Barriers to Quality End-of-Life Care for Latinos Hospice Health Care Professionals' Perspective
Barriers to Quality End-of-Life Care for Latinos Hospice Health Care Professionals' Perspective
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DOI：
10.1097/njh.0000000000000277
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发表时间：
2016-12-01
影响因子：
1.8
通讯作者：
Sanchez-Reilly, Sandra
中科院分区：
文献类型：
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作者：
Cruz-Oliver, Dulce M.;Sanchez-Reilly, Sandra
临终关怀是一种满足临终病人护理需求的选择。然而，在拉美裔美国人中推广追求临终关怀(EOL)的意识是具有挑战性的。拉美裔美国人是美国增长最快的少数族裔群体，但他们最不可能为EOL使用临终关怀服务。该项目旨在确定卫生保健提供者(HCP)的自我感知障碍/解决方案，以改善拉美裔和白人占主导地位的社区的拉丁裔患者对临终关怀的利用。焦点小组在2个临终关怀机构进行，以比较对西班牙裔EOL护理的看法。来自德克萨斯州VITAS临终关怀中心的两个HCP组(n=9，12)和密苏里州的1个HCP组(n=24)参与了研究。并进行了定性分析。在各个群体中，所有的初级保健医生都有相似的职业分布(主要是护理)。尽管密苏里州的种族不同，拉美裔患者很少，但发现了共同的EOL障碍，包括语言、宗教和家庭文化。已确定的可能解决办法包括对家庭进行西班牙语教育，利用社区宗教领袖，以及利用媒体(“肥皂剧”)将临终关怀的概念带到西班牙裔家庭。从社区卫生方案的角度，本研究确定了具有潜在卫生保健影响的障碍和解决方案，以文化上适当的方式改善日益增长的西班牙裔社区的临终关怀。
Hospice is an option that serves the care needs of terminally ill patients. However, promoting awareness of pursuing end-of-life (EOL) care among Hispanics is challenging. Hispanics are the fastest growing ethnic minority group in the United States but the most unlikely to use hospice services for EOL. This project was intended to identify health care providers' (HCPs') self-perceived barriers/solutions to improve use of hospice among Latino patients in both Hispanic-predominant and white-predominant communities. Focus groups were conducted at 2 hospice agencies to compare views on Hispanic EOL care. Two HCP groups from VITAS hospice in Texas (n = 9, 12) and 1 in Missouri (n = 24) participated. Qualitative analysis was performed. Across groups, all HCPs had similar distributions of professions (predominantly nursing). Despite the differences in ethnicity and few Hispanic patients in Missouri, common EOL barriers were identified, including language, religion, and family culture. Potential solutions identified included education in Spanish to families, the use of community religious leaders, and use of media ("telenovelas = soap operas") to bring the concept of Hospice to Hispanic homes. From the perspective of HCPs, this study identifies barriers and solutions with potential health care implications to improve hospice care among growing Hispanic communities in a culturally appropriate manner.