An examination of Latino advanced cancer patients' and their informal caregivers' preferences for communication about advance care planning: A qualitative study

• Published in: Palliative & supportive care Vol. 18; no. 3; p. 277
• Main Authors: Shen, Megan Johnson, Gonzalez, Cyndi, Leach, Benjamin, Maciejewski, Paul K, Kozlov, Elissa, Prigerson, Holly G
• Format: Journal Article
• Language: English
• Published: England 01-06-2020
• Subjects: Advance Care Planning - trends; Aged; Caregivers - psychology; Communication; Consumer Behavior; Female; Hispanic Americans - psychology; Humans; Male; Middle Aged; Neoplasms - complications; Neoplasms - psychology; Patient Care - methods; Patient Care - psychology; Professional-Patient Relations; Qualitative Research; Terminal Care - methods; Terminal Care - psychology; Terminal Care - standards; Advance care planning; End-of-life care; Latino; Cancer; Communication; Health disparities
• ISSN: 1478-9523
• DOI: 10.1017/S1478951519000890

Latino-advanced cancer patients engage in advance care planning (ACP) at lower rates than non-Latino patients. The goal of the present study was to understand patients' and caregivers' preferred methods of communicating about ACP.
Patients and caregivers were interviewed about cultural, religious, and familial beliefs that influence engagement in ACP and preferences for ACP communication.
Findings highlighted that Latino patients respect doctors' medical advice, prefer the involvement of family members in ACP discussions with doctors, hold optimistic religious beliefs (e.g., belief in miracles) that hinder ACP discussions, and prefer culturally competent approaches, such as using their native language, for learning how to discuss end-of-life (EoL) care preferences.
Key cultural, religious, and familial beliefs and dynamics influence Latino engagement in ACP. Patients prefer a family-centered, physician informed approach to discussing ACP with consideration and incorporation of their religious medical beliefs about EoL care. Promising targets for improving the communication of and engagement in ACP include integrating cultural and religious beliefs in ACP discussions, providing information about ACP from the physician, involving family members in ACP discussions and decision-making, and giving instructions on how to engage in ACP discussions.