Advance Directives: Young Adult African-American Family Members' Perceptions, Knowledge, Attitudes, and Utilization

Tuesday, 13 July 2010: 2:05 PM

Carolyn Ramsey, PhD, ARNP
Nursing Department, Florida Hospital College of Health Sciences, Orlando, FL

Learning Objective 1: Understand the knowledge, attitudes, and utilization of Advance Directives in family members.

Learning Objective 2: Identify the perceptions of family members of young adult African Americans toward Advance Directives.

Purpose: The purpose of this descriptive, mixed-method study was to discover the perceptions, knowledge, and attitudes of young adult African American family members towards the use of ADs.  The study further sought to determine whether there was a relationship between gender, education level, marital status, and occupation in making this decision. 

Methods: This study used a mixed-methodology design primarily involving the use of quantitative data and secondarily involving the use of qualitative data. A purposive, convenience sample of 112 young adult African American family members ages 21-40 years was used for the quantitative portion of the study.  A power analysis was completed to obtain a participant sample size of N = 112 with a probability level of p = .05 (two-tailed), effect size of .3, and power of .90.  A chi-square analysis and Fisher Exact test was used to address these two questions and two hypotheses.  Qualitative data consisted of 10 participants, 5 males and 5 females in a focus group session that identified various themes.

Results: The data did not support evidence of significant relationships between the variables gender, marital status, education, and occupation and the knowledge, attitudes, and utilization of ADs with the exception for the relationship between gender and the feeling of being treated differently for having a living will in place.  The data revealed perceptions, knowledge, and attitudes of ADs which the researcher categorized into seven themes:  (a) lack of knowledge, (b) fear of death, (c) trust in God, (d) family as decision maker, (e) decrease in family stress, (f) family as decision-maker, and (g) respecting choices.

Conclusion: Results suggest a need for members of young adult African American families to obtain knowledge of ADs prior to suffering any unforeseen illness or incapacitation resulting in their inability to make potentially life-altering medical decisions for themselves.