End-of-life preferences and presence of advance directives among ethnic populations with severe chronic cardiovascular illnesses. (April 2014)

• Record Type: Journal Article
• Authors: Piamjariyakul, Ubolrat; Myers, Sarah; Werkowitch, Marilyn; Smith, Carol E
• Other Names: Årestedt Kristofer guest-editor.; Beattie James M guest-editor.
• Is Part Of: European journal of cardiovascular nursing. Volume 13:Number 2(2014)
• Page Start: 185
• Page End: 189
• Publication Date: 2014-04
• Subjects: End-of-life care preferences -- palliative care preferences -- ethnic minority -- cardiovascular illnesses; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515113519523
• Languages: English
• ISSNs: 1474-5151

Abstract

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.