Janet J. Lee|Alan Long|J. Randall Curtis|Ruth A. Engelberg
The Influence of Race/Ethnicity and Education on Family Ratings of the Quality of Dying in the ICU
University of Washington|University of Washington|University of Washington|University of Washington
contextracial ethnic differences endoflife care may attributable patient preferences healthcare disparities identifying factors differentiate preferences disparities may enhance endoflife care critically ill patients familiesobjectivesto understand association minority raceethnicity education family ratings quality dying death taking consideration possible markers patient family preferences endoflife care mediators associationmethodsdata obtained 15 intensive care units participating clusterrandomized trial palliative care intervention family members decedents completed selfreport surveys evaluating quality dying used regression analyses identify associations raceethnicity education quality dying ratings used path analyses investigate whether advance directives lifesustaining treatment acted mediators patient characteristics ratings quality dyingresultsfamily members returned 1290 surveys 2850 decedents patient family minority raceethnicity associated lower ratings quality dying presence living dying setting full support mediated relationship patient race family ratings patient race exerted indirect rather direct effect quality dying family minority race direct effect lower ratings quality dying neither patient family education associated quality dyingconclusionminority raceethnicity associated lower family ratings quality dying association mediated factors may markers patient family preferences living death setting full support family member minority raceethnicity directly associated lower ratings quality dying findings generate hypothesized pathways require future evaluation