title: Care at the end of life: focus on communication and race.
abstract: OBJECTIVE
  To profile communication and recommendations reported by adults with terminal illness and explore differences by patient and physician characteristics.
  
  
  METHODS
  This pilot was a cross-sectional study sample of 90 patients (39 Caucasian, 51 African American) with advanced heart failure or cancer. Participants completed an in-person, race-matched interview.
  
  
  RESULTS
  Participation was high (94%).
  
  
  CONCLUSIONS
  For example, only 30% reported discussion of advance directives, and 22% reported their physician inquired about spiritual support. Participants with cancer were significantly more likely to be receiving pain and/or symptom management at home, aware of prognosis, and participating in hospice. African American participants who were under the care of African American physicians were less likely to report pain and/or symptom management than other racial matches.Discussion: Although additional research on factors related to communication is important, initiation of patient-centered counseling by all physicians with seriously ill patients is essential.
authors.affiliation: Medical University of South Carolina, USA.
authors.forename: Jane G
authors.initials: JG
authors.lastname: Zapka
authors.forename: Rickey
authors.initials: R
authors.lastname: Carter
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Carter
authors.forename: Winnie
authors.initials: W
authors.lastname: Hennessy
authors.forename: Jerome E
authors.initials: JE
authors.lastname: Kurent
authors.forename: Susan
authors.initials: S
authors.lastname: DesHarnais
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D013727:Terminal Care; D014481:United States