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Terminally ill Black elders: Making the choice to receive hospice care

TitleTerminally ill Black elders: Making the choice to receive hospice care
Publication TypeThesis
Year of Publication2013
AuthorsNoh, H
UniversityNoh, Hyunjin: U Wisconsin - Madison, US
Accession NumberDissertation Abstract: 2013-99110-455
Keywords*Blacks, *Elder Care, *Health Care Utilization, *Hospice, *Terminally Ill Patients, Developmental Psychology [2800], Human Adulthood (18 yrs & older) Aged (65 yrs & older), terminal illness, Black elders, hospice care, health care utilization, cultural preferences, us
AbstractThe underuse of hospice care by African-Americans has been witnessed for decades in the United States. Researchers have explored the barriers to African-American patients' accessing hospice care and their end-of-life healthcare preferences. Though knowledge from previous studies provides insight into why African-American elders might not choose to use hospice care even when they have access to it, currently there appears to be no research that has explored why some African-American elders do choose to receive such care. This study seeks to address this gap by interviewing terminally ill older African-American hospice patients and gathering information regarding the following three research questions: why do terminally ill African-American elders choose to use hospice care?; what structural barriers do they face when accessing hospice care, and how have they overcome them?; and what cultural preferences do they have in receiving hospice care and what is their experience in having their preferences respected? To gain such information, face-to-face interviews were conducted using a semi-structured survey with 28 older African-American hospice patients in Georgia. Participants' responses were analyzed using the directed content analysis guided by the Behavioral Model for Vulnerable Populations, which provided predetermined coding categories for the content analysis. Themes answering to the first research question emerged in the predetermined categories of religion, family-centered culture of care and information source. In addition, three new thematic categories emerged: opposition to aggressive treatment, perceived health decline and knowledge of terminal condition. Answers to the second research question were sought using predetermined categories of income, health insurance, location, administrative procedure and full-time caregiver requirement. The third research question was answered by themes that emerged in the predetermined categories of values concerning health and illness, outreach efforts by the hospice agency and diversity among healthcare providers. The findings of this study has micro-, mezzo- and macro-level implications and will provide end-of-life care providers and policy makers with insights for strategies to promote the hospice use by African-American elders. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
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