Predictors of intensive end-of-life and hospice care in Latino and white advanced cancer patients. Academic Article Article uri icon

Overview

MeSH

  • Adaptation, Psychological
  • Advance Directives
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • United States

MeSH Major

  • Attitude to Death
  • European Continental Ancestry Group
  • Hispanic Americans
  • Hospice Care
  • Neoplasms
  • Terminal Care

abstract

  • The role of end-of-life (EOL) care preferences and conversations in receipt of care near death for Latinos is unclear. This study examines rates and predictors of intensive EOL and hospice care among Latino and white advanced cancer patients. Two-hundred-and-ninety-two self-reported Latino (n=58) and white (n=234) Stage IV cancer patients participated in a U.S. multisite, prospective, cohort study from September 2002 to August 2008. The Latino and white, non-Hispanic participants were interviewed and followed until death, a median of 118.5 days from baseline. Patient-reported, baseline predictors of EOL care included EOL care preference; terminal illness acknowledgement; EOL discussion; completion of a DNR order; and religious coping. Caregiver postmortem interviews provided information regarding EOL care received. Intensive EOL care was defined as resuscitation and/or ventilation followed by death in an intensive care unit. Hospice was either in- or outpatient. Latino and white patients received intensive EOL and hospice care at similar rates (5.2% and 3.4% for intensive care, p=0.88; 70.7% versus 73.4% for hospice, p=0.33). No white or Latino patient who reported a DNR order or EOL discussion at baseline received intensive EOL care. Religious coping and a preference for life-extending care predicted intensive EOL care for white patients (adjusted odds ratio [aOR] 6.69 [p=0.02] and aOR 6.63 [p=0.01], respectively), but not for Latinos. No predictors were associated with Latino hospice care. EOL discussions and DNR orders may prevent intensive EOL care among Latino cancer patients. Efforts should continue to engage Latino patients and caregivers in these activities.

publication date

  • October 2013

has subject area

  • Adaptation, Psychological
  • Advance Directives
  • Attitude to Death
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Hospice Care
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Neoplasms
  • Prospective Studies
  • Quality of Life
  • Terminal Care
  • United States

Research

keywords

  • Journal Article
  • Multicenter Study

Identity

Language

  • eng

PubMed Central ID

  • PMC3791053

Digital Object Identifier (DOI)

  • 10.1089/jpm.2013.0164

PubMed ID

  • 24053593

Additional Document Info

start page

  • 1249

end page

  • 1254

volume

  • 16

number

  • 10