1 University of Michigan-Flint, School of Nursing, Flint, MI, USA.
2 Duquesne University School of Nursing, Pittsburgh, PA, USA.
J Transcult Nurs. 2018 Nov;29(6):578-590. doi: 10.1177/1043659617753042. Epub 2018 Jan 22.
Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are affected by demographic variables, cultural distinctives related to patient autonomy, mistrust of the health care system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. An integrative review was conducted to synthesize nursing knowledge regarding cultural perspectives of end-of-life and advance care planning among African Americans. Twenty-four articles were reviewed. Nurses educate patients and families about end-of-life planning as mandated by the Patient Self-Determination Act of 1991. Implementation of advance directives promote patient and family centered care, and should be encouraged. Clinicians must be sensitive and respectful of values and practices of patients of diverse cultures, and initiate conversations with open-ended questions facilitating patient trust and sharing within the context of complex beliefs, traditions, and lifeways.
一般人群中预立医疗指示的完成率较低。研究报告称，非裔美国人的完成率更低，受到人口统计学变量、与患者自主性相关的文化特征、对医疗保健系统的不信任、低健康素养、强烈的精神信仰、对积极干预的渴望、家庭-社区决策的重要性以及合并症的影响。进行了一项综合审查，以综合护理知识，了解非裔美国人临终关怀和预先医疗指示规划的文化观点。审查了 24 篇文章。根据 1991 年的《患者自决法案》，护士对患者和家属进行临终关怀计划教育。实施预先指示促进以患者和家庭为中心的护理，应予以鼓励。临床医生必须对不同文化背景的患者的价值观和实践保持敏感和尊重，并使用开放式问题进行对话，在复杂的信仰、传统和生活方式背景下，建立患者的信任和分享。
