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Communicating terminal diagnoses to Hispanic patients

Published online by Cambridge University Press:  23 March 2010

Iraida V. Carrion*
Affiliation:
School of Social Work, University of South Florida, Tampa, Florida
*
Address correspondence and reprint requests to: Iraida V. Carrion, University of South Florida, School of Social Work, 4202 East Fowler Ave., MGY 132 Tampa, FL 33620-6600. E-mail: icarrion@bcs.usf.edu

Abstract

Objective:

This study addressed factors physicians employ in their communication of a terminal diagnosis and a hospice referral to Hispanic patients.

Method:

The research method used was an exploratory qualitative in-depth semi-structured interview with thematic analysis. The interviews were with ten physicians in Central Florida. The interviews were conducted in Spanish and/or English with physicians who serve terminally ill Hispanic patients.

Results:

The findings provide vital information on factors that impact communication of diagnosis and hospice referral. Themes emerged relating to role of family members and end-of-life decision-making. Language barriers and limited knowledge of cultural factors and beliefs impacted communication related to end-of-life decisions. Gaps in training and education for physicians were also identified.

Significance of results:

These results suggest that discussing end-of-life issues with the diverse category of Hispanic patients and families will be enhanced by eliminating language barriers, increased understanding of the role of family members, and knowledge of cultural factors and beliefs related to end-of-life decisions.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

Bernard, H.R. (2002). Research Methods in Anthropology: Qualitative and Quantitative Approaches. 3rd. Ed., New York: Altamira Press.Google Scholar
Berzoff, J., Swantkowski, J. & Cohen, L.M. (2008). Developing a renal supportive care team from the voices of patients, families and palliative care staff. Palliative and Supportive Care, 6, 133139.Google Scholar
Bruera, E., Sweeney, C., Calder, K., et al. (2001). Patient preferences versus physicians perceptions of treatment decisions in cancer care. Journal of Clinical Oncology, 19, 28832885.CrossRefGoogle ScholarPubMed
Carlson, M.D.A., Morrison, S.R. & Bradley, E.H. (2008). Improving access to hospice care: Informing the debate. Journal of Palliative Care, 11, 426443.Google Scholar
Casarett, D.J., Crowley, R.L. & Hirschman, K.B. (2004). How should clinicians describe hospice to patients and families. American Medical Journal Geriatric Cardiologist, 52, 19231928.Google ScholarPubMed
Chochinov, H.M. (2002). Dignity-conserving care-A new model for palliative care: Helping the patient feel valued. JAMA, 287, 22532260.Google Scholar
Creswell, J.W. (1998). Qualitative Inquiry and Research Design Choosing Among Five Traditions. Thousand Oaks, CA: Sage Publications.Google Scholar
Gelfand, D., Balcazar, H., Parzuchowski, J., et al. (2004). Issues in hospice utilization by Mexicans. The Journal of Applied Gerontology, 23: 319.Google Scholar
Goldstein, N.E., Mehta, D., Teitelbaum, E., et al. (2008). “It's like crossing a bridge”: Complexities preventing physicians from discussing deactivation of implantable defibrillators at the end of life. Journal of General Internal Medicine, 23,26.Google Scholar
Haley, W., Allen, R., Reynolds, S., et al. (2002). Family issues in end-of-life making and end-of-life care. American Behavioral Scientist, 46, 284298.CrossRefGoogle Scholar
Lackan, N.A., Ostir, G.V., Freeman, J.L., et al. (2004). Hospice use by Hispanic and non-Hispanic White cancer decedents. Health Services Research, 39, 969983.Google Scholar
Payne, R., Medina, E. & Hampton, J.W. (2003). Quality of life concerns in patients with breast cancer: Evidence for disparity of outcomes and experiences in pain management and palliative care among African American women. Cancer. 97(Supplement 1), 311317.CrossRefGoogle ScholarPubMed
Pope, C., Ziebland, S. & Mays, N. (2000). Qualitative research in health care: analyzing qualitative data. British Medical Journal, 320, 114116.Google Scholar
Randall, H. & Csikai, E.L. (2003). Issues affecting utilization of hospice services by rural Hispanics. Journal of Ethnic & Cultural Diversity in Social Work, 12, 7994.CrossRefGoogle Scholar
Schonwetter, R.S. (2006). Hospice and palliative medicine: Ten years has made a difference. Journal of Palliative Medicine, 9, 236238.Google Scholar
Talamantes, M., Gomez, D. & Braun, K.L. (2000). Advance directives and end-of-life care: The Hispanic perspective. In Cultural Issues in End-of-Life Decision Making Braun, K.L., Pietsch, J.H., Blanchette, P.L., (eds.), pp. 83100. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Tulsky, J.A. (2005). Interventions to enhance communication among patients, providers, and families. Journal of Palliative Medicine, 8(Supplement 1), 95102.Google Scholar
U.S. Census Bureau. (2000). U.S. Census Web Site. Electronic Document, (http://www.census.gov/hhes/www/income/html), accessed April 1, 2007.Google Scholar
Ward, E., Jamal, A., Cokkinides, V., et al. (2004). Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer Journal for Clinicians, 54, 7893.CrossRefGoogle Scholar