title: A multicenter survey of Hispanic caregiver preferences for patient decision control in the United States and Latin America.
abstract: BACKGROUND
  Understanding family caregivers' decisional role preferences is important for communication, quality of care, and patient and family satisfaction. The family caregiver has an important role in a patient's decisional role preferences. There are limited studies on family caregivers' preferences of the patient's decision control at the end of life among Hispanics.
  
  
  OBJECTIVE
  To identify Hispanic caregivers' preferences of the decision control of patients with advanced cancer and to compare the preferences of caregivers in Hispanic Latin American and Hispanic American caregivers.
  
  
  METHODS
  We surveyed patients and their family caregivers referred to outpatient palliative care clinics in the United States, Chile, Argentina, and Guatemala. Caregiver preferences of patient's decision control were evaluated using the Control Preference Scale. Caregivers' and patients' sociodemographic variables, patient performance status, and Hispanic American patient acculturation level were also collected.
  
  
  METHODS
  A total of 387 caregivers were surveyed: 100 (26%) in Chile, 99 (26%) in Argentina, 97 (25%) in Guatemala, and 91 (24%) in the United States. The median age was 56 years, and 59% were female.
  
  
  RESULTS
  Caregiver preference of patient's decision control was passive, shared, and active for 10 (11%), 45 (52%), and 32 (37%) Hispanic American caregivers and 54 (19%), 178 (62%), and 55 (19%) Hispanic Latin American caregivers (p = 0.0023), respectively. Caregiver acculturation level did not affect the preferences of the Hispanic American sample (p = 0.60).
  
  
  CONCLUSIONS
  Most Hispanic family caregivers preferred the patient to make shared decisions. Hispanic Latin American caregivers more frequently preferred patients to assume a passive decisional role. Acculturation did not influence the preferences of Hispanic American caregivers.
authors.affiliation: Department of Palliative Care & Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Sriram
authors.initials: S
authors.lastname: Yennurajalingam
authors.forename: Antonio
authors.initials: A
authors.lastname: Noguera
authors.forename: Henrique Afonseca
authors.initials: HA
authors.lastname: Parsons
authors.forename: Isabel
authors.initials: I
authors.lastname: Torres-Vigil
authors.forename: Eva Rosina
authors.initials: ER
authors.lastname: Duarte
authors.forename: Alejandra
authors.initials: A
authors.lastname: Palma
authors.forename: Sofia
authors.initials: S
authors.lastname: Bunge
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.forename: Marvin Omar
authors.initials: MO
authors.lastname: Delgado-Guay
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000069:Acculturation; D001118:Argentina / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology*; D002677:Chile / Q000453:epidemiology; D003657:Decision Making; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: Decisional role preferences; Hispanics; Latinos; family caregivers; palliative care