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An examination of Latino-advanced cancer patients' and their informal caregivers' preferences for communication about advance care planning: A qualitative study

Published online by Cambridge University Press:  08 November 2019

Megan Johnson Shen Open the ORCID record for Megan Johnson Shen [Opens in a new window] ,
Cyndi Gonzalez ,
Benjamin Leach ,
Paul K. Maciejewski ,
Elissa Kozlov  and
Holly G. Prigerson
Megan Johnson Shen*
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
Cyndi Gonzalez
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
Benjamin Leach
Affiliation:
Department of Medicine, City of Hope, Duarte, CA
Paul K. Maciejewski
Affiliation:
Cornell Center for Research on End-of-Life Care, New York, NY Department of Radiology, Weill Cornell Medicine, New York, NY
Elissa Kozlov
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
Holly G. Prigerson
Affiliation:
Department of Medicine, Weill Cornell Medicine, New York, NY Cornell Center for Research on End-of-Life Care, New York, NY
*
Author for correspondence: Megan Johnson Shen, Weill Cornell Medicine, 420 East 70th St., Office LH 323 New York, NY10021, USA. E-mail: mes2050@med.cornell.edu
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Abstract

Objectives

Latino-advanced cancer patients engage in advance care planning (ACP) at lower rates than non-Latino patients. The goal of the present study was to understand patients' and caregivers' preferred methods of communicating about ACP.

Methods

Patients and caregivers were interviewed about cultural, religious, and familial beliefs that influence engagement in ACP and preferences for ACP communication.

Results

Findings highlighted that Latino patients respect doctors' medical advice, prefer the involvement of family members in ACP discussions with doctors, hold optimistic religious beliefs (e.g., belief in miracles) that hinder ACP discussions, and prefer culturally competent approaches, such as using their native language, for learning how to discuss end-of-life (EoL) care preferences.

Significance of results

Key cultural, religious, and familial beliefs and dynamics influence Latino engagement in ACP. Patients prefer a family-centered, physician informed approach to discussing ACP with consideration and incorporation of their religious medical beliefs about EoL care. Promising targets for improving the communication of and engagement in ACP include integrating cultural and religious beliefs in ACP discussions, providing information about ACP from the physician, involving family members in ACP discussions and decision-making, and giving instructions on how to engage in ACP discussions.

Keywords

Advance care planningCancerCommunicationEnd-of-life careHealth disparitiesLatino

Information

Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 3 , June 2020 , pp. 277 - 284
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

This article has been corrected since its original publication. See doi:10.1017/S1478951520000504.

References

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