| Acculturation of attitudes toward end-of-life care: a cross-cultural survey of Japanese Americans and Japanese. | |
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MedLine Citation:
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PMID: 12133143 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cross-cultural ethical conflicts are common. However, little is known about how and to what extent acculturation changes attitudes toward end-of-life care and advance care planning. We compared attitudes toward end-of-life care among Japanese Americans and Japanese in Japan. DESIGN: Self-administered questionnaire in English and Japanese. SETTING AND PARTICIPANTS: Community-based samples of Japanese Americans in Los Angeles and Japanese in Nagoya, Japan: 539 English-speaking Japanese Americans (EJA), 340 Japanese-speaking Japanese Americans (JJA), and 304 Japanese living in Japan (JJ). MEASUREMENTS AND MAIN RESULTS: Few subjects (6% to 11%) had discussed end-of-life issues with physicians, while many (EJA, 40%; JJA, 55%; JJ, 54%) desired to do so. Most preferred group surrogate decision making (EJA, 75%; JJA, 57%; JJ, 69%). After adjustment for demographics and health status, desire for informing the patient of a terminal prognosis using words increased significantly with acculturation (EJA, odds ratio [OR] 8.85; 95% confidence interval, [95% CI] 5.4 to 14.3; JJA, OR 2.8; 95% CI 1.8 to 4.4; JJ, OR 1.0). EJA had more-positive attitudes toward forgoing care, advance care planning, and autonomous decision making. CONCLUSION: Preference for disclosure, willingness to forgo care, and views of advance care planning shift toward western values as Japanese Americans acculturate. However, the desire for group decision making is preserved. Recognition of the variability and acculturation gradient of end-of-life attitudes among Japanese Americans may facilitate decision making and minimize conflicts. Group decision making should be an option for Japanese Americans. |
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Authors:
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Shinji Matsumura; Seiji Bito; Honghu Liu; Katharine Kahn; Shunichi Fukuhara; Marjorie Kagawa-Singer; Neil Wenger |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of general internal medicine Volume: 17 ISSN: 0884-8734 ISO Abbreviation: J Gen Intern Med Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-22 Completed Date: 2002-09-19 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 8605834 Medline TA: J Gen Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 531-9 Citation Subset: E; IM |
Affiliation:
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Division of General Internal Medicine and Health Services, University of California-Los Angeles, Los Angeles, Calif 90095-1736, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acculturation* Adolescent Adult Advance Directives Aged Aged, 80 and over Attitude to Health* Cross-Cultural Comparison* Decision Making Female Humans Japan / ethnology Los Angeles / epidemiology Male Middle Aged Terminal Care* |
| Grant Support | |
ID/Acronym/Agency:
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P50HS07370/HS/AHRQ HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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