Relationship among Trust in Physicians, Demographics, and End-of-life Treatment Decisions Made by African American Dementia Caregivers
- PMID: 24353477
- PMCID: PMC3864045
- DOI: 10.1097/njh.0b013e318243920c
Relationship among Trust in Physicians, Demographics, and End-of-life Treatment Decisions Made by African American Dementia Caregivers
Abstract
Purpose: A pilot study was conducted in an urban African American community to explore the relationship between trust in physicians, demographics and end-of-life treatment decisions made by African American caregivers of family members with dementia: namely, cardiopulmonary resuscitation, mechanical ventilation and tube feeding.
Methods: In a cross-sectional design, standard measures were administered to a convenience sample of 68 African American caregivers of family members with dementia. Univariate and multivariate analyses were used to explore associations among the variables.
Results: Those with more education exhibited higher (p = 0.035) trust in physicians than less educated individuals. Caregivers who were more trusting of their physicians were more likely to use mechanical ventilation (p = 0.0005) than were less trusting caregivers. Conversely, more trusting caregivers were less likely to use tube feeding (p = 0.022).
Conclusions: Our findings suggest relationships exist among trust in physicians, demographics and end-of-life treatment decisions. Thus, health care providers should consider African American caregivers' perceived trust in physicians when counseling about dementia and end-of-life treatment choices.
Keywords: African American; Trust in physicians; cardiopulmonary resuscitation; dementia; mechanical ventilation; tube feeding.
Conflict of interest statement
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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References
-
- Rastogi S, Johnson TD, Hoeffel EM, et al. The Black population: 2010 (census 2010 brief) Washington DC: US Census Bureau; 2010.
-
- Alzheimer’s Association. Special Report: Race, Ethnicity, and Alzheimer’s Disease. Chicago: Author; 2010 Alzheimer’s Disease Facts and Figures.
-
- Elliott BA, Gessert CE, Peden-McAlpine C. Family decision-making in advanced dementia: narrative and ethics. Scand J Caring Sci. 2009;23(2):251–8. - PubMed
-
- Braun UK, McCullough LB, Beyth RJ, et al. Racial and ethnic differences in the treatment of seriously ill patients: a comparison of African-American, Caucasian and Hispanic veterans. J Natl Med Assoc. 2008;100(9):1041–51. - PubMed
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