must be used for discussions about goals of care with Spanish-speaking patients and families, or when negotiating conflict between the patient, family, and the health care team. Concrete suggestions are provided for clinicians in working with interpreters, eliciting culturally-based attitudes and beliefs, and implementing universal strategies for clear health communication.

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Mexicans and care for the terminally ill: Family, hospice, and the church

Cited by 50 publications

References 14 publications

Acculturation and Attitudes of Latinos Toward Hospice

Acculturation and Attitudes of Latinos Toward Hospice

Hospice Knowledge and Intentions among Latinos Using Safety-Net Clinics

Palliative Care for Latino Patients and Their Families

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