The effects of race on patient preferences and spouse substituted judgments.
The effects of race on patient preferences and spouse substituted judgments.
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DOI：
10.2190/ag.69.1.c
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发表时间：
2009
影响因子：
2
通讯作者：
Wilson-Genderson M
中科院分区：
文献类型：
--
作者：
Pruchno R;Cartwright FP;Wilson-Genderson M
关于种族如何影响临终决策的方式的了解很少，但这些信息对于在临终时提供文化敏感的护理至关重要。对 34 名患有终末期肾病的黑人和 34 名白人患者及其配偶的社会人口统计特征进行匹配的数据显示，黑人和白人患者对继续透析的偏好没有显着差异。然而，黑人和白人配偶的替代判断彼此不同，黑人配偶更有可能表明他们相信患者在一系列假设条件下比白人配偶更倾向于继续透析。结构方程模型分析显示，黑人和白人配偶之间配偶替代判断的差异被解释为患者健康认知和护理负担方面的种族差异的直接函数，而间接影响则与配偶对死亡的恐惧和参与宗教服务有关。我们得出的结论是，这些变量而不是种族本身解释了临终决策的差异。
Knowledge about the ways in which race affects decision-making at the end of life is minimal, yet this information is critical for providing culturally sensitive care at the end of life. Data matching socio-demographic characteristics of 34 black and 34 white patients with end-stage renal disease and their spouses reveal that there are no significant differences in the preferences to continue dialysis on the part of black and white patients. However, the substituted judgments of black and white spouses differ from one another, with black spouses being more likely to indicate that they believe that the patient would be more inclined to continue dialysis under a host of hypothetical conditions than white spouses. Structural equation modeling analyses revealed that differences in spouse substituted judgments between black and white spouses are explained as a direct function of race differences in perception of patient’s health, and caregiver burden, and that indirect effects are associated with spouse’s fear of death and participation in religious services. We conclude that these variables rather than race per se explain differences in end of life decision making.