Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium.
End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels and Ghent, Belgium.
Eur J Gen Pract. 2023 Dec;29(1):2271661. doi: 10.1080/13814788.2023.2271661. Epub 2023 Oct 23.
Data on advance care planning (ACP) among migrants in Europe is lacking. Research has shown that few older migrants in the United States perform ACP due to healthcare system distrust, collectivistic values and spirituality/religion.
To explore the ACP knowledge and perspectives of older Turkish-origin adults in Belgium requiring palliative care.
General practitioners (GPs) in Brussels and Antwerp recruited Turkish-origin participants aged ≥ 65 years with palliative care eligibility for this qualitative study. A GP conducted semi-structured interviews in Turkish in respondents' homes between May 2019 and February 2022 using a topic guide. Two researchers performed combined inductive/deductive thematic data analysis.
All 15 interviewees (average age, 79 years) lacked ACP awareness and information. Some had discussed specific end-of-life preferences (e.g. care location, burial place) with family. Still, many did not feel the need to discuss future healthcare preferences, due mainly to trust in God and family for caretaking and decision-making. Some respondents viewed ACP discussions as applicable, relieving the burden on family and enabling proactive addressing of 'what if' questions. Self-identified ACP barriers were fear of making wrong decisions, 'living in the moment' and difficulty discussing death. Facilitators were obtaining sufficient ACP information and recent family illness or death.
Our sample of Turkish-origin older adults in Belgium requiring palliative care lacked ACP knowledge. Our findings suggest that their lack of engagement in discussing end-of-life medical care planning was linked to their family dynamics and religion. The findings have implications for healthcare providers to ethnic-minority groups.
欧洲有关移徙者预先医疗指示（ACP）的数据匮乏。研究表明，由于对医疗保健系统的不信任、集体主义价值观以及精神/宗教信仰，美国的少数老年移民很少进行 ACP。
探索比利时需要姑息治疗的老年土耳其裔成年人的 ACP 知识和观点。
布鲁塞尔和安特卫普的全科医生（GP）招募了符合姑息治疗条件的≥65 岁的土耳其裔参与者，进行这项定性研究。一位 GP 在 2019 年 5 月至 2022 年 2 月期间在受访者家中用土耳其语进行半结构化访谈，使用主题指南。两名研究人员采用了归纳/演绎相结合的主题数据分析方法。
所有 15 名接受访谈者（平均年龄 79 岁）缺乏 ACP 意识和信息。一些人曾与家人讨论过特定的临终偏好（例如护理地点、埋葬地点）。尽管如此，由于主要信任上帝和家人照顾和决策，许多人认为没有必要讨论未来的医疗保健偏好。一些受访者认为 ACP 讨论是适用的，可以减轻家庭的负担，并使他们能够主动解决“如果”的问题。自我识别的 ACP 障碍是担心做出错误的决定、“活在当下”以及难以讨论死亡。促进因素是获得足够的 ACP 信息以及最近的家庭疾病或死亡。
我们的研究样本是比利时需要姑息治疗的老年土耳其裔成年人，他们缺乏 ACP 知识。我们的研究结果表明，他们缺乏参与讨论临终医疗保健计划的意愿与他们的家庭动态和宗教信仰有关。这些发现对医疗保健提供者向少数民族群体提供服务具有启示意义。
