Multiple Stakeholders' Perspectives Regarding Barriers to Hospice Enrollment in Diverse Patient Populations: A Qualitative Study

Journal of Pain and Symptom Management
Katherine Cicolello, Gowri Anandarajah

Abstract

Although studies show disparities in hospice care utilization, many questions remain regarding the causes of these disparities. Most studies focus on a single ethnic/racial group, and most use physician informants. None compare and contrast views of multiple stakeholders or use a systems approach within a single geographic region. To gain an in-depth understanding of causes of hospice enrollment disparities in diverse patient populations within one state in the U.S. We conducted in-depth, individual interviews with multiple stakeholders in hospice care for diverse communities in Rhode Island. We identified participants through purposeful and snowball sampling strategies, aiming for a maximum variation sample. Interviews were audio-recorded, transcribed verbatim, and analyzed using a multistep grounded theory approach. Participants, self-identifying from a wide variety of ethnic backgrounds, included physicians, nurses, social workers, chaplains, nursing assistants, administrators, and caregivers. Five themes emerged regarding patient- and provider-level barriers to hospice enrollment: 1) universal challenges of goals of care (GOC) conversations; 2) cultural norms and beliefs; 3) language barriers; 4) provider-specific challenge...Continue Reading

Citations

May 19, 2019·Journal of Surgical Oncology·Cary Jo R Schlick, David J Bentrem
Jan 1, 2020·The American Journal of Hospice & Palliative Care·Channing E TateDaniel D Matlock
Jan 9, 2020·Journal of Palliative Care·Leigh M Vaughan, Emma L Kofmehl
Mar 21, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Anghela Z ParedesTimothy M Pawlik
Nov 25, 2020·Journal of Gerontological Nursing·Susan O'Conner-Von, Frank Bennett
Aug 24, 2020·Journal of Pain and Symptom Management·Gabrielle DresslerGowri Anandarajah
Feb 5, 2021·The American Journal of Hospice & Palliative Care·Mohsen BazarganLucy W Kibe
Sep 17, 2021·Journal of Medical Internet Research·M Pilar IngleJennifer Portz

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