McDonnell Jenny, Idler Ellen
Emory University, Atlanta, GA, USA.
Palliat Care Soc Pract. 2020 Dec 7;14:2632352420975780. doi: 10.1177/2632352420975780. eCollection 2020.
Advance care planning is under-used among Black Americans, often because of experiences of racism in the health care system, resulting in a lower quality of care at the end of life. African American faith communities are trusted institutions where such sensitive conversations may take place safely. Our search of the literature identified five articles describing faith-based advance care planning education initiatives for Black Americans that have been implemented in local communities. We conducted a content analysis to identify key themes related to the success of a program's implementation and sustainability. Our analysis showed that successful implementation of advance care planning programs in Black American congregations reflected themes of building capacity, using existing ministries, involving faith leadership, exhibiting cultural competency, preserving a spiritual/Biblical context, addressing health disparities, building trust, selectively using technology, and fostering sustainability. We then evaluated five sets of well-known advance care planning education program materials that are frequently used by pastors, family caregivers, nurse's aides, nurses, physicians, social workers, and chaplains from a variety of religious traditions. We suggest ways these materials may be tailored specifically for Black American faith communities, based on the key themes identified in the literature on local faith-based advance care planning initiatives for Black churches. Overall, the goal is to achieve better alignment of advance care planning education materials with the African American faith community and to increase implementation and success of advance care planning education initiatives for all groups.
预先护理计划在美国黑人中未得到充分利用，这通常是由于他们在医疗保健系统中遭遇种族主义经历，导致临终时护理质量较低。非裔美国人的宗教团体是值得信赖的机构，在这些机构中可以安全地进行此类敏感对话。我们对文献的检索发现了五篇文章，描述了已在当地社区实施的针对美国黑人的基于宗教信仰的预先护理计划教育倡议。我们进行了内容分析，以确定与项目实施成功和可持续性相关的关键主题。我们的分析表明，在美国黑人教会中成功实施预先护理计划项目反映了以下主题：建设能力、利用现有事工、让宗教领袖参与、展现文化能力、保持精神/圣经背景、解决健康差距、建立信任、有选择地使用技术以及促进可持续性。然后，我们评估了五套广为人知的预先护理计划教育项目材料，这些材料经常被来自各种宗教传统的牧师、家庭护理人员、护士助理、护士、医生、社会工作者和牧师使用。我们根据关于美国黑人教会基于宗教信仰的当地预先护理计划倡议的文献中确定的关键主题，提出了这些材料可如何专门针对美国黑人宗教团体进行调整的方法。总体目标是使预先护理计划教育材料更好地与非裔美国人宗教团体相契合，并提高所有群体预先护理计划教育倡议的实施和成功率。
