Encouraging Advance Care Planning among Spanish-Speaking Immigrants (Research Paper Sample)

Encouraging Advance Care Planning among Spanish-Speaking Immigrants
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Table of Contents TOC \o "1-3" \h \z \u Background PAGEREF _Toc102392950 \h 5Methods PAGEREF _Toc102392951 \h 7Study Overview PAGEREF _Toc102392952 \h 7Aims and Objectives PAGEREF _Toc102392953 \h 7Research Question PAGEREF _Toc102392954 \h 8Research hypothesis PAGEREF _Toc102392955 \h 8Setting PAGEREF _Toc102392956 \h 9Study Sample Size PAGEREF _Toc102392957 \h 9Intervention Procedures and Instrumentation PAGEREF _Toc102392958 \h 9Data Collection PAGEREF _Toc102392959 \h 10Data Analysis PAGEREF _Toc102392960 \h 11Results PAGEREF _Toc102392961 \h 11Participants’ Characteristics PAGEREF _Toc102392962 \h 11Discussion PAGEREF _Toc102392963 \h 12Strengths and limitations, and Further study PAGEREF _Toc102392964 \h 15Ethics PAGEREF _Toc102392965 \h 15Conclusion PAGEREF _Toc102392966 \h 16
Encouraging Advance Care Planning among Spanish-Speaking Immigrants
Abstract
Introduction
Advance care planning (ACP) improves end of life care, increases delivery of patient-centered care, and has been associated with empowering patients to have a voice in their end of life care even when they have lost the power and ability to relay their medical preferences. It is a process that allows critically ill patients to relay or express their goal and preferences of care when they have lost the power to communicate. ACP directives, even though important in improving the end of life care, have faced significant barriers that have contributed to their low uptake and acceptance among minority groups such as immigrants. Cultural and language barriers have received significant attention for contributing to low uptake of ACP directives among Spanish-speaking immigrants.
Methods
In this study, the researcher investigated the impact of delivering ACP education to Spanish-speaking immigrants in Spanish language to determine if there will be a change in attitude and possible uptake of ACP. The study was conducted in a sample of twenty Spanish-speaking immigrants, with a mean age of 59.7 years from a palliative care unit in the United States. During the study period, the researcher, with the help of a professional nurse assistant delivered two sessions of ACP education and discussion to participants twice a week in their convenient Spanish language throughout the month of April 2022.
Results
The primary outcome measure of this study was the completion of ACP form. Secondary measures included changes in behaviors regarding ACP discussions, choosing of surrogates, willingness to complete the ACP directives, and overall willingness to open up to clinicians during the period and after the study. These outcome measures were measured at one week after every week of ACP discussions through a questionnaire prepared by the researcher, and the documented changes recorded in a table.
Ethics
This study was approved by the appropriate institutional review board of the researcher, permission was obtained from the ethics committee of the palliative care facility, and informed consent obtained from participants before their participation in this study. The findings from this study are only meant for academic purposes and no name of the participants has been used in this study. All demographic data of participants remains concealed.
Conclusion and Relevance
ACP discussions in patients’ preferred language and culture leads to a change in attitude about end of life care and increases uptake of ACP directives. The positive gain obtained in the attitude and willingness to complete an ACP in future indicates the importance of patient-centered interventions when dealing with linguistically and culturally diverse population. Many Spanish-speaking immigrants had turned down completion of ACP directives because it was foreign and they did not understand its importance. Sessions of ACP discussions delivered to critically ill patients in their convenient language will increase its uptake and improve end of life care among Spanish-speaking immigrants. The evidence reported in this paper is expected to promote future communication between Spanish-speaking patients and physicians regarding the quality of end of life care decisions.
Background
A significant population of Americans is ageing, and cases of chronic conditions are surging, especially among the underserved minority groups. The prevalence of chronic diseases comes with in vulnerable population increases with age, and their vulnerability exposes them to poor health outcomes compared to other populations. Previous studies have established that minority groups are at a higher chance of developing poor health outcomes due to disparities such as low education levels, systematic barriers such as racism, and cultural barriers such as language barriers, fear of talking about death in the presence of a dying person, and social beliefs and practices (Frechman et al., 2020). The need to overcome these barriers requires that cultural-centered intervention to empower and enable minority groups to access and utilize healthcare services by making these services not only available, but also accessible (McDermott & Selman, 2018). Systematic and cultural barriers limit medical decisions when the patient is critically ill, creating a need for a more patient-centered approach that resonates with needs and preferences of patients and their surrogates (Risk et al., 2019). The use of advance care planning (ACP) has found significant application in handling this issue, but it remains underutilized,