1 School of Aging Studies, University of South Florida, Tampa, FL, USA.
2 Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA.
Res Aging. 2019 Oct;41(9):823-844. doi: 10.1177/0164027519858716. Epub 2019 Jun 23.
This study examined racial, ethnic, and other factors associated with whether older adults discussed their end-of-life (EOL) care wishes with family. A sample of 223 White, 95 African American, and 46 Hispanic adults aged 50 and older from a five-county area of Florida answered questions about sociodemographics, health, and preferences for involving family/friends in health-care decision-making. Analyses describe associations between whether discussions occurred and race/ethnicity and other factors, including preferences for family/friend involvement in health care. In descriptive analyses, one third ( = 113) had not discussed EOL care. No differences were evident between African Americans and non-Hispanic Whites. In multivariate analyses, EOL care discussions were less likely for Hispanics. Further analysis showed this lower likelihood existed among Hispanics with lesser family/friend involvement. Ethnicity influences EOL care discussion, moderated by family/friend involvement, though results are considered preliminary. Knowing the involvement of patients' family/friends could help providers initiate EOL care discussions.
本研究调查了与老年人是否与家人讨论其临终(EOL)护理意愿相关的种族、民族和其他因素。佛罗里达州五个县的一个样本,包括 223 名白人、95 名非裔美国人和 46 名西班牙裔成年人,年龄在 50 岁及以上,回答了关于社会人口统计学、健康状况以及参与家庭/朋友进行医疗决策的偏好的问题。分析描述了讨论是否发生与种族/民族和其他因素之间的关联,包括对家庭/朋友参与医疗保健的偏好。在描述性分析中,三分之一(=113)人没有讨论过 EOL 护理。非裔美国人和非西班牙裔白人之间没有明显差异。在多变量分析中,西班牙裔人进行 EOL 护理讨论的可能性较小。进一步的分析表明,在家庭/朋友参与度较低的西班牙裔人中,这种可能性较低。尽管结果被认为是初步的,但族裔会影响 EOL 护理讨论,受家庭/朋友参与度的影响。了解患者的家人/朋友的参与程度可以帮助提供者启动 EOL 护理讨论。