Success of a community-based delivery at recruiting individuals from underserved communities for an observational cohort study of an advance care planning intervention

2021 ◽  
Author(s):  
Lauren Jodi Van Scoy ◽  
Pamela D. Witt ◽  
Cindy Bramble ◽  
Christopher Richardson ◽  
Irene Putzig ◽  
...  
Keyword(s):  
Cohort Study ◽  
Advance Care Planning ◽  
Observational Cohort Study ◽  
Care Planning ◽  
Community Based ◽  
Underserved Communities ◽  
Observational Cohort ◽  
Advance Care ◽  
Planning Intervention

Heart to Heart Cards: A Novel, Culturally Tailored, Community-Based Advance Care Planning Tool for Chinese Americans

2021 ◽  
pp. 104990912198998
Author(s):  
Zhimeng Jia ◽  
Sandy C. Stokes ◽  
Shirley Y. Pan ◽  
Richard E. Leiter ◽  
Hillary D. Lum ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Minority Group ◽  
Chinese American ◽  
Chinese Americans ◽  
Care Planning ◽  
Compassionate Care ◽  
Community Based ◽  
Cultural Appropriateness ◽  
Culturally Tailored ◽  
Advance Care

Context: A paucity of literature describes the growing Chinese American community’s end-of-life (EOL) priorities and preferences. Objective: Develop a culturally-tailored advance care planning (ACP) tool to understand the EOL preferences of this underserved minority group. Methods: Informed by the Cultural Appropriateness Theory, the Chinese American Coalition for Compassionate Care (CACCC) developed Heart to Heart (HTH) Cards using a 3-step approach. First, CACCC created and refined a list of bilingual, culturally relevant EOL issues. Next, CACCC organized the EOL issues into a card deck. Finally, CACCC developed a unique playstyle of the cards—the HTH Café. From 2014-2019, CACCC recruited Chinese American volunteers and participants for HTH Cafés. Following each Café, participants completed an anonymous survey describing their sociodemographics, top 3 cards, and café evaluation. Results: The 54 HTH Cards were organized into 4 suits (spiritual, physical, financial/legal, and social). Each card displayed a culturally-tailored EOL issue in English and Chinese. Playstyles included one-on-one and group formats (ie. HTH Café). CACCC volunteers conducted 316 HTH Cafés for 2,267 Chinese American adults. Most participants were female (61.6%), between 18-50 years old (56.7%), lived in California (80.2%) and born in Asia (74.3%). The top priority (25.5%) was “If I’m going to die anyway, I don’t want to be kept alive by machines.” Participants thought the session was pleasant (99.5%) and expressed intent to complete advance directives (86.5%). Conclusion: HTH Cards represents the first, theory-driven, culturally-tailored ACP tool for Chinese Americans. More research is needed to establish its impact on ACP conversations and outcomes.

Association of advance care planning with place of death and utilisation of life-sustaining treatments in deceased patients at Taipei City Hospital in Taiwan

2020 ◽  
pp. bmjspcare-2020-002520
Author(s):  
Yung-Feng Yen ◽  
Ya-Ling Lee ◽  
Hsiao-Yun Hu ◽  
Wen-Jung Sun ◽  
Ming-Chung Ko ◽  
...  
Keyword(s):  
Cohort Study ◽  
Advance Care Planning ◽  
Place Of Death ◽  
Care Planning ◽  
City Hospital ◽  
Taipei City ◽  
Advance Care ◽  
Eol Care ◽  
To Receive ◽  
At Home

ObjectiveEvidence is mixed regarding the impact of advance care planning (ACP) on place of death. This cohort study investigated the effect of ACP programmes on place of death and utilisation of life-sustaining treatments for patients during end-of-life (EOL) care.MethodsThis prospective cohort study identified deceased patients between 2015 and 2016 at Taipei City Hospital. ACP was determined by patients’ medical records and defined as a process to discuss patients’ preferences with respect to EOL treatments and place of death. Place of death included hospital or home death. Stepwise logistic regression determined the association of ACP with place of death and utilisation of life-sustaining treatments during EOL care.ResultsOf the 3196 deceased patients, the overall mean age was 78.6 years, and 46.5% of the subjects had an ACP communication with healthcare providers before death. During the study follow-up period, 166 individuals died at home, including 98 (6.59%) patients with ACP and 68 (3.98%) patients without ACP. After adjusting for sociodemographic factors and comorbidities, patients with ACP were more likely to die at home during EOL care (adjusted OR (AOR)=1.71, 95% CI 1.24 to 2.35). Moreover, patients with ACP were less likely to receive cardiopulmonary resuscitation (AOR 0.36, 95% CI 0.25 to 0.51) as well as intubation and mechanical ventilation support (AOR 0.54, 95% CI 0.44 to 0.67) during the last 3 months of life.ConclusionPatients with ACP were more likely to die at home and less likely to receive life-sustaining treatments during EOL care.

scholarly journals Community-Based Conversations about Advance Care Planning for Underserved Populations Using Lay Patient Navigators

2020 ◽  
Vol 23 (7) ◽  
pp. 907-914
Author(s):  
Regina M. Fink ◽  
Danielle M. Kline ◽  
F. Amos Bailey ◽  
Daniel L. Handel ◽  
Sarah R. Jordan ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Underserved Populations ◽  
Care Planning ◽  
Community Based ◽  
Patient Navigators ◽  
Advance Care

Honing an Advance Care Planning Intervention Using Qualitative Analysis: The Living Well Interview

2003 ◽  
Vol 6 (4) ◽  
pp. 593-603 ◽  
Author(s):  
Carolyn Schwartz ◽  
Inga Lennes ◽  
Bernard Hammes ◽  
Carrie Lapham ◽  
Wayne Bottner ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Advance Care Planning ◽  
Care Planning ◽  
Living Well ◽  
Advance Care ◽  
Planning Intervention
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