Knowledge Gaps About End-of-Life Decision Making Among Mexican American Older Adults and Their Family Caregivers: An Integrative Review

J Transcult Nurs. 2019 Jul;30(4):380-393. doi: 10.1177/1043659618812949. Epub 2018 Nov 22.

Abstract

Introduction: Mexican Americans (MAs) are the largest, fastest growing Latino subgroup in the United States, yet their use of hospice is limited. To better understand this disparity, the authors conducted an integrative review focused on MA caregiving families' end-of-life (EOL) care decisions.

Method: In this literature review, the authors content analyzed results and discussions of 22 research studies focused on EOL decisions, which sampled MA adults at least 50 years old and/or families. The authors used Whittemore and Knafl's integrative review process, employing constructs from the Ethno-Cultural Gerontological Nursing Model.

Results: Topics included attitudes toward hospice, life-sustaining treatment, advance care planning, EOL decision making, perceptions of a good death, and life-limiting illnesses. EOL research for MA caregiving families is meager, largely atheoretical, and rarely validated by subsequent studies.

Discussion: Nursing research is needed to extend theory and policy in order to skillfully match EOL care with MA caregiving families' needs.

Keywords: end-of-life care; family health; gerontology; health disparities; integrative review; public health policy; systematic reviews.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Caregivers / psychology*
  • Decision Making*
  • Female
  • Health Literacy / standards*
  • Health Literacy / statistics & numerical data
  • Humans
  • Male
  • Mexican Americans / education
  • Mexican Americans / psychology
  • Mexican Americans / statistics & numerical data
  • Terminal Care
  • United States