Key result
Only ~50% of ethnic minority cardiac patients hold advance directives, citing fears like deportation.
Why the study?
Little end-of-life planning occurs among ethnic minorities with severe cardiovascular illnesses, and their preferences and presence of advance directives are not well characterized.
Cross-Sectional (n=30)
Ethnic minority patients with severe cardiovascular illness are willing to discuss end-of-life preferences, highlighting the need for culturally sensitive communication and continuity of care.
Supports culturally sensitive advance care planning in ethnic minorities with severe CVD; leaves open prospective studies on deportation barriers.
BACKGROUND: Little end-of-life planning occurs among ethnic minorities with severe cardiovascular illnesses. AIM: The purpose of this study was to explore end-of-life preferences and determine the presence of signed end-of-life advanced directives. METHODS: Thirty ethnic minority patients volunteered for an open-ended question interview. Content analysis was used to summarize responses into themes using patients' terms. FINDINGS: Five themes emerged: (a) importance of family involvement in care at end of life; (b) being pain free (or pain controlled) at the end of life; (c) having a comfortable environment for death was desired; (d) wanting no procedures for prolonging life; and (e) desiring a relationship with a professional for end-of-life decision making (reported as inconsistently available). New unique findings were related to concerns about multiple and repeatedly rotating professionals not allowing these ethnic patients end-of-life discussions and fear that signing forms would lead to deportation. Overall, 50% of the participants had signed standard advanced directives as requested upon entry to the home care agency. CONCLUSIONS: Most of these very ill patients did readily discuss these sensitive issues with the research nurse. Cardiovascular training in end-of-life care should include sensitivity to ethnic and cultural preferences and competencies in interviewing on sensitive topics.
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Piamjariyakul et al. (2014) conducted a cross-sectional in severe chronic cardiovascular illnesses (n=30). Qualitative interview on end-of-life preferences was evaluated on Presence of signed standard advanced directives. Qualitative interviews of ethnic minority patients with severe cardiovascular illness showed that 50% had signed advance directives, with unique concerns including fear of deportation.
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