This review by Lilian clearly proves that there is a clear disparity in the utilization of hospice services by the minority groups. [Lilian, 2008]
Yuri et.al (2010) studied the willingness of older Korean-American people in using Hospice services. Using Andersen's behavioral model factors that either contribute or affect, the willingness to use hospices services were explored. The subjects for the study were chosen from the data collected for the 'Mental Health Literacy Among Korean-American Elders project'. Using the information from the Florida Korean-American Association, the subjects for the study were selected based on the eligibility criteria of age above 60. In all, 675 participants fulfilled the selection criteria and questionnaires composed in Korean language were used to gather information which were categorized into three distinct measures namely 1) predisposing Factors, 2) Potential Health Needs and 3) Enabling factors. Predisposing factors included age, sex, education and marital status. Health needs were assessed using questions relating to chronic conditions such as heart ailments, arthritis, stroke, diabetes, cancer etc. Also using the 'older American resources and Services Questionnaire' the researchers were able to gauge the functional status of the subjects with scores ranging from 0 or no disability to a high 40 implying severe disability. Enabling factors included availability of insurance coverage, awareness about hospice services and degree of acculturation. The '12-item acculturation inventory' was used to assess this. The subjects were asked the following question "Hospice is a program that helps people who are dying by making them feel comfortable and free of pain when they can no longer be cured of their disease. If you needed hospice services, would you use them?" [Yuri et.al (2010) ]and they were asked to answer in a yes or no format.
Analysis of the gathered information revealed that 82% of the subjects had medical insurance and that almost 52.8% of the sample had previous knowledge about hospice services. The Acculturation scores were 15.8 ± 7.6 (max of 36). Statistical analysis showed that higher insurance coverage (OR = 0.59, 95% CI = 0.37 -- 0.94), higher acculturation score (OR = 1.07, 95% CI = 1.03 -- 1.10) and previous awareness of hospice services (OR = 4.43, 95% CI = 2.85 -- 6.90) contributed to increased willingness to accept hospice care. Statistical analysis also showed that the age and education were important predisposing factors with the younger (odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.93 -- 0.98) and those with education above high school level (OR = 1.67, 95% CI = 1.13 -- 2.48) were more willing to use hospice services. Though the present study indicated that more than 73% of the sample expressed their willingness to try hospice services, it is to be noted that this number is still lower compared to 94.4% among the white American population. Another important fact that can be inferred from this study is that though age is an important variable, the introduction of the previous awareness of hospice services measure into the study model significantly reduced the effect of age. This indicates that physicians and other care providers have an important task in getting rid of the prevailing misconceptions about hospice care and in increasing awareness about it. This would greatly help in changing the attitude of minority community about hospice care and lead to greater utilization of hospice services. This study also attests to previous findings that educational programs to spread awareness about hospice care will help remove apprehensions about end of life care services. [Yuri et.al, (2010)]
Discussion
Hospice offers the best quality of services for the terminally ill patients. Growing body of evidence suggests that hospice environment is the best for end of life caregiving compared to hospital settings. Despite these advantages, there is still a distinct lack of willingness among the U.S. population in choosing Hospice services. Within the national population, the minorities including the African-Americans, Hispanics and the Asian-Americans are disproportionately served in the hospice facilities. The research studies that were discussed above clearly highlight this discrepancy in end of life care utilization among the minority population. For instance, Jennifer et.al (2007) reported poor utilization of hospice programs in regions with high minority population. The researchers reported that cultural and social factors might have a big role in this disparity. The fact that African-Americans have high death rates among people with cancer and a generally prevailing mistrust of healthcare may be one of the important reasons why hospice care is not well accepted among the minority community. This in the light of the fact that Medicare requires that curative treatments be stopped before hospice services could be started creates more confusion and doubts.
Givens et.al (2010) concluded...
Hawaiian elder care professionals improve patient eldercare services to Japanese nationals, taking into consideration Japanese cultural norms and expectations Caregiving for elderly parents in Japan Japan has witnessed a significant growth in its elder population. In the year 1950, 4.9% of the Japanese population was aged 65 years and above. This figure increased to 14.8% (1995). By 2025, it is estimated to grow to 25.8% (Yamamoto & Wallhagen, 1997). Japan's 'very
Works CitedOur semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.
Get Started Now