Focus Group Findings about the Influence of Culture on Communication Preferences in End-of-Life Care
Article first published online: 17 JUN 2005
Journal of General Internal Medicine
Volume 20, Issue 8, pages 703–709, August 2005
How to Cite
Shrank, W. H., Kutner, J. S., Richardson, T., Mularski, R. A., Fischer, S. and Kagawa-Singer, M. (2005), Focus Group Findings about the Influence of Culture on Communication Preferences in End-of-Life Care. Journal of General Internal Medicine, 20: 703–709. doi: 10.1111/j.1525-1497.2005.0151.x
- Issue published online: 26 JUL 2005
- Article first published online: 17 JUN 2005
- Received for publication March 1, 2005 and in revised form March 3, 2005 Accepted for publication March 15, 2005
- cultural sensitivity;
- focus groups;
Background: Little guidance is available for health care providers who try to communicate with patients and their families in a culturally sensitive way about end-of-life care.
Objective: To explore the content and structure of end-of-life discussions that would optimize decision making by conducting focus groups with two diverse groups of patients that vary in ethnicity and socioeconomic status.
Design: Six focus groups were conducted; 3 included non-Hispanic white patients recruited from a University hospital (non-Hispanic white groups) and 3 included African-American patients recruited from a municipal hospital (African-American groups). A hypothetical scenario of a dying relative was used to explore preferences for the content and structure of communication.
Participants: Thirty-six non-Hispanic white participants and 34 African-American participants.
Approach: Content analysis of focus group transcripts.
Results: Non-Hispanic white participants were more exclusive when recommending family participants in end-of-life discussions while African-American participants preferred to include more family, friends and spiritual leaders. Requested content varied as non-Hispanic white participants desired more information about medical options and cost implications while African-American participants requested spiritually focused information. Underlying values also differed as non-Hispanic white participants expressed more concern with quality of life while African-American participants tended to value the protection of life at all costs.
Conclusions: The groups differed broadly in their preferences for both the content and structure of end-of-life discussions and on the values that influence those preferences. Further research is necessary to help practitioners engage in culturally sensitive end-of-life discussions with patients and their families by considering varying preferences for the goals of end-of-life care communication.