Advance Care Planning Engagement and End-of-life Preference Among Older Chinese Americans: Do Family Relationships and Immigrant Status Matter?
J Am Med Dir Assoc
; 22(2): 340-343, 2021 Feb.
Article
in English
| MEDLINE | ID: covidwho-723778
ABSTRACT
OBJECTIVES:
To examine how immigrant status and family relationships are associated with advance care planning (ACP) engagement and end-of-life (EOL) preference in burial planning among older Chinese Americans, the largest subgroup of Asian Americans.DESIGN:
Cross-sectional survey.SETTING:
Communities in Honolulu, Hawai'i.PARTICIPANTS:
Participants were 430 older Chinese Americans aged 55 years and older.MEASURES:
Measures included ACP contemplation, ACP discussion, and EOL preference in burial planning, immigrant status, family cohesion, family conflict, demographic information, and health status.RESULTS:
Results show that in comparison to foreign-born Chinese Americans, US-born Chinese Americans were more likely to have ACP contemplation [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.39-5.63], ACP discussion (OR 3.02, 95% CI 1.50-6.08), and preferences for burial plans at the end of life (OR 4.56, 95% CI 2.04-10.18). Family conflict increased the possibility of having ACP contemplation (OR 1.21, 95% CI 1.07-1.38), ACP discussion (OR 1.22, 95% CI 1.07-1.39), and EOL preference in burial planning (OR 1.22, 95% CI 1.04-1.42), whereas family cohesion was not associated with these study outcomes. CONCLUSIONS AND IMPLICATIONS This study suggests that ACP should be adapted to be more culturally appropriate, especially in a time of coronavirus and xenophobia, such as framing ACP as a tool to help families reduce stress while fulfilling filial obligations, in order to ensure equitable access to ACP.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Burial
/
Asian
/
Decision Making
/
Advance Care Planning
/
Emigrants and Immigrants
/
Family Relations
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
/
Asia
Language:
English
Journal:
J Am Med Dir Assoc
Journal subject:
History of Medicine
/
Medicine
Year:
2021
Document Type:
Article
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