美国老年人中非正式和正式的预先医疗护理计划的种族和民族差异。
Racial and Ethnic Differences in Informal and Formal Advance Care Planning Among U.S. Older Adults.
机构信息
Department of Health Behavior and Biological Sciences, 16121University of Michigan School of Nursing, Ann Arbor, MI, USA.
Department of Systems, Populations, and Leadership, 16121University of Michigan School of Nursing, Ann Arbor, MI, USA.
出版信息
J Aging Health. 2022 Dec;34(9-10):1281-1290. doi: 10.1177/08982643221104926. Epub 2022 May 27.
OBJECTIVE
To examine advance care planning (ACP) trends among an increasingly diverse aging population, we compared informal and formal ACP use by race/ethnicity among U.S. older adults (≤65 years).
METHODS
We used Health and Retirement Study data (2012-2018) to assess relationships between race/ethnicity and ACP type (i.e., no ACP, informal ACP only, formal ACP only, or both ACP types). We reported adjusted risk ratios with 95% confidence intervals.
RESULTS
Non-Hispanic Black and Hispanic respondents were 1.77 (1.60, 1.96) and 1.76 (1.55, 1.99) times as likely, respectively, to report no ACP compared to non-Hispanic White respondents. Non-Hispanic Black and Hispanic respondents were 0.74 (0.71, 0.78) and 0.74 (0.69, 0.80) times as likely, respectively, to report using both ACP types as non-Hispanic White respondents.
DISCUSSION
Racial/ethnic differences in ACP persist after controlling for a variety of barriers to and facilitators of ACP which may contribute to disparities in end-of-life care.
目的
为了研究在日益多样化的老年人口中，预先医疗指示（ACP）的趋势，我们比较了美国老年成年人（≤65 岁）中，不同种族/民族的非正式和正式 ACP 使用情况。
方法
我们使用健康与退休研究数据（2012-2018 年）来评估种族/民族与 ACP 类型（即无 ACP、仅非正式 ACP、仅正式 ACP 或两种 ACP 类型）之间的关系。我们报告了调整后的风险比及其 95%置信区间。
结果
与非西班牙裔白人相比，非西班牙裔黑人及西班牙裔受访者分别有 1.77 倍（1.60，1.96）和 1.76 倍（1.55，1.99）的可能性报告没有 ACP。与非西班牙裔白人相比，非西班牙裔黑人及西班牙裔受访者分别有 0.74 倍（0.71，0.78）和 0.74 倍（0.69，0.80）的可能性报告同时使用两种 ACP 类型。
讨论
在控制了 ACP 的各种障碍和促进因素后，种族/民族差异仍然存在，这可能导致临终关怀方面的差异。
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