Living Well with Living Wills: Application of Protection Motivation Theory to Living Wills Among Older Caucasian and African American Adults

Abstract

Using protection motivation theory, we examined racial differences in intent to complete a living will, rational problem solving (e.g., information seeking), and maladaptive coping responses (i.e., wishful thinking) to a health crisis. Sixty healthy, older adults without living wills responded to written vignettes, including information about living wills as an effective coping mechanism to avoid a health crisis. Use of adaptive coping responses predicted intent to execute a living will. A significant race-by-threat interaction predicted use of rational problem solving, with Caucasians more likely to seek information in response to perceived threat in comparison with African Americans. A significant race-by-adaptive-coping interaction predicted maladaptive coping, indicating that Caucasians were more variable in their maladaptive responses. The effectiveness of health care messages regarding living wills for older adults may be enhanced by focusing on racial differences in response to perceived health threat and perceived adaptive coping information.

FIGURE 1

The cognitive mediating processes of protection motivation theory (adapted from Rogers & Prentice-Dunn, 1997).

FIGURE 2

Race by threat interaction predicting use of rational problem solving in response to the threat of living in a persistent vegetative state. Values along the horizontal and vertical axes are presented as z scores.

FIGURE 3

Race by coping interaction predicting older adults' use of maladaptive coping responses to the health threat of living in a persistent vegetative state. Values along the horizontal and vertical axes are presented as z scores.