Xiang Gao1, Fei Sun1, Eunjeong Ko2, Jung Kwak3, Huei-Wern Shen4. 1. School of Social Work,Arizona State University,Phoenix,Arizona. 2. School of Social Work,San Diego State University,San Diego,California. 3. School of Social Work,University of Wisconsin-Milwaukee,Milwaukee,Wisconsin. 4. School of Social Work,University of Missouri-St. Louis,St. Louis,Missouri.
Abstract
OBJECTIVE: This study aimed to describe knowledge of an advance directive (AD) and preferences regarding end-of-life (EoL) care communication, decision making, and designation of surrogates in Chinese-American elders and to examine the role of acculturation variables in AD awareness. METHOD: Survey data were collected through face-to-face interviews on a sample of 385 Chinese-American elders aged 55 or above living in the Phoenix metropolitan area. The choice of language (Mandarin, Cantonese, or English) and place of interview (senior apartments, Chinese senior centers, or homes) was at the respondent's preference. Hierarchical logistic regression analysis was employed to examine the influence of acculturation variables on AD awareness. RESULTS: Some 21% of participants had heard about ADs, and only 10% had completed one. Elders with higher acculturation levels (OR = 1.04, p < 0.10) and those residing more than 20 years in the United States (OR = 6.87, p < 0.01) were more likely to be aware of ADs after controlling for the effects of demographics, health, and experiences of EoL care. The majority preferred physicians to initiate AD discussions (84.9%) and identified burdens on families as the most important factor in making EoL decisions (89.3%). About 55.1 % considered daughters as the preferred healthcare surrogate. SIGNIFICANCE OF RESULTS: Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.
OBJECTIVE: This study aimed to describe knowledge of an advance directive (AD) and preferences regarding end-of-life (EoL) care communication, decision making, and designation of surrogates in Chinese-American elders and to examine the role of acculturation variables in AD awareness. METHOD: Survey data were collected through face-to-face interviews on a sample of 385 Chinese-American elders aged 55 or above living in the Phoenix metropolitan area. The choice of language (Mandarin, Cantonese, or English) and place of interview (senior apartments, Chinese senior centers, or homes) was at the respondent's preference. Hierarchical logistic regression analysis was employed to examine the influence of acculturation variables on AD awareness. RESULTS: Some 21% of participants had heard about ADs, and only 10% had completed one. Elders with higher acculturation levels (OR = 1.04, p < 0.10) and those residing more than 20 years in the United States (OR = 6.87, p < 0.01) were more likely to be aware of ADs after controlling for the effects of demographics, health, and experiences of EoL care. The majority preferred physicians to initiate AD discussions (84.9%) and identified burdens on families as the most important factor in making EoL decisions (89.3%). About 55.1 % considered daughters as the preferred healthcare surrogate. SIGNIFICANCE OF RESULTS: Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.
Entities:
Keywords:
Acculturation; Advance directive; Chinese-American elders; End-of-life care
Authors: Wan-Ting Tsai; Chun-Min Chen; Ming-Cheng Chung; Pei-Yu Tsai; Yen-Tzu Liu; Feng-Cheng Tang; Ying-Li Lin Journal: Int J Environ Res Public Health Date: 2022-04-26 Impact factor: 4.614
Authors: Zhimeng Jia; Richard E Leiter; Justin J Sanders; Donald R Sullivan; Pedro Gozalo; Jennifer N Bunker; Joan M Teno Journal: J Gen Intern Med Date: 2021-04-26 Impact factor: 5.128