Journal of palliative medicine
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Comparative Study
Health literacy not race predicts end-of-life care preferences.
Several studies have reported that African Americans are more likely than whites to prefer aggressive treatments at the end of life. ⋯ Health literacy and not race was an independent predictor of end-of-life preferences after hearing a verbal description of advanced dementia. In addition, after viewing a video of a patient with advanced dementia there were no longer any differences in the distribution of preferences according to race and health literacy. These findings suggest that clinical practice and research relating to end-of-life preferences may need to focus on a patient education model incorporating the use of decision aids such as video to ensure informed decision-making.
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Serious illness can cause economic devastation for families. Locally run patient day care programs, or programs for training caregivers for future caregiving employment, could provide a measure of economic resilience. We sought to gather pilot data on the circumstances of informal caregivers and the desirability of such programs. ⋯ Most ICs in this survey faced financial and personal hardships. A large majority reported that they would use day care or hired home care for their patients if it existed, and also reported interest in becoming certified, paid caregivers. These data suggest that an economic resilience option for families based on IC training in palliative care might work at Hospice Africa Uganda.
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Access to hospice is a growing public health matter given that quality care at the end of life should be provided to all individuals regardless of race, ethnicity, or socioeconomic status. Health care disparities, particularly among racial and ethnic groups, have been well documented in the scientific literature. However, little is known about the demographics of hospice users or the use of hospice services by specific racial and ethnic groups. ⋯ Racial variations in hospice use indicate minorities use services disproportionately less than white patients, even after researchers control for specific sociodemographic and clinical characteristics.
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To assess the reliability of quality indicators of end-of-life cancer care (QI-EOL) and evaluate the quality of end-of-life cancer care in general wards by using QI-EOL. ⋯ QI-EOL is generally a reliable quality measure instrument. We found the need for improvements of end-of-life cancer care in general wards using the QI-EOL.