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Barriers to and Facilitators of South Asian Indian‐Americans’ Engagement in Advanced Care Planning Behaviors
Author(s) -
Radhakrishnan Kavita,
Saxena Shubhada,
Jillapalli Regina,
Jang Yuri,
Kim Miyong
Publication year - 2017
Publication title -
journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 1527-6546
DOI - 10.1111/jnu.12293
Subject(s) - focus group , advance care planning , psychological intervention , qualitative research , health care , psychology , nursing , qualitative property , medicine , palliative care , sociology , social science , machine learning , anthropology , computer science , economics , economic growth
Purpose To identify barriers to and facilitators of older South Asian Indian‐Americans’ (SAIAs’) engagement in behaviors associated with advance care planning (ACP). Methods Using a descriptive qualitative design guided by the transcultural nursing assessment model, data were collected in focus groups of community‐dwelling older SAIA participants, SAIA family caregivers, and SAIA physicians. A directed approach using predetermined coding categories derived from the Transcultural Nursing Assessment model and aided by NVivo 10 software (Melbourne, Australia) facilitated the qualitative data analysis. Results Eleven focus groups with 36 older SAIAs (61% female, 83% 70+ years old), 10 SAIA family caregivers, and 4 SAIA physicians indicated prior lack of awareness of ACP, good health status, lack of access to linguistically and health literacy–tailored materials, healthcare provider hesitation to initiate discussions on ACP, trust in healthcare providers’ or oldest sons' decision making, busy family caregiver work routines, and cultural assumptions about filial piety and after‐death rituals as major barriers to engaging in ACP. Introducing ACP using personal anecdotes in a neutral, group‐based community setting and incentivizing ACP discussions by including long‐term care planning were suggested as facilitators to engage in ACP. Clinical Relevance The study's findings will guide development of culturally sensitive interventions to raise awareness about ACP among SAIAs and encourage SAIA older adults to engage in ACP.