title: Exploring uncertainty in advance care planning in African Americans: does low health literacy influence decision making preference at end of life.
abstract: African Americans over 65 represent 3.5 of the 35.6 million Americans. Morbidity and mortality rates are highest among this group; associated with lack of resources and awareness of health problems. But health needs are the same at end of life, yet care is less than optimal. African Americans are less likely to have advance directives nonetheless desire communication, information, respect, and a trusting doctor-patient relationship. Low health literacy may contribute to this disparity. This scholarly review examines the health literacy in advance care planning and refines concepts of uncertainty in illness theory deriving a model for advance care planning in African Americans.
authors.affiliation: Lee Memorial Health System, Gulf Coast Medical Center, FL 33912, USA. Lolita.melhado@leememorial.org
authors.forename: Lolita
authors.initials: L
authors.lastname: Melhado
authors.forename: Angeline
authors.initials: A
authors.lastname: Bushy
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration*; D001741:Black or African American; D000368:Aged; D001293:Attitude to Death; D003142:Communication; D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy / Q000706:statistics & numerical data*; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D020380:Needs Assessment; D057240:Patient Preference / Q000208:ethnology*; D010817:Physician-Patient Relations; D013727:Terminal Care; D035501:Uncertainty