School of Social Work, Indiana University, Indianapolis.
YLC Consulting, Windsor, Colorado.
Gerontologist. 2019 Mar 14;59(2):347-355. doi: 10.1093/geront/gnx211.
Advance care planning (ACP) is crucial for quality end-of-life care for patients with Alzheimer's disease. However, limited evidence is available about ACP among ethnic minorities, particularly in the context of Alzheimer's disease. The purpose of this study was to examine intention to discuss ACP for a family member with Alzheimer's disease among Korean Americans. Guided by the theory of planned behavior and prior research, we examined the relationships between acculturation, attitudes, subjective norms, perceived control, and intention to discuss ACP for a family member with Alzheimer's disease.
Path analyses were conducted on a cross-sectional convenience sample of 261 Korean Americans. Age, gender, education, and knowledge about Alzheimer's disease and ACP were included as covariates.
Our descriptive findings showed positive attitudes, strong subjective norms, and a high level of perceived control toward ACP discussion among the participants. The path analyses revealed that attitudes and subjective norms were positively related to intention for ACP discussion. Perceived control was not related to intention for ACP discussion. Among the covariates, greater knowledge about Alzheimer's disease was the only factor shown to be associated with the intention for ACP discussion.
To promote ACP among this population, educational interventions designed to address positives attitudes and subjective norms toward ACP are suggested.
预先医疗指示（ACP）对于阿尔茨海默病患者的临终关怀至关重要。然而，关于少数民族的 ACP 证据有限，特别是在阿尔茨海默病的背景下。本研究的目的是调查美籍韩裔人群中对于阿尔茨海默病家庭成员进行 ACP 讨论的意愿。本研究以计划行为理论和既往研究为指导，探讨了文化适应、态度、主观规范、感知控制与对于阿尔茨海默病家庭成员进行 ACP 讨论的意愿之间的关系。
对 261 名美籍韩裔人群进行了横断面便利抽样调查。年龄、性别、教育程度以及对阿尔茨海默病和 ACP 的了解被纳入协变量。
我们的描述性研究结果显示，参与者对于 ACP 讨论持有积极的态度、强烈的主观规范和高水平的感知控制。路径分析显示，态度和主观规范与 ACP 讨论的意愿呈正相关。感知控制与 ACP 讨论的意愿无关。在协变量中，对阿尔茨海默病的了解程度是唯一与 ACP 讨论意愿相关的因素。
为了在这一人群中促进 ACP，建议开展教育干预，以解决对 ACP 的积极态度和主观规范。
