End-of-Life Decision Making and Communication of Bereaved Family Members of African Americans with Serious Illness
End-of-Life Decision Making and Communication of Bereaved Family Members of African Americans with Serious Illness
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DOI：
10.1089/jpm.2015.0314
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发表时间：
2016-02-01
影响因子：
2.8
通讯作者：
Rawl, Susan M.
中科院分区：
文献类型：
--
作者：
Smith-Howell, Esther R.;Hickman, Susan E.;Rawl, Susan M.
目的：本研究的目的是探讨影响非裔美国人（AA）家庭成员的临终关怀决策结果的一个相对谁最近死于严重疾病。方法：采用横断面描述性研究设计的因素。二元逻辑和线性回归被用来确定与决策后悔和决策冲突的因素。从中西部的一家安全网医院和一家大都会教堂的姑息治疗项目中招募了49名在入组前2 - 6个月死于严重疾病的AA死者的AA家属。所使用的测量方法是决策冲突，决策遗憾，信仰和价值观，沟通scales.Results质量：家庭成员谁报告更高质量的沟通与卫生保健提供者有较低的决策冲突。接受以舒适为中心的护理（CFC）的死者家属比接受延长生命治疗（LPT）的家属有更少的决定后悔。家庭成员谁报告更强的信念和价值观有更高的质量与供应商和较低的决策confliction.Conclusions的沟通：这项研究增加了一个小的机构的文学之间的相关性的临终决策结果AA。尽管AA对积极的临终关怀的偏好是有据可查的，但我们发现收到CFC与较少的决定后悔有关。为了减少决策冲突和决策遗憾在生命的最后，未来的研究应确定策略，以改善家庭成员提供者的沟通，同时考虑相关的家庭成员和死者的特点。
Objective: The study objective was to examine factors that influence African American (AA) family members' end-of-life care decision outcomes for a relative who recently died from serious illness.Methods: A cross-sectional descriptive study design was used. Binary logistic and linear regressions were used to identify factors associated with decision regret and decisional conflict. Forty-nine bereaved AA family members of AA decedents with serious illness who died two to six months prior to enrollment were recruited from the palliative care program in a safety net hospital and a metropolitan church in the Midwest. Measurements used were the Decisional Conflict, Decision Regret, Beliefs and Values, and Quality of Communication scales.Results: Family members who reported higher quality of communication with health care providers had lower decisional conflict. Family members of decedents who received comfort-focused care (CFC) had significantly less decision regret than family members of those who received life-prolonging treatment (LPT). Family members who reported stronger beliefs and values had higher quality of communication with providers and lower decisional conflict.Conclusions: This research adds to a small body of literature on correlates of end-of-life decision outcomes among AAs. Although AAs' preference for aggressive end-of-life care is well-documented, we found that receipt of CFC was associated with less decision regret. To reduce decisional conflict and decision regret at the end of life, future studies should identify strategies to improve family member-provider communication, while considering relevant family member and decedent characteristics.