Stacy Fischer|Angela Sauaia|Sung?Joon Min|Jean S. Kutner
Advance Directive Discussions: Lost in Translation or Lost Opportunities?
University of Colorado Denver|Colorado School of Public Health|University of Colorado Denver|University of Colorado Denver
previous studies shown minority populations low rates documented advance directives express preferences lifeprolonging interventions end life sought determine impact latino ethnicity patients selfreport advance directive discussion completed advance directive medical record index hospitalization serious medical illnessthis prospective observational cohort study 458 adults admitted general medical services safety net hospital academic medical center veterans affairs va hospital patients asked discussed advance directives reviewed medical records documented advance directivesoverall 45 patients reported discussion advance directives 29 latinos compared 54 caucasians p00002 24 patients completed advance directive medical record 25 latinos 26 caucasians pnot significant ns using logistic regression modeling adjusting socioeconomic status ses education level language spoken latinos odds ratio 042 confidence interval ci 024075 less likely report advance directive discussions compared caucasians referent however modeling completed advance directive medical record showed significant difference latinos 144 ci 073285 caucasians referentthe unexpected discrepancy found highlights need effective communication advance care planning includes education culturally sensitive accessible persons low health literacy