African Americans (AA) participate less in end of life advance care planning (ACP) than their non-Hispanic white counterparts. The purpose of this study was to explore how AAs in the Delta region prefer to participate in ACP and to describe the factors impacting end of life (EOL) care decision-making. AA citizens of Delta counties (n=18) participated in phenomenological semi-structured interviews based on the Theory of Planned Behavior. Narratives were analyzed using content analysis and constant comparison. Demographic data was gathered then analyzed using descriptive statistics. Two themes emerged to explain participation preferences regarding essential participants in decision-making: Who Helps the Informants Decide and Provider May Help Me Decide. One theme emerged to describe how the informants preferred to communicate their decisions: I or My Proxy Will tell You Verbally. Three themes emerged that described factors that impacted EOL decision-making: Values, The Situation, and Perceptions and Fears Affecting Trust in Healthcare . AAs in the Delta region frequently discuss EOL decisions with their family, but may not discuss this with their healthcare providers until necessary. This population group did not want to provide written advance directives, and preferred to allow their family to decide, if needed, when a specific situation was presented. Multifaceted factors impact the informants as they approach EOL decision-making. Important specific cultural factors shared by the informants including values, their response to the specific situation, and mistrust of healthcare must be understood to help ensure quality of their end of life care. The findings from this study are the first to describe EOL decision-making factors and preferences of this population group. Providers are challenged to consider that AAs in the Delta frequently discuss their EOL preferences within their families and may communicate their preferences verbally if the provider shows attributes that help mitigate potential perceptions and fears.
|Advisor:||Lefler, Leanne L.|
|Commitee:||Harrington, Sarah E., Heo, Seongkum, Matthews, Ellyn E., Wright, Patricia B.|
|School:||University of Arkansas for Medical Sciences|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 78/12(E), Dissertation Abstracts International|
|Subjects:||Health sciences, Nursing|
|Keywords:||Advance care planning, Advance directive, African American, End of life|
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