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An examination of Latino-advanced cancer patients' and their informal caregivers' preferences for communication about advance care planning: A qualitative study

Published online by Cambridge University Press:  08 November 2019

Megan Johnson Shen Open the ORCID record for Megan Johnson Shen [Opens in a new window] ,
Cyndi Gonzalez ,
Benjamin Leach ,
Paul K. Maciejewski ,
Elissa Kozlov  and
Holly G. Prigerson
Megan Johnson Shen*
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
Cyndi Gonzalez
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
Benjamin Leach
Affiliation:
Department of Medicine, City of Hope, Duarte, CA
Paul K. Maciejewski
Affiliation:
Cornell Center for Research on End-of-Life Care, New York, NY Department of Radiology, Weill Cornell Medicine, New York, NY
Elissa Kozlov
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
Holly G. Prigerson
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
*
Author for correspondence: Megan Johnson Shen, Weill Cornell Medicine, 420 East 70th St., Office LH 323 New York, NY10021, USA. E-mail: [email protected]
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Abstract

Objectives

Latino-advanced cancer patients engage in advance care planning (ACP) at lower rates than non-Latino patients. The goal of the present study was to understand patients' and caregivers' preferred methods of communicating about ACP.

Methods

Patients and caregivers were interviewed about cultural, religious, and familial beliefs that influence engagement in ACP and preferences for ACP communication.

Results

Findings highlighted that Latino patients respect doctors' medical advice, prefer the involvement of family members in ACP discussions with doctors, hold optimistic religious beliefs (e.g., belief in miracles) that hinder ACP discussions, and prefer culturally competent approaches, such as using their native language, for learning how to discuss end-of-life (EoL) care preferences.

Significance of results

Key cultural, religious, and familial beliefs and dynamics influence Latino engagement in ACP. Patients prefer a family-centered, physician informed approach to discussing ACP with consideration and incorporation of their religious medical beliefs about EoL care. Promising targets for improving the communication of and engagement in ACP include integrating cultural and religious beliefs in ACP discussions, providing information about ACP from the physician, involving family members in ACP discussions and decision-making, and giving instructions on how to engage in ACP discussions.

Keywords

Advance care planningCancerCommunicationEnd-of-life careHealth disparitiesLatino
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 3 , June 2020 , pp. 277 - 284
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

This article has been corrected since its original publication. See doi:10.1017/S1478951520000504.

References

REFERENCES

Beach, MC, Saha, S, Cooper, LA, et al. (2006). The Role and Relationship of Cultural Competence and Patient-Centeredness in Health Care Quality, Vol. 36. New York, NY: Commonwealth Fund.Google Scholar
Blackhall, LJ, Frank, G, Murphy, ST, et al. (1999) Ethnicity and attitudes towards life sustaining technology. Social Science & Medicine 48(12), 1779–1789.CrossRefGoogle ScholarPubMed
Braun, UK, McCullough, LB, Beyth, RJ, et al. (2008) Racial and ethnic differences in the treatment of seriously ill patients: A comparison of African-American, Caucasian and Hispanic veterans. Journal of the National Medical Association 100(9), 1041–1051.CrossRefGoogle ScholarPubMed
Braun, V, Clarke, V and Terry, G (2014) Thematic analysis. In Rohleder, P and Lyons, A (eds), Qualitative Research in Clinical and Health Psychology. Basingstoke: Palgrave MacMillan, pp. 95–113.Google Scholar
Carr, D (2011) Racial differences in end-of-life planning: Why don't Blacks and Latinos prepare for the inevitable? OMEGA--Journal of Death and Dying 63(1), 1–20.CrossRefGoogle ScholarPubMed
Carrion, IV, Nedjat-Haiem, FR and Marquez, DX (2013) Examining cultural factors that influence treatment decisions: A pilot study of Latino men with cancer. Journal of Cancer Education 28(4), 729–737.CrossRefGoogle ScholarPubMed
Cohen, LL (2008) Racial/ethnic disparities in hospice care: A systematic review. Journal of Palliative Medicine 11(5), 763–768.CrossRefGoogle ScholarPubMed
Detering, KM, Hancock, AD, Reade, MC, et al. (2010) The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial. BMJ 340, c1345.CrossRefGoogle ScholarPubMed
Enguidanos, S, Yip, J and Wilber, K (2005) Ethnic variation in site of death of older adults dually eligible for Medicaid and Medicare. Journal of the American Geriatrics Society 53(8), 1411–1416.CrossRefGoogle ScholarPubMed
Felix-Ortiz, M, Newcomb, MD and Myers, H (1994) A multidimensional measure of cultural identity for Latino and Latina adolescents. Hispanic Journal of Behavioral Sciences 16(2), 99–115.CrossRefGoogle Scholar
Garrido, MM, Harrington, ST and Prigerson, HG (2014) End-of-life treatment preferences: A key to reducing ethnic/racial disparities in advance care planning? Cancer 120, 3981–3986.CrossRefGoogle ScholarPubMed
Gordon, HS, Street, RL, Sharf, BF, et al. (2006) Racial differences in doctors’ information-giving and patients’ participation. Cancer 107(6), 1313–1320.CrossRefGoogle ScholarPubMed
Hines, SC, Moss, AH and McKenzie, J (1997) Prolonging life or prolonging death: Communication's role in difficult dialysis decisions. Health Communication 9(4), 369–388.CrossRefGoogle Scholar
Krupat, E, Irish, JT, Kasten, LE, et al. (1999) Patient assertiveness and physician decision-making among older breast cancer patients. Social Science & Medicine 49(4), 449–457.CrossRefGoogle ScholarPubMed
Kwak, J and Haley, WE (2005) Current research findings on end-of-life decision making among racially or ethnically diverse groups. The Gerontologist 45(5), 634–641.CrossRefGoogle ScholarPubMed
Nedjat-Haiem, FR, Lorenz, KA, Ell, K, et al. (2012) Experiences with advanced cancer among Latinas in a public health care system. Journal of Pain and Symptom Management 43(6), 1013–1024.CrossRefGoogle Scholar
Nedjat-Haiem, FR, Carrion, IV, Lorenz, KA, et al. (2013) Psychosocial concerns among Latinas with life-limiting advanced cancers. OMEGA--Journal of Death and Dying 67(1–2), 167–174.CrossRefGoogle ScholarPubMed
Ratner, E, Norlander, L and McSteen, K (2001) Death at home following a targeted advance-care planning process at home: The kitchen table discussion. Journal of the American Geriatrics Society 49(6), 778–781.CrossRefGoogle ScholarPubMed
Smith, AK, McCarthy, EP, Paulk, E, et al. (2008) Racial and ethnic differences in advance care planning among patients with cancer: Impact of terminal illness acknowledgment, religiousness, and treatment preferences. Journal of Clinical Oncology 26(25), 4131–4137.CrossRefGoogle ScholarPubMed
Street, RL (1991) Information-giving in medical consultations: The influence of patients’ communicative styles and personal characteristics. Social Science & Medicine 32(5), 541–548.CrossRefGoogle ScholarPubMed
Teal, CR and Street, RL (2009) Critical elements of culturally competent communication in the medical encounter: A review and model. Social Science & Medicine 68(3), 533–543.CrossRefGoogle ScholarPubMed
Volandes, AE, Ariza, M, Abbo, ED, et al. (2008) Overcoming educational barriers for advance care planning in Latinos with video images. Journal of Palliative Medicine 11(5), 700–706.CrossRefGoogle ScholarPubMed