Improving End-of-Life Care for Diverse Populations: Communication, Competency, and System Supports.
Sara G McCleskey, Cindy L Cain
PMID 30727741WHAT IT FOUND
Across African American, Latino and white community members, participants described wanting honest direct end-of-life information, but desired amount varied.
Nurses should ask patients and families what they want to know, not assume by race.
Key findings
01Direct communication about diagnosis, prognosis, and treatment options was a strong theme across groups, but the amount of information desired varied by individual regardless of race or ethnicity.
02African American and Latino participants emphasized provider characteristics, including shared background, cultural sensitivity, and trust, while white participants did not discuss provider characteristics.
03All groups raised health system barriers, including high costs, insurance problems, understaffed facilities, and poor care coordination.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Sample was small, from Los Angeles, recruited through community organizations and online postings, and not necessarily representative. All focus groups were in English, so non-English speakers were not included. Participants had varied experience with serious illness, and some may have had less knowledge about care. Qualitative perceptions cannot show that communication, cultural competency, or workforce changes improve patient outcomes. Themes describe groups in this study, not all African American, Latino, or white patients.
The easy way to misread this
Do not read these themes as proof that cultural matching, chaplain presence, or communication training improves end-of-life outcomes. The study reports perceptions from a small English-speaking focus group sample and tested no intervention.