Assessing Challenges in End-of-Life Conversations With Patients Utilizing a Public Safety-Net Health Care System

Multiple factors influence end-of-life (EOL) care discussions that occur in health care systems, within organizations, among individuals working within these systems and in patients and family/friend support networks. This study examined barriers to EOL care discussions as experienced by health care...

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Bibliographic Details
Published in:American journal of hospice & palliative medicine 2015-08, Vol.32 (5), p.528-536
Main Authors: Nedjat-Haiem, Frances R., Carrion, Iraida V.
Format: Article
Language:English
Subjects:
Clergy - psychology
Communication
Emigrants and Immigrants
Family - ethnology
Health Personnel - psychology
Hispanic Americans
Humans
Interviews as Topic
Los Angeles
Nursing
Poverty
Qualitative Research
Safety-net Providers - organization & administration
Social Workers - psychology
Socioeconomic Factors
Terminal Care - organization & administration
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Summary:Multiple factors influence end-of-life (EOL) care discussions that occur in health care systems, within organizations, among individuals working within these systems and in patients and family/friend support networks. This study examined barriers to EOL care discussions as experienced by health care providers working in a public safety-net health care system where the majority of their patients were low-income and immigrant Latinos seeking medical treatment. Qualitative data were collected in South Central Los Angeles through semistructured interviews with 46 health care providers from different disciplines in medicine, nursing, social work, and chaplaincy. The themes indicated communication barriers in the public sector health care setting and sociocultural patient- and family-level factors. All providers made valuable contributions to clarify the complexity of the problems. Universal strategies are needed to improve communication.
ISSN:1049-9091
1938-2715
DOI:10.1177/1049909114530550