Care processes and racial/ethnic differences in family reports of end‐of‐life care among Veterans : A mediation analysis

2022 ◽  
Author(s):  
Ann Kutney‐Lee ◽  
Scarlett L. Bellamy ◽  
Mary Ersek ◽  
Elina L. Medvedeva ◽  
Dawn Smith ◽  
...  
Keyword(s):  
End Of Life ◽  
Ethnic Differences ◽  
Mediation Analysis ◽  
End Of Life Care ◽  
Life Care ◽  
Care Processes ◽  
Racial Ethnic

scholarly journals Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End‐of‐Life Care

2018 ◽  
Vol 53 (6) ◽  
pp. 4291-4309 ◽  
Author(s):  
Shi‐Yi Wang ◽  
Sylvia H. Hsu ◽  
Siwan Huang ◽  
Kathy C. Doan ◽  
Cary P. Gross ◽  
...  
Keyword(s):  
End Of Life ◽  
Ethnic Differences ◽  
End Of Life Care ◽  
Practice Patterns ◽  
Life Care ◽  
Racial Ethnic

scholarly journals Understanding Racial And Ethnic Differences In End of Life Care For Hospitalized Patients

2016 ◽  
Vol 19 (7) ◽  
pp. A622-A623
Author(s):  
TJ Johnson ◽  
S O'Mahony ◽  
S Levine ◽  
SM Walton ◽  
A Baron
Keyword(s):  
End Of Life ◽  
Ethnic Differences ◽  
End Of Life Care ◽  
Hospitalized Patients ◽  
Life Care ◽  
Racial And Ethnic Differences

scholarly journals Racial-Ethnic Disparities in End-of-Life Care Quality among Lung Cancer Patients: A SEER-Medicare–Based Study

2018 ◽  
Vol 13 (8) ◽  
pp. 1083-1093 ◽  
Author(s):  
Siddharth Karanth ◽  
Suja S. Rajan ◽  
Gulshan Sharma ◽  
Jose-Miguel Yamal ◽  
Robert O. Morgan
Keyword(s):  
Lung Cancer ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Ethnic Disparities ◽  
Care Quality ◽  
Life Care ◽  
Lung Cancer Patients ◽  
Racial Ethnic

scholarly journals Racial Disparities in End-of-Life Care Planning and Hospital Utilization: A Single Center Retrospective Study

Blood ◽  
2017 ◽  
Vol 130 (Suppl_1) ◽  
pp. 859-859
Author(s):  
Kedar Kirtane ◽  
Lois Downey ◽  
Stephanie J. Lee ◽  
Jared Randall Curtis ◽  
Ruth Engelberg
Keyword(s):  
End Of Life ◽  
Ethnic Minorities ◽  
Solid Tumor ◽  
End Of Life Care ◽  
Inpatient Care ◽  
Board Member ◽  
Hematologic Malignancies ◽  
Advisory Board ◽  
Life Care ◽  
Racial Ethnic

Abstract Introduction- Some prior studies suggest patients with hematologic malignancies receive more aggressive end-of-life care when compared to patients with solid tumor malignancies. Hematologic malignancies differ from solid tumors because of the continued potential for cure even in advanced disease, and potential difficulty identifying the terminal portion of a patient's illness. Racial/ethnic minorities are reported to have lower rates of hospice care, advanced directive use, and palliative care utilization. We studied differences in hospital utilization patterns and documentation of advance care planning between solid tumor and hematologic malignancy patients. In the subgroup of patients with hematologic malignancy, we also examined differences in these outcomes associated with racial/ethnic minority status. Methods- We conducted a retrospective cohort study of 9,469 patients with a diagnosis of cancer who received care at University of Washington (UW) Medicine and died between 2010 and 2015. Administrative data were available for the following events during the last 30 days of life: emergency department use, hospitalizations, and intensive care unit (ICU) utilization. We also examined death in a hospital and any documentation of advance directives (AD) in the electronic health record. We regressed each outcome on the binary predictor, adjusting for confounders (taken from a pool of potential confounders: age at death, patient gender, racial/ethnic minority status, level of education, insurance type, attributed facility, and number of Dartmouth Atlas chronic conditions). A variable was considered a confounder if its addition to the bivariate model changed the coefficient for the predictor by at least 10%. Binary outcomes were modeled with logistic regression. For count outcomes, we included only patients who had 1 or more days of the relevant type of care and modeled the remaining cases with negative binomial regression. All estimation was done with restricted maximum likelihood. Statistical significance was p <0.05. Results- In the last 30 days of life, decedents with hematologic cancer were significantly more likely to have aggressive hospital-based care, as measured by receipt of inpatient care, hospitalization for 14 or more days, multiple hospital admissions, and more days of hospital care, once admitted, than were those with solid tumor malignancies. They were also significantly more likely to have received ICU care, and to have spent more time in the ICU, once admitted, in the last 30 days of life. Finally, patients with hematologic malignancies were more likely to have died in a hospital rather than in other locations and more likely to have had documentation of AD in their electronic record. Among patients with hematologic malignancies, racial/ethnic minorities were less likely than white non-Hispanics to have documentation of AD and more likely to have 2+ emergency department visits or 14+ days of inpatient care, and had more days of inpatient care and ICU care, once admitted, in the last 30 days of life Conclusions- Patients with hematologic malignancies received more aggressive care at the end of life as measured by hospital utilization, despite having more documentation of AD than patients with solid tumor malignancy. Racial/ethnic minorities with hematologic malignancies had lower rates of AD documentation and received even more aggressive care than their white counterparts. Although these are administrative data, they suggest opportunities to improve end-of-life care of patients with hematologic malignancies, particularly racial/ethnic minorities. Disclosures Lee: Mallinckrodt: Honoraria; Amgen: Other: One-time advisory board member; Bristol-Myers-Squibb: Other: One-time advisory board member; Kadmon: Other: One-time advisory board member.

scholarly journals Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 142
Author(s):  
Hyo-Jin Park ◽  
Yun-Mi Lee ◽  
Mi Hwa Won ◽  
Sung-Jun Lim ◽  
Youn-Jung Son
Keyword(s):  
Linear Regression ◽  
End Of Life ◽  
Mediation Analysis ◽  
End Of Life Care ◽  
Cross Sectional Study ◽  
Hospital Nurses ◽  
Life Care ◽  
Cross Sectional ◽  
Mediating Role

Few studies have explored how nurses in acute care hospitals perceive and perform end-of-life care in Korea. Therefore, this study aimed to evaluate the influence of nurses’ perceptions of death on end-of-life care performance and analyze the mediating role of attitude towards end-of-life care among hospital nurses. This cross-sectional study included a total of 250 nurses who have had experience with end-of-life care from four general hospitals in Korea. We used the Korean validated tools with the View of Life and Death Scale, the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, and the performance of end-of-life care. Hierarchical linear regression and mediation analysis, applying the bootstrapping method. The results of hierarchical linear regression showed that nurses’ positive perceptions of death and attitude towards end-of-life care were significantly associated with their performance of end-of-life care. A mediation analysis further revealed that nurses’ attitude towards end-of-life care mediates the relationship between the perceptions of death and performance of end-of-life care. Our findings suggest that supportive and practical death educational programs should be designed, based on nurses’ professional experience and work environment, which will enable them to provide better end-of-life care.

End of Life Care and Reactions to Death in African-American and White Family Caregivers of Relatives with Alzheimer's Disease

2001 ◽  
Vol 43 (4) ◽  
pp. 349-361 ◽  
Author(s):  
Jason E. Owen ◽  
Kathryn T. Goode ◽  
William E. Haley
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African American ◽  
End Of Life ◽  
Family Caregivers ◽  
Ethnic Differences ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
White Caregivers

Family caregivers for relatives with Alzheimer's Disease (AD) often experience significant stress-related problems in mental and physical health. Patients with AD often survive for protracted periods of time, placing an extensive burden of care on the caregiver prior to the patient's death. The present study addresses ethnic differences in the experience of AD caregivers around the time of their loved one's death, including life-sustaining treatment decisions and reactions to death. The results showed that, in our sample, more patients died in their homes than has been reported for deaths in the United States. African-American and White caregivers differed substantially in their reports of end of life care and subjective reactions to the death. Compared with White caregivers, African-American caregivers were less likely to make a decision to withhold treatment at the time of death, less likely to have their relative die in a nursing home, and reported less acceptance of the relative's death and greater perceived loss. Results suggest that death after AD caregiving deserves further study, and that ethnic differences in end of life care and bereavement may be of particular importance.

scholarly journals Racial/Ethnic Preferences, Sex Preferences, and Perceived Discrimination Related to End-of-Life Care

2006 ◽  
Vol 54 (1) ◽  
pp. 150-157 ◽  
Author(s):  
Sonia A. Duffy ◽  
Frances C. Jackson ◽  
Stephanie M. Schim ◽  
David L. Ronis ◽  
Karen E. Fowler
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Perceived Discrimination ◽  
Life Care ◽  
Sex Preferences ◽  
Racial Ethnic
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