Singleton Mekiayla C, Kozlov Elissa, Friedman M Reul, Enguidanos Susan M
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
Department of Health Behavior, Society and Policy, School of Public Health, Rutgers University, Piscataway, NJ, USA.
Am J Hosp Palliat Care. 2024 Dec 19:10499091241309670. doi: 10.1177/10499091241309670.
Prior research has shown that advance care planning (ACP) knowledge and discussion varies among racial and ethnic groups. However, little is known if similar disparities exist within the sexual minority (SM) population. To investigate racial disparities in ACP knowledge, discussion, and decision making within the SM population. Data from an online survey (N = 281) asked Black and White SM adults ages 50+ about their knowledge and actions about future healthcare wishes and their healthcare experiences. A series of multivariable logistic regressions were conducted to examine the association between ACP knowledge, discussion, and medical decision-making and race, while adjusting for other demographic and health-related variables. On average, respondents were 57 years old (SD = 6.04) and just over half identified as being White (52%) and as men (55%). Most participants had heard of ACP (74%) and had an ACP discussion with someone (65%). Sixty-six percent of participants were very comfortable with medical decision-making. White SM adults had higher odds of having ACP knowledge (aOR = 3.56; 95% CI = 1.78, 7.07) and discussions (aOR = 2.43; 95% CI = 1.28, 4.61). While no racial differences were found in comfort with medical decision-making, other sociodemographics were significantly associated with comfort with medical decision-making. Outcomes from this work indicate persistent racial disparities in ACP within the SM population in addition to highlighting other factors that influence ACP. These findings emphasize the need for resources to address this systemic issues and to ensure that SM adults have access to and engage in ACP.
先前的研究表明，预先护理计划（ACP）的知识和讨论在不同种族和族裔群体中存在差异。然而，对于性少数群体（SM）内部是否存在类似差异，人们知之甚少。为了调查SM群体在ACP知识、讨论和决策方面的种族差异。一项在线调查（N = 281）的数据询问了50岁及以上的黑人和白人SM成年人关于他们对未来医疗保健愿望的知识和行动以及他们的医疗保健经历。进行了一系列多变量逻辑回归，以检验ACP知识、讨论和医疗决策与种族之间的关联，同时调整其他人口统计学和健康相关变量。平均而言，受访者年龄为57岁（标准差 = 6.04），略超过一半的人认为自己是白人（52%）且为男性（55%）。大多数参与者听说过ACP（74%），并与某人进行过ACP讨论（65%）。66%的参与者对医疗决策非常放心。白人SM成年人拥有ACP知识（调整后比值比 = 3.56；95%置信区间 = 1.78，7.）和进行讨论（调整后比值比 = 2.43；95%置信区间 = 1.28，4.61）的几率更高。虽然在对医疗决策的放心程度上未发现种族差异，但其他社会人口统计学因素与对医疗决策的放心程度显著相关。这项工作的结果表明，SM群体在ACP方面存在持续的种族差异，同时也凸显了影响ACP的其他因素。这些发现强调需要资源来解决这一系统性问题，并确保SM成年人能够接触并参与ACP。 07）
不过，在对医疗决策的放心程度方面未发现种族差异，但其他社会人口统计学因素与对医疗决策的放心程度显著相关。这项工作的结果表明，SM群体在ACP方面存在持续的种族差异，同时也凸显了影响ACP的其他因素。这些发现强调需要资源来解决这一系统性问题，并确保SM成年人能够接触并参与ACP。
