Acculturation of attitudes toward end-of-life care: a cross-cultural survey of Japanese Americans and Japanese. Export

@article{citeulike:572255, abstract = {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.}, address = {Division of General Internal Medicine and Health Services, University of California-Los Angeles, Los Angeles, Calif 90095-1736, USA.}, author = {Matsumura, S. and Bito, S. and Liu, H. and Kahn, K. and Fukuhara, S. and Kagawa-Singer, M. and Wenger, N.}, citeulike-article-id = {572255}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/12133143}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=12133143}, issn = {0884-8734}, journal = {J Gen Intern Med}, keywords = {culturalcompetence, decisionmaking, doctorpatientrelationship, endoflife, japan}, month = {July}, number = {7}, pages = {531--539}, posted-at = {2006-04-01 00:38:24}, priority = {2}, title = {Acculturation of attitudes toward end-of-life care: a cross-cultural survey of Japanese Americans and Japanese.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/12133143}, volume = {17}, year = {2002} }

TY - JOUR ID - citeulike:572255 L3 - citeulike-article-id:572255 N2 - 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. IS - 7 JF - J Gen Intern Med SN - 0884-8734 AD - Division of General Internal Medicine and Health Services, University of California-Los Angeles, Los Angeles, Calif 90095-1736, USA. EP - 539 TI - Acculturation of attitudes toward end-of-life care: a cross-cultural survey of Japanese Americans and Japanese. VL - 17 SP - 531 KW - culturalcompetence KW - decisionmaking KW - doctorpatientrelationship KW - endoflife KW - japan AU - Matsumura, S AU - Bito, S AU - Liu, H AU - Kahn, K AU - Fukuhara, S AU - Kagawa-Singer, M AU - Wenger, N PY - 2002/07// UR - http://view.ncbi.nlm.nih.gov/pubmed/12133143 ER -