End-of-life decision making and communication of bereaved family members of African Americans with serious illness

Esther R. Smith-Howell, Susan Hickman, Salimah H. Meghani, Susan Perkins, Susan Rawl

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: The study objective was to examine factors that influence African American (AA) family members' end-of-life care decision outcomes for a relative who recently died from serious illness. Methods: A cross-sectional descriptive study design was used. Binary logistic and linear regressions were used to identify factors associated with decision regret and decisional conflict. Forty-nine bereaved AA family members of AA decedents with serious illness who died two to six months prior to enrollment were recruited from the palliative care program in a safety net hospital and a metropolitan church in the Midwest. Measurements used were the Decisional Conflict, Decision Regret, Beliefs and Values, and Quality of Communication scales. Results: Family members who reported higher quality of communication with health care providers had lower decisional conflict. Family members of decedents who received comfort-focused care (CFC) had significantly less decision regret than family members of those who received life-prolonging treatment (LPT). Family members who reported stronger beliefs and values had higher quality of communication with providers and lower decisional conflict. Conclusions: This research adds to a small body of literature on correlates of end-of-life decision outcomes among AAs. Although AAs' preference for aggressive end-of-life care is well-documented, we found that receipt of CFC was associated with less decision regret. To reduce decisional conflict and decision regret at the end of life, future studies should identify strategies to improve family member-provider communication, while considering relevant family member and decedent characteristics.

Original languageEnglish (US)
Pages (from-to)174-182
Number of pages9
JournalJournal of Palliative Medicine
Volume19
Issue number2
DOIs
StatePublished - Feb 1 2016

Fingerprint

African Americans
Decision Making
Communication
Emotions
Terminal Care
Safety-net Providers
Palliative Care
Health Personnel
Linear Models
Cross-Sectional Studies
Logistic Models
Conflict (Psychology)
Research

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

End-of-life decision making and communication of bereaved family members of African Americans with serious illness. / Smith-Howell, Esther R.; Hickman, Susan; Meghani, Salimah H.; Perkins, Susan; Rawl, Susan.

In: Journal of Palliative Medicine, Vol. 19, No. 2, 01.02.2016, p. 174-182.

Research output: Contribution to journalArticle

@article{df75c7675b1c45f08523f2c7a0c42fc8,
title = "End-of-life decision making and communication of bereaved family members of African Americans with serious illness",
abstract = "Objective: The study objective was to examine factors that influence African American (AA) family members' end-of-life care decision outcomes for a relative who recently died from serious illness. Methods: A cross-sectional descriptive study design was used. Binary logistic and linear regressions were used to identify factors associated with decision regret and decisional conflict. Forty-nine bereaved AA family members of AA decedents with serious illness who died two to six months prior to enrollment were recruited from the palliative care program in a safety net hospital and a metropolitan church in the Midwest. Measurements used were the Decisional Conflict, Decision Regret, Beliefs and Values, and Quality of Communication scales. Results: Family members who reported higher quality of communication with health care providers had lower decisional conflict. Family members of decedents who received comfort-focused care (CFC) had significantly less decision regret than family members of those who received life-prolonging treatment (LPT). Family members who reported stronger beliefs and values had higher quality of communication with providers and lower decisional conflict. Conclusions: This research adds to a small body of literature on correlates of end-of-life decision outcomes among AAs. Although AAs' preference for aggressive end-of-life care is well-documented, we found that receipt of CFC was associated with less decision regret. To reduce decisional conflict and decision regret at the end of life, future studies should identify strategies to improve family member-provider communication, while considering relevant family member and decedent characteristics.",
author = "Smith-Howell, {Esther R.} and Susan Hickman and Meghani, {Salimah H.} and Susan Perkins and Susan Rawl",
year = "2016",
month = "2",
day = "1",
doi = "10.1089/jpm.2015.0314",
language = "English (US)",
volume = "19",
pages = "174--182",
journal = "Journal of Palliative Medicine",
issn = "1096-6218",
publisher = "Mary Ann Liebert Inc.",
number = "2",

}

TY - JOUR

T1 - End-of-life decision making and communication of bereaved family members of African Americans with serious illness

AU - Smith-Howell, Esther R.

AU - Hickman, Susan

AU - Meghani, Salimah H.

AU - Perkins, Susan

AU - Rawl, Susan

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Objective: The study objective was to examine factors that influence African American (AA) family members' end-of-life care decision outcomes for a relative who recently died from serious illness. Methods: A cross-sectional descriptive study design was used. Binary logistic and linear regressions were used to identify factors associated with decision regret and decisional conflict. Forty-nine bereaved AA family members of AA decedents with serious illness who died two to six months prior to enrollment were recruited from the palliative care program in a safety net hospital and a metropolitan church in the Midwest. Measurements used were the Decisional Conflict, Decision Regret, Beliefs and Values, and Quality of Communication scales. Results: Family members who reported higher quality of communication with health care providers had lower decisional conflict. Family members of decedents who received comfort-focused care (CFC) had significantly less decision regret than family members of those who received life-prolonging treatment (LPT). Family members who reported stronger beliefs and values had higher quality of communication with providers and lower decisional conflict. Conclusions: This research adds to a small body of literature on correlates of end-of-life decision outcomes among AAs. Although AAs' preference for aggressive end-of-life care is well-documented, we found that receipt of CFC was associated with less decision regret. To reduce decisional conflict and decision regret at the end of life, future studies should identify strategies to improve family member-provider communication, while considering relevant family member and decedent characteristics.

AB - Objective: The study objective was to examine factors that influence African American (AA) family members' end-of-life care decision outcomes for a relative who recently died from serious illness. Methods: A cross-sectional descriptive study design was used. Binary logistic and linear regressions were used to identify factors associated with decision regret and decisional conflict. Forty-nine bereaved AA family members of AA decedents with serious illness who died two to six months prior to enrollment were recruited from the palliative care program in a safety net hospital and a metropolitan church in the Midwest. Measurements used were the Decisional Conflict, Decision Regret, Beliefs and Values, and Quality of Communication scales. Results: Family members who reported higher quality of communication with health care providers had lower decisional conflict. Family members of decedents who received comfort-focused care (CFC) had significantly less decision regret than family members of those who received life-prolonging treatment (LPT). Family members who reported stronger beliefs and values had higher quality of communication with providers and lower decisional conflict. Conclusions: This research adds to a small body of literature on correlates of end-of-life decision outcomes among AAs. Although AAs' preference for aggressive end-of-life care is well-documented, we found that receipt of CFC was associated with less decision regret. To reduce decisional conflict and decision regret at the end of life, future studies should identify strategies to improve family member-provider communication, while considering relevant family member and decedent characteristics.

UR - http://www.scopus.com/inward/record.url?scp=84957563218&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957563218&partnerID=8YFLogxK

U2 - 10.1089/jpm.2015.0314

DO - 10.1089/jpm.2015.0314

M3 - Article

VL - 19

SP - 174

EP - 182

JO - Journal of Palliative Medicine

JF - Journal of Palliative Medicine

SN - 1096-6218

IS - 2

ER -