Addressing the Underutilization of Hospice Care in Asian American Communities: A Scoping Review

ObjectivesDespite national improvements in hospice care, utilization remains low among Asian American (AA) communities. This scoping review aims to systematically map the literature on barriers to hospice use in this population, focusing on the roles of communication, cultural beliefs, and healthcare system factors.MethodsA scoping review was conducted on studies published in English between January 2010 and December 2024 to capture recent trends. Seven databases (Academic Search Complete, CINAHL Complete, Medline with Full Text, PubMed, Web of Science, Cochrane, and Scopus) were systematically searched. The review followed Arksey and O'Malley's methodological framework for scoping studies.ResultsOut of 644 publications initially screened, 25 studies, including two literature reviews, met the inclusion criteria. Most employed cross-sectional surveys or qualitative descriptive designs. Identified barriers to hospice utilization included language and communication challenges; cultural values and beliefs surrounding death; family-centered decision-making and filial piety; religious influences such as beliefs in karma and suffering; and broader issues like low acculturation and mistrust of the healthcare system.ConclusionEnhancing culturally competent hospice care is a promising approach to addressing disparities in end-of-life care for AAs. Comprehensive cultural competence training is needed for healthcare providers, especially physicians, nurse practitioners, registered nurses, and social workers involved in hospice and palliative care. Further research is recommended to identify the core components of hospice care and develop effective interventions tailored to diverse AA subgroups.