Decision-making styles of seriously ill male Veterans for end-of-life care: Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders

Patient Education and Counseling
Ursula K BraunLaurence B McCullough

Abstract

To describe self-reported decision-making styles and associated pathways through end-of-life (EOL) decision-making for African-American, Caucasian, and Hispanic seriously ill male Veterans, and to examine potential relationships of race/ethnicity on these styles. Forty-four African American, White, and Hispanic male Veterans with advanced serious illnesses participated in 8 racially/ethnically homogenous focus groups. Transcripts were qualitatively analyzed to identify major themes, with particular attention to themes that might be unique to each of the racial/ethnic groups. Patients described two main decision-making styles, deciding for oneself and letting others decide, leading to five variants that we labeled Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders. These variants, with exception of avoiders (not found among White patients), were found across all racial/ethnic groups. The variants suggested different 'implementation strategies', i.e., how clear patients made decisions and whether or not they then effectively communicated them. These identified decision-making styles and variants generate strategies for clinicians to better address individualized advance care planning. Physicians should elicit se...Continue Reading

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Citations

Feb 4, 2016·Journal of Palliative Medicine·Justin J SandersSusan D Block
Oct 16, 2015·Palliative & Supportive Care·Shailaja MenonUrsula K Braun
Aug 1, 2016·Emergency Medicine Clinics of North America·Alyssia McEwan, Joshua Z Silverberg
Feb 26, 2016·Journal of Applied Gerontology : the Official Journal of the Southern Gerontological Society·Nathan A Boucher
Jul 5, 2018·Journal of the American Geriatrics Society·Laura A PetrilloRebecca L Sudore
Oct 26, 2018·International Journal of Older People Nursing·Michael LeporeKirsten Corazzini
Feb 26, 2020·Journal of Palliative Care·Evangeline M Ortiz-DowlingLinda R Phillips
Nov 23, 2018·Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society·Janice D CristLinda R Phillips
Jul 22, 2018·Journal of Pain and Symptom Management·Ella McDermott, Lucy Ellen Selman

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