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Learning Objective 1: Discuss the planning, development, and evaluation of a culturally sensitive seminar on advance care planning.
Learning Objective 2: Describe the effectiveness of an educational intervention on attitudes towards advance directives in Chinese Americans.
Background: Advance directives are documents that guide end-of-life (EOL) decisions when decision-making capacity is lost. Research about ADs is limited in minority populations. Chinese Americans represent the third largest immigrant group in the United States. Interventions to increase awareness and knowledge of ACP in CA are important in promoting quality EOL care.
Methods: A cross-sectional pre-test post-test design was used. Institutional review board approval was obtained. A convenience sample of community-dwelling CA was recruited. Using Five Wishes, an AD available in Chinese, a bilingual seminar with hands-on activities was conducted. The Advance Directive Attitude Survey (ADAS) was completed pre-and post-seminar. Descriptive analyses and t-tests were conducted using SPSS.
Results: Of the 72 participants, 44 (61.1%) were female, 45 (62.5%) were college educated, and 23 (31.9%) had a chronic disease. Participant age ranged from 32 to 87 (M= 60.91+12.31). Only one had been on life support and had made EOL decisions. Post-seminar ADAS scores were significantly higher (M= 52.05, SE=5.99) than pre-seminar (M=50.17, SE=4.28), t(62)= -3.159, p <.05, r= .37.
Conclusion: Positive attitudes toward ACP increase the likelihood of AD completion. We found community dwelling CA had a less positive attitude towards AD compared to the US inpatient population. The findings of this study have global implications that a culturally sensitive seminar improved the attitudes of ADs in minority ethnic groups. Chinese Americans in this study were open and eager to learn about ACP. Nurses can create culturally-sensitive educational programs to meet the needs of individuals within their communities and to promote the completion of AD and ACP.