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Rural Hispanic/Latino cancer patients’ perspectives on facilitators, barriers, and suggestions for advance care planning: A qualitative study

Published online by Cambridge University Press:  05 October 2021

Eunjeong Ko Open the ORCID record for Eunjeong Ko [Opens in a new window] ,
Annie J. Keeney ,
Doreen Higgins ,
Nayeli Gonzalez  and
Helen Palomino
Eunjeong Ko*
Affiliation:
School of Social Work, San Diego State University, San Diego, CA
Annie J. Keeney
Affiliation:
School of Social Work, San Diego State University, San Diego, CA
Doreen Higgins
Affiliation:
Social Work Professional Programs, University of Wisconsin-Green Bay, Green Bay, WI
Nayeli Gonzalez
Affiliation:
Cancer Resource Center of the Desert, El Centro, CA
Helen Palomino
Affiliation:
Cancer Resource Center of the Desert, El Centro, CA
*
Author for correspondence: Eunjeong Ko, School of Social Work, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4119, USA. E-mail: eko@sdsu.edu
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Abstract

Objective

Hispanic/Latinos living in rural areas have limited healthcare resources, including palliative and hospice care. Moreover, little is known about advance care planning (ACP) among Hispanic/Latino cancer patients in rural areas. This study explores facilitators and barriers for ACP. It elicits suggestions to promote ACP among rural Hispanic/Latino cancer patients in a US/Mexico border region.

Methods

Hispanic/Latino cancer patients (n = 30) were recruited from a nonprofit cancer organization. Data were collected via in-person interviews. Interviews were transcribed and translated from Spanish to English. Data were uploaded into NVivo 12 and analyzed using thematic analysis.

Results

A common theme for facilitators and barriers for ACP was safeguarding family. Additional facilitators included (1) Desire for honoring end-of-life (EoL) care wishes and (2) experience with EoL care decision making. Additional barriers include (1) Family's reluctance to participate in EoL communication and (2) Patient–clinicians’ lack of EoL communication. Practice suggestions include (1) Death education and support for family, (2) ACP education, and (3) Dialogue vs. documentation.

Significance of results

ACP functions not only as a decisional tool; its utility reflects complex dynamics in personal, social, and cultural domains. ACP approaches with this underserved population must consider family relationships as well as cultural implications, including language barriers.

Keywords

Advance care planningBarriersCancerFacilitatorsRural Hispanic/Latino
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 535 - 541
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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