Exploring attitudes toward advance care directives in two diverse settings

Area of Science:

• Health Disparities
• Cultural Competence in Healthcare
• End-of-Life Care Planning

Background:

• Advance care directives (ACD) exhibit unequal usage across ethnic groups in the U.S.
• Potential factors include healthcare access, mistrust, lack of surrogates, and limited knowledge.
• Limited research exists on attitudes toward advance care planning in Latino and Cambodian communities.

Purpose of the Study:

• To explore attitudes toward advance care planning and advance directives.
• To identify cultural factors influencing end-of-life decision-making among Latino and Cambodian patients.

Main Methods:

• Six focus groups conducted with 20 Latino and 19 Cambodian patients.
• Data were audiotaped, transcribed, and qualitatively analyzed.
• Identified themes related to advance directives and care planning discussions.

Main Results:

• Most participants lacked a healthcare proxy or had not discussed it with their doctor.
• Key themes: integration of belief systems (religion, destiny, quality of life) and decision-making processes (family/provider roles, ACD clarity, learning willingness).

Conclusions:

• End-of-life decision-making discussions revealed themes of belief systems and care preferences.
• Improving ACD completion requires considering quality of life, destiny beliefs, and family consensus in diverse populations.