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Association between region of birth and advance care planning documentation among older Australian migrant communities: A multi-center audit study.
J Gerontol B Psychol Sci Soc Sci. 2020 Aug 17 [Online ahead of print]JG

Abstract

OBJECTIVES

This study explored associations between birth region, socio-demographic predictors and advance care planning (ACP) uptake.

METHODS

A prospective, multi-center, cross-sectional audit study of 100 sites across eight Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital and long-term care facility (LTCF) settings. Advance care directives (ACD) completed by the person ('person completed ACDs') and ACP documents completed by a health professional or other person ('health professional or someone else ACP') were counted. Hierarchical multi-level logistic regression assessed associations with birth region.

RESULTS

From 4187 audited records, 30.0% (1152/3839) were born outside Australia. 'Person completed ACDs' were less common among those born outside Australia (21.9% vs 28.9%, X2 (1, N = 3840) = 20.3, p & 0.001), while 'health professional or someone else ACP' was more common among those born outside Australia (46.4% vs 34.8%, X2 (1, N = 3840) = 45.5, p & 0.001). Strongest associations were found for those born in Southern Europe: 'person completed ACD' (OR = 0.56, 95% CI = 0.36-0.88), and 'health professional or someone else ACP' (OR = 1.41, 95% CI = 1.01-1.98). English-language proficiency and increased age significantly predicted both ACP outcomes.

DISCUSSION

Region of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP.

Authors+Show Affiliations

School of Psychology, University of New South Wales, Sydney, Australia. Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, Australia. Neuroscience Research Australia (NeuRA), Sydney, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Australia. Australian Centre for Health Research Law, Faculty of Law, Queensland University of Technology, Brisbane, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Australia. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia.Australian Centre for Health Research Law, Faculty of Law, Queensland University of Technology, Brisbane, Australia.Advance Care Planning Australia, Austin Health, Melbourne, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32803263

Citation

Sinclair, Craig, et al. "Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: a Multi-center Audit Study." The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 2020.
Sinclair C, Sellars M, Buck K, et al. Association between region of birth and advance care planning documentation among older Australian migrant communities: A multi-center audit study. J Gerontol B Psychol Sci Soc Sci. 2020.
Sinclair, C., Sellars, M., Buck, K., Detering, K. M., White, B. P., & Nolte, L. (2020). Association between region of birth and advance care planning documentation among older Australian migrant communities: A multi-center audit study. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences. https://doi.org/10.1093/geronb/gbaa127
Sinclair C, et al. Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: a Multi-center Audit Study. J Gerontol B Psychol Sci Soc Sci. 2020 Aug 17; PubMed PMID: 32803263.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between region of birth and advance care planning documentation among older Australian migrant communities: A multi-center audit study. AU - Sinclair,Craig, AU - Sellars,Marcus, AU - Buck,Kimberly, AU - Detering,Karen M, AU - White,Ben P, AU - Nolte,Linda, Y1 - 2020/08/17/ PY - 2020/04/29/received PY - 2020/8/18/entrez KW - advance care directive KW - autonomy KW - cultural and linguistic diversity KW - end-of-life care JF - The journals of gerontology. Series B, Psychological sciences and social sciences JO - J Gerontol B Psychol Sci Soc Sci N2 - OBJECTIVES: This study explored associations between birth region, socio-demographic predictors and advance care planning (ACP) uptake. METHODS: A prospective, multi-center, cross-sectional audit study of 100 sites across eight Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital and long-term care facility (LTCF) settings. Advance care directives (ACD) completed by the person ('person completed ACDs') and ACP documents completed by a health professional or other person ('health professional or someone else ACP') were counted. Hierarchical multi-level logistic regression assessed associations with birth region. RESULTS: From 4187 audited records, 30.0% (1152/3839) were born outside Australia. 'Person completed ACDs' were less common among those born outside Australia (21.9% vs 28.9%, X2 (1, N = 3840) = 20.3, p & 0.001), while 'health professional or someone else ACP' was more common among those born outside Australia (46.4% vs 34.8%, X2 (1, N = 3840) = 45.5, p & 0.001). Strongest associations were found for those born in Southern Europe: 'person completed ACD' (OR = 0.56, 95% CI = 0.36-0.88), and 'health professional or someone else ACP' (OR = 1.41, 95% CI = 1.01-1.98). English-language proficiency and increased age significantly predicted both ACP outcomes. DISCUSSION: Region of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP. SN - 1758-5368 UR - https://www.unboundmedicine.com/medline/citation/32803263/Association_between_region_of_birth_and_advance_care_planning_documentation_among_older_Australian_migrant_communities:_A_multi_center_audit_study_ L2 - https://academic.oup.com/psychsocgerontology/article-lookup/doi/10.1093/geronb/gbaa127 DB - PRIME DP - Unbound Medicine ER -
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