317046
Guidance for Practice: End-of-Life Decisions, Advance Care Planning, and Culture Viewed by Dominican and Puerto Rican Elders in East Harlem, NYC
Tuesday, November 3, 2015
Nathan Boucher, PA-C, MS, MPA, CPHQ, DrPH Cand.,
Community Health Sciences, SUNY-Downstate Medical Center, School of Public Health, NY, NY
End-of-life and palliative care concerns in Puerto Rican and Dominican populations are not well described. This study explored the association of common Hispanic cultural characteristics related to family involvement in health decisions, filial piety, fatalism, and religiosity/spiritualism with knowledge of and attitudes towards advance care planning and end of life considerations. Fifty one semi-structured qualitative interviews with 60 + y/o Dominican and Puerto Rican men and woman living in East Harlem (NYC) were conducted with a large subset of these being public housing residents. Transcripts of the interviews were coded by three coders in two rounds of coding for emerging themes utilizing a grounded theory approach. Themes were Confusion About Related Terms, Influence of Caregiver Experience, Family Burden, Financial Concerns, Privacy of End-of-Life Wishes, Surrender to God, Importance of Autonomy, Control Over Health/Death, and Unknown Availability of Services. This study resulted in recommendations to the partnering community-based organization and the two major area medical centers. These reports will help guide East Harlem health providers and institutional entities in tailoring care related to the end of life and palliative care, including advance care planning, to the dominant Dominican and Puerto Rican Hispanic subgroups of East Harlem. A particular focus on how to improve health care quality using these data will be discussed.
Learning Areas:
Administer health education strategies, interventions and programs
Diversity and culture
Provision of health care to the public
Learning Objectives:
Describe 3 ways providers and organizations working with Dominicans and Puerto Ricans can improve communication about end-of-life issues, including advance care planning.
Describe 2 ways that the presented study data can inform policies related to end-of-life and palliative care delivery in Hispanic communities with Dominican and Puerto Rican residents.
Keyword(s): End-of-Life Care, Community Health Planning
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a doctoral trained health services researcher and professor in health sciences.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
