This research will address cultural variation in approaches to autonomous decisionmaking, treatment preferences at the end of life, and family caregiver satisfaction with end of life care for their family member. The long-term objective is to develop models of cultural variations towards end of life decisions in order to promote respect for diversity and provide quality care to patients and their families dealing with eventually fatal illnesses. A cohort of 108 patients diagnosed with advanced lung or colon cancer, half of whom will be African American and half White (not of Hispanic origin), along with their identified family caregivers, will be studied prospectively over a two year study period. After death interviews will be conducted with family caregivers of patients who die. Survivor interviews will be conducted with patients who are still alive (and their family caregivers) at 8 months. Analysis of quantitative and qualitative data will lead to the identification of 1) A subset of values and outcomes which are important to both groups; 2) Subsets over which there are substantial differences by study group, e.g., treatment preferences for end of life care, characteristics of the patient's death and dying, valuing of the basic tenets of autonomy, and caregiver satisfaction with patient's end of life care, and 3) Reasons for the above differences using a combination of qualitative and quantitative techniques. The success of the project will be determined by our ability to identify a set of factors related to cultural variation and to be able to elucidate differences between and among study groups through analyses of the data. The results of this research will allow us to develop a subsequent, larger scale, research application on cultural variation and end of life care that can be tested with additional minority populations.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21NR005112-01
Application #
6080939
Study Section
Special Emphasis Panel (ZRG1-NURS (01))
Program Officer
O'Mara, Ann M
Project Start
1999-09-30
Project End
2001-08-31
Budget Start
1999-09-30
Budget End
2000-08-31
Support Year
1
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Albert Einstein Medical Center (Philadelphia)
Department
Type
DUNS #
City
Philadelphia
State
PA
Country
United States
Zip Code
19141
Phipps, Etienne; Harris, Diana; Braitman, Leonard E et al. (2005) Who enrolls in observational end of life research? Report from the cultural variations in approaches to end of life study. J Palliat Med 8:115-20
True, Gala; Phipps, Etienne J; Braitman, Leonard E et al. (2005) Treatment preferences and advance care planning at end of life: the role of ethnicity and spiritual coping in cancer patients. Ann Behav Med 30:174-9
Phipps, Etienne J; Braitman, Leonard E (2004) Family caregiver satisfaction with care at end of life: report from the cultural variations study (CVAS). Am J Hosp Palliat Care 21:340-2
Phipps, Etienne; True, Gala; Harris, Diana et al. (2003) Approaching the end of life: attitudes, preferences, and behaviors of African-American and white patients and their family caregivers. J Clin Oncol 21:549-54
Phipps, Etienne; Braitman, Leonard E; True, Gala et al. (2003) Family care giving for patients at life's end: report from the cultural variations study (CVAS). Palliat Support Care 1:165-70