RACIAL DIFFERENCES IN END-OF-LIFE PLANNING: WHY DON'T BLACKS AND LATINOS PREPARE FOR THE INEVITABLE?
RACIAL DIFFERENCES IN END-OF-LIFE PLANNING: WHY DON'T BLACKS AND LATINOS PREPARE FOR THE INEVITABLE?
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DOI：
10.2190/om.63.1.a
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发表时间：
2011-01-01
影响因子：
2
通讯作者：
Carr, Deborah
中科院分区：
文献类型：
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作者：
Carr, Deborah
我评估在何种程度上提前护理规划的种族差异反映了文化和宗教的态度和亲人的痛苦死亡的经验。数据来自293名慢性病老年人的样本，他们在新泽西城市的两个大型医疗中心之一寻求护理。黑人和西班牙裔人比白人更不可能有生前遗嘱，医疗保健的持久授权书（DPAHC），并讨论了他们的临终治疗偏好。多变量分析显示，黑人和白人在提前护理计划方面的差距在很大程度上是由于黑人相信上帝控制死亡的时间和性质。西班牙裔和白人之间的差距部分是由于人们认为自己的疾病会对家人产生负面影响。种族差异在生活意愿和DPAHC使用方面最为明显，在讨论方面则不那么明显。政策和实践的影响进行了讨论。
I evaluate the extent to which ethnic disparities in advance care planning reflect cultural and religious attitudes and experience with the painful deaths of loved ones. Data are from a sample of 293 chronically ill older adults who are seeking care at one of two large medical centers in urban New Jersey. Blacks and Hispanics are significantly less likely than Whites to have a living will, a durable power of attorney for health care (DPAHC), and to have discussed their end of life treatment preferences. Multivariate analyses reveal that the Black-White gap in advance care planning is largely accounted for by Blacks' belief that God controls the timing and nature of death. The Hispanic-White gap is partially accounted for by the belief that one's illness negatively affects one's family. Ethnic disparities are starkest for living will and DPAHC use, and less pronounced for discussions. Implications for policy and practice are discussed.