Advance Care Planning Engagement and End-of-life Preference Among Older Chinese Americans: Do Family Relationships and Immigrant Status Matter?
Yaolin Pei, Wei Zhang, Bei Wu
PMID 32830042WHAT IT FOUND
Older Chinese Americans who were US-born were more likely to think about, discuss, and choose burial planning.
Family conflict was also linked to more engagement, while family closeness was not.
Key findings
01In this survey, 48.5% had thought about end-of-life care with family, 43.3% had discussed it with family, and 24.1% chose burial planning as important if they had 6 months to live.
02US-born participants were more likely than foreign-born participants to have thought about, discussed, and preferred burial planning in end-of-life care.
03Higher family conflict was associated with higher likelihood of thinking about end-of-life care, discussing it, and choosing burial planning, while family cohesion was not significantly related.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample came from one region and was recruited through snowball and convenience sampling, so it may not represent older Chinese Americans elsewhere. The data are cross-sectional, so they cannot show that immigrant status or family relationships caused advance care planning engagement. The survey measured only thinking about end-of-life care, discussing it, and burial planning preference, not completion of living wills, advance directives, or durable power of attorney. Advance care planning knowledge was not measured, although the authors note it could confound immigrant status and engagement. Missing rates for the outcomes were 13%, 15%, and 23%, and the analysis used multiple imputation.
The easy way to misread this
Do not read these results as proof that being US-born or having family conflict causes advance care planning engagement. This is a cross-sectional survey, so it cannot show cause, and the associations may reflect other factors.