Hong Michin, Yi Eun-Hye, Johnson Kimberly J, Adamek Margaret E
Indiana University School of Social Work, 902 West New York Street, Indianapolis, IN, 46202, USA.
J Immigr Minor Health. 2018 Oct;20(5):1277-1287. doi: 10.1007/s10903-017-0670-9.
Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experiences, (3) cultural values, and (4) spirituality. Socio-demographic factors showed inconsistent findings regarding their association with ACP engagement. Worse health status and knowledge about ACP are common facilitators across ethnic minority groups, whereas mistrust toward the health care system was a barrier only for Blacks. Collectivistic cultural values influenced ACP engagement among Latinos and Asian Americans; however, spirituality/religion played an important role among Blacks. The implications for culturally competent approaches to promote ACP and future research directions are discussed.
越来越多的证据表明，美国少数民族对预先护理计划（ACP）的参与度较低。本研究的目的是综合先前关于少数民族ACP的研究结果。使用多个电子数据库进行了广泛的文献检索。在应用纳入标准后，纳入了26项研究。确定了ACP的四类促进因素和障碍：（1）社会人口因素，（2）健康状况、识字率和经历，（3）文化价值观，以及（4）精神层面。社会人口因素与ACP参与度的关联结果不一致。较差的健康状况和对ACP的了解是所有少数民族群体中常见的促进因素，而对医疗保健系统的不信任只是黑人面临的障碍。集体主义文化价值观影响了拉丁裔和亚裔美国人对ACP的参与度；然而，精神层面/宗教在黑人中发挥了重要作用。讨论了采用具有文化胜任力的方法促进ACP的意义以及未来的研究方向。
