Examining the relationship between death attitude and AD completion and attitude among older Chinese Americans

研究老年华裔美国人的死亡态度与 AD 完成度和态度之间的关系

• 批准号: 10575699
• 负责人: Kaipeng Wang
• 金额: $ 8.56万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10575699
• 关键词: Acculturation; Address; Advance Care Planning; Advance Directives; Affect; Age; Aging; American; Asian Americans; Attitude; Awareness; Behavioral Model; Buddhism; Cessation of life; Chinese; Chinese American; Communication; Cross-Sectional Studies; Data; Demographic Factors; Elderly; Ensure; Ethnic Population; Family; Family Relationship; Family member; Focus Groups; Future; Goals; Grant; Health; Health Personnel; Health Professional; Health behavior; Healthcare; Hospitals; Immigrant; Individual; Intervention; Knowledge; Legal; Life; Literature; Medical; Medical Care Costs; Methods; Minority; Minority Groups; Modeling; Participant; Patients; Personal Satisfaction; Persons; Play; Population; Positioning Attribute; Predisposing Factor; Quality of Care; Questionnaires; Religion; Religiosity; Research; Role; Shapes; Surveys; Terminal Disease; Theoretical model; United States; Work; age group; aged; behavior change; design; disparity elimination; end of life; end of life care; expectation; health service use; improved; intergenerational; multiple chronic conditions; negative affect; preference; psychosocial; sex; social; social factors; structural determinants

PROJECT ABSTRACT Advance directive (AD) completion is associated with improved quality of end-of-life (EOL) care, reduced use of aggressive and costly medical treatments, lower likelihood of in-hospital deaths, and lessened decisional burden of healthcare surrogates. Older Chinese Americans, despite being the fastest growing and the second largest immigrant population in the United States, have significantly lower AD completion rate (10%-14%) than the general older American population (37%-60%). Although a few studies have examined demographic and cultural factors of AD completion among older Chinese Americans, death attitude, a modifiable and culturally salient factor, has been overlooked. Death attitude closely intersects with many aspects of Chinese culture, such as filial piety, centrality of the family, familial hierarchy, and religion. Furthermore, Chinese Americans believe that discussing death brings bad luck and therefore they tend to avoid topics related to death in conversation, which greatly hinders advance care planning and negatively affects the well-being of older Chinese Americans and their family members. To address this knowledge gap, this project will use an explanatory sequential mixed-methods design and focus on the following specific aims: (Aim 1) identify factors, i.e., demographic, social, and structural factors, that are associated with older Chinese Americans’ death attitude; (Aim 2) examine the association between death attitude and attitude toward AD and AD completion among older Chinese Americans; and (Aim 3) evaluate how and in what ways any significant factors identified in Aim 2 influence older Chinese Americans’ AD completion and attitude toward AD through focus groups. Informed by the Andersen’s Health Service Utilization Model, we will collect and analyze quantitative survey data to address Aims 1 and 2. Then, informed by the Transtheoretical Model for Behavioral Change, we will collect and analyze qualitative data from focus groups to address Aim 3. Findings will inform future research on developing, evaluating, and implementing culturally responsive interventions that improve advance care planning and AD completion and fill critical gaps in research specifically to the advance care planning needs among older Chinese Americans.

项目摘要 提前指令（AD）完成与改善寿命终止（EOL）护理的质量有关，使用减少 侵略性和昂贵的医疗治疗，院内死亡的可能性较低，决策降低了 医疗保健代理的负担。年长的中国美国人，多皮是增长最快的人，第二个 美国最大的移民人口的广告完成率明显降低（10％-14％） 美国较老的人口（37％-60％）。尽管一些研究检查了人口统计和 年长美国人的广告完成的文化因素，死亡态度，一种可修改和文化的变化 显着因素被忽略了。死亡态度与中国文化的许多方面紧密相交， 例如，家庭，家庭等级和宗教的虔诚，中心地位。此外，华裔美国人 相信讨论死亡会带来厄运，因此他们倾向于避免与死亡有关的话题 对话，这极大地阻碍了护理计划，并对年龄较大的福祉产生负面影响 中国美国人及其家人。为了解决这个知识差距，该项目将使用 剥夺顺序混合方法设计并关注以下特定目的：（目标1）确定因素， 即与老年美国人死亡有关的人口，社会和结构性因素 态度; （目标2）检查死亡态度与对广告的态度与完成的态度之间的关联 在中国年长的美国人中； （目标3）评估如何以及以什么方式确定任何重要因素 在AIM 2中影响了老年美国人通过焦点小组对广告的广告完成和态度。 在安徒生的卫生服务利用模型中，我们将收集和分析定量调查 要解决目标1和2的数据。然后，由行为改变的跨理论模型告知，我们将 从焦点小组收集和分析定性数据以解决目标3。发现将为未来的研究提供信息 在开发，评估和实施文化反应迅速的干预措施以改善预先护理 规划和广告完成并填补了针对预先护理计划需求的研究的关键空白 在中国年长的美国人中。