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Patient–family EoL communication and its predictors: Reports from caregivers of Latino patients in the rural U.S.–Mexico border region

Published online by Cambridge University Press:  26 October 2017

Eunjeong Ko ,
Jaehoon Lee ,
Carlos Ramirez ,
Denicka Lopez  and
Stephanie Martinez
Eunjeong Ko*
Affiliation:
School of Social Work, San Diego State University, San Diego, California
Jaehoon Lee
Affiliation:
College of Education, Texas Tech University, Lubbock, Texas
Carlos Ramirez
Affiliation:
AccentCare Home Health, University of Phoenix, San Diego, California
Denicka Lopez
Affiliation:
Department of Psychology, San Diego State University, San Diego, California
Stephanie Martinez
Affiliation:
School of Social Work, San Diego State University, San Diego, California
*
Address correspondence and reprint requests to: Eunjeong Ko, School of Social Work, San Diego State University, 5500 Campanile Drive, San Diego, California 92182-4119. E-mail: eko@mail.sdsu.edu.
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Abstract

Objective:

Family caregivers play an important role in end-of-life (EoL) decision making when the patient is unable to make his/her own decisions. While communication about EoL care between patients and family is perhaps a first step toward advance care planning (ACP)/EoL decisions, not every culture puts great value on open communication about this topic. The aims of the present study were to explore EoL communication and the aspects of communication among caregivers of Latino patients in the rural United States (U.S.)–Mexico border region.

Method:

This study analyzed data from a hospice needs assessment collected from 189 family caregivers of Latino patients at a home health agency in a rural U.S.–Mexico border region. Bivariate tests and logistic regression were used to address our aims.

Results:

About half of the family caregivers (n = 96, 50.8%) reported to have ever engaged in EoL discussion with patients. Significant predictors of EoL discussion included life-sustaining treatment preference (odds ratio [OR] = 0.44, p < 0.05); knowledge of an advance directive (AD) (OR = 5.50, p < 0.01); and distrust of physicians (OR = 0.29, p < 0.01). Caregivers who preferred extending the life of their loved one even if he/she had to rely on life supports were less likely to engage in EoL communication. Also, caregivers who worried that physicians might want to stop treatments (i.e., “pull the plug”) too soon were less likely to do so. Conversely, caregivers who had knowledge about ADs were more likely to engage in EoL communication.

Significance of Results:

EoL communication is a complex process influenced by individual, social, and cultural values and the beliefs of both the patient and his/her family. Inclusion of family caregivers in the ACP process and facilitating culturally tailored EoL communication between patients and family caregivers is important.

Keywords

End-of-life communicationRural U.S.–Mexico borderCaregivers
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 5 , October 2018 , pp. 520 - 527
Copyright
Copyright © Cambridge University Press 2017 

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