The 131st Annual Meeting (November 15-19, 2003) of APHA |
Gala True, PhD1, Etienne J Phipps, PhD2, Leonard E. Braitman, PhD3, and Diana Harris, MA1. (1) Einstein Center for Urban Health Policy and Research, Albert Einstein Healthcare Network, One Penn Boulevard, Wister Tower, 4th Fl. Suite 4442, Philadelphia, PA 19144, (2) Einstein Center for Urban Health Policy and Research, Thomas Jefferson University, Albert Einstein Healthcare Network-Germantown Community Health Services, 1 Penn Blvd, Philadelphia, PA 19144, (3) Biostatistics/Research and Technology, Albert Einstein Healthcare Network, 5501 Old York Road, Philadelphia, PA 19141
Objectives: To investigate differences in coping and spirituality between African American and White patients, and to examine the role of spiritual coping in attitudes, behaviors, and preferences related to end of life. Methods: Interviews were conducted with 68 African American and White patients with advanced lung or colon cancer. Results: African American patients were more likely to report active religious surrender and seeking spiritual support as compared to White patients (all p<0.04). Patients who reported belief in divine intervention and seeking spiritual support were less likely to have a Living Will (p<0.04). Belief in divine intervention, turning to higher power for support and using spirituality to cope with cancer were associated with preference for CPR, mechanical ventilation, and hospitalization in a near-death scenario. Some of these differences remained statistically significant after controlling for ethnicity. Conclusion: Patients who used specific domains of spiritual coping to a greater extent were less likely to have a Living Will and more likely to desire life sustaining measures at the end of life. This suggests that spirituality is an important factor in ethnic differences in approaches to end of life. If efforts aimed at improving end of life care are to be successful, they must take into account the complex interplay of ethnicity, culture, and spirituality as they shape patients’ views and preferences around end of life.
Learning Objectives:
Keywords: Religion, End-of-Life Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.