Appointment of a Healthcare Power of Attorney Among Older Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Adults in the Southern United States
Appointment of a Healthcare Power of Attorney Among Older Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Adults in the Southern United States
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DOI：
10.1177/1049909120979787
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发表时间：
2020-12-09
影响因子：
1.9
通讯作者：
Spencer, Mindi
中科院分区：
文献类型：
--
作者：
Dickson, Lexus;Bunting, Samuel;Spencer, Mindi
背景：女同性恋、男同性恋、双性恋、跨性别者和酷儿 (LGBTQ) 老年人口在老龄化过程中可能对医疗和支持性护理的需求更高。这使得医疗保健授权书 (HCPoA) 的任命成为临终关怀的重要组成部分，以确保患者的愿望在生命结束时得到尊重。本研究的目的是评估居住在美国南部的老年 LGBTQ 成年人中对 HCPoA 预约的普遍性和偏好。方法：向居住在美国南部的老年 LGBTQ 成年人分发了一份关于 2018 年 1 月至 3 月期间预约 HCPoA 的在线调查。参与者：该调查由来自北卡罗来纳州、南卡罗来纳州、佐治亚州、阿拉巴马州、密西西比州、路易斯安那州和佛罗里达州的 789 名老年 LGBTQ 成年人完成。 2018 年 1 月至 3 月。结果：总体而言，61.6% 的受访者指定了 HCPoA。拥有指定 HCPoA 的受访者更有可能已婚 (aOR = 5.04, p < .001)、拥有更大的社交网络 (aOR = 3.87, p < .001) 和年龄更大 (aOR = 1.07, p < .001)。与顺性别受访者相比，性别多样化受访者获得指定 HCPoA 的可能性较小（aOR = 0.39，p = .04）。总体而言，大多数受访者表示配偶或其他重要人士担任他们的 HCPoA（n = 311，64.5%）。结论：美国南部近 40% 的老年 LGBTQ 成年人没有指定的 HCPoA。具体来说，那些在社会上更加孤立、单身或被认定为跨性别者或非二元性别的人获得指定 HCPoA 的可能性较小。这些人可能会受益于有关预先护理计划的有针对性的外展活动。
Background:The Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) older adult population may have a heightened need of medical and supportive care while aging. This makes appointment of a healthcare power of attorney (HCPoA) an essential component of end-of-life care to ensure patients' wishes are honored at the end of their lives. The objective of this study was to evaluate the prevalence and preferences for HCPoA appointment among older LGBTQ adults living in the Southern United States.Methods:An online survey was distributed to older LGBTQ adults living in the Southern US regarding appointment of a HCPoA between January-March 2018.Participants:The survey was completed by 789 older LGBTQ adults from North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana, and Florida in January-March 2018.Results:Overall, 61.6% of respondents had appointed a HCPoA. Respondents with an appointed HCPoA were more likely to be married (aOR = 5.04, p < .001), have larger social networks (aOR = 3.87, p < .001) and be older (aOR = 1.07, p < .001). Gender diverse respondents were less likely to have an appointed HCPoA relative to cisgender respondents (aOR = 0.39, p = .04). Overall, the majority of respondents indicated a spouse or significant other served as their HCPoA (n = 311, 64.5%).Conclusions:Nearly 40% of older LGBTQ adults in the Southern US did not have an appointed HCPoA. Specifically, those who were more socially isolated, single, or who identified as transgender or gender non-binary were less likely to have an appointed HCPoA. These people may benefit from targeted outreach regarding advance care planning.