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Factors related to advance care planning among older African American women: Age, medication, and acute care visits.
Palliat Support Care. 2019 Nov 27 [Online ahead of print]PS

Abstract

OBJECTIVES

Advance care planning (ACP) is linked with high-quality clinical outcomes at the end of life. However, ACP engagement is lower among African Americans than among Whites. In this study, we sought to identify correlates of ACP among African American women with multiple chronic conditions for two reasons: (1) African American women with multiple chronic conditions have high risks for serious illnesses, more intensive treatments, and circumstances that may require substitutes' decision-making and (2) identifying correlates of ACP among African American women can help us identify important characteristics to inform ACP outreach and interventions for this group.

METHODS

A cross-sectional survey was conducted with 116 African American women aged ≥50 years who were recruited from the central area of a mid-western city.

RESULTS

On average, participants were 64 years old (SD = 9.42). The majority were not married (78%), had less than a college education (50%), and had an annual income of $15,000 (54%). Their mean numbers of chronic conditions and prescribed medications were 3.31 (SD = 1.25) and 8.75 (SD = 4.42), respectively. Fifty-nine per cent reported having talked with someone about their preferences (informal ACP); only 30% had completed a living will or a power of attorney for healthcare (formal ACP). Logistic regression showed that age, the number of hospitalizations or emergency department visits, and the number of prescription medications were significantly correlated with both informal and formal ACP; other demographic and psychosocial characteristics (the knowledge of ACP, self-efficacy, and trust in the medical system) were not.

SIGNIFICANCE OF RESULTS

Results of this study suggest a need for targeted, culturally sensitive outpatient ACP education to promote ACP engagement in older African American women, taking into account age, the severity of chronic conditions, and levels of medication management.

Authors+Show Affiliations

School of Nursing, The University of Texas at Austin, Austin, TX.College of Nursing, University of Wisconsin Milwaukee, Milwaukee, WI.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31771671

Citation

Kwak, Jung, and Julie L. Ellis. "Factors Related to Advance Care Planning Among Older African American Women: Age, Medication, and Acute Care Visits." Palliative & Supportive Care, 2019, pp. 1-6.
Kwak J, Ellis JL. Factors related to advance care planning among older African American women: Age, medication, and acute care visits. Palliat Support Care. 2019.
Kwak, J., & Ellis, J. L. (2019). Factors related to advance care planning among older African American women: Age, medication, and acute care visits. Palliative & Supportive Care, 1-6. https://doi.org/10.1017/S1478951519001007
Kwak J, Ellis JL. Factors Related to Advance Care Planning Among Older African American Women: Age, Medication, and Acute Care Visits. Palliat Support Care. 2019 Nov 27;1-6. PubMed PMID: 31771671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors related to advance care planning among older African American women: Age, medication, and acute care visits. AU - Kwak,Jung, AU - Ellis,Julie L, Y1 - 2019/11/27/ PY - 2019/11/28/entrez PY - 2019/11/28/pubmed PY - 2019/11/28/medline KW - Advance care planning KW - African American KW - Chronic conditions KW - End of life SP - 1 EP - 6 JF - Palliative & supportive care JO - Palliat Support Care N2 - OBJECTIVES: Advance care planning (ACP) is linked with high-quality clinical outcomes at the end of life. However, ACP engagement is lower among African Americans than among Whites. In this study, we sought to identify correlates of ACP among African American women with multiple chronic conditions for two reasons: (1) African American women with multiple chronic conditions have high risks for serious illnesses, more intensive treatments, and circumstances that may require substitutes' decision-making and (2) identifying correlates of ACP among African American women can help us identify important characteristics to inform ACP outreach and interventions for this group. METHODS: A cross-sectional survey was conducted with 116 African American women aged ≥50 years who were recruited from the central area of a mid-western city. RESULTS: On average, participants were 64 years old (SD = 9.42). The majority were not married (78%), had less than a college education (50%), and had an annual income of $15,000 (54%). Their mean numbers of chronic conditions and prescribed medications were 3.31 (SD = 1.25) and 8.75 (SD = 4.42), respectively. Fifty-nine per cent reported having talked with someone about their preferences (informal ACP); only 30% had completed a living will or a power of attorney for healthcare (formal ACP). Logistic regression showed that age, the number of hospitalizations or emergency department visits, and the number of prescription medications were significantly correlated with both informal and formal ACP; other demographic and psychosocial characteristics (the knowledge of ACP, self-efficacy, and trust in the medical system) were not. SIGNIFICANCE OF RESULTS: Results of this study suggest a need for targeted, culturally sensitive outpatient ACP education to promote ACP engagement in older African American women, taking into account age, the severity of chronic conditions, and levels of medication management. SN - 1478-9523 UR - https://www.unboundmedicine.com/medline/citation/31771671/Factors_related_to_advance_care_planning_among_older_African_American_women:_Age,_medication,_and_acute_care_visits L2 - https://www.cambridge.org/core/product/identifier/S1478951519001007/type/journal_article DB - PRIME DP - Unbound Medicine ER -
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