title: Assessing Challenges in End-of-Life Conversations With Patients Utilizing a Public Safety-Net Health Care System.
abstract: Multiple factors influence end-of-life (EOL) care discussions that occur in health care systems, within organizations, among individuals working within these systems and in patients and family/friend support networks. This study examined barriers to EOL care discussions as experienced by health care providers working in a public safety-net health care system where the majority of their patients were low-income and immigrant Latinos seeking medical treatment. Qualitative data were collected in South Central Los Angeles through semistructured interviews with 46 health care providers from different disciplines in medicine, nursing, social work, and chaplaincy. The themes indicated communication barriers in the public sector health care setting and sociocultural patient- and family-level factors. All providers made valuable contributions to clarify the complexity of the problems. Universal strategies are needed to improve communication.
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA School of Social Work, University of Southern California, Los Angeles, CA, USA nedjatha@gmail.com.
authors.forename: Frances R
authors.initials: FR
authors.lastname: Nedjat-Haiem
authors.affiliation: School of Social Work, University of South Florida, Tampa, FL, USA.
authors.forename: Iraida V
authors.initials: IV
authors.lastname: Carrion
mesh_terms: D002977:Clergy / Q000523:psychology; D003142:Communication; D054242:Emigrants and Immigrants; D005190:Family / Q000208:ethnology; D006282:Health Personnel / Q000523:psychology; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D015141:Los Angeles; D011203:Poverty; D036301:Qualitative Research; D064876:Safety-net Providers / Q000458:organization & administration*; D000068217:Social Workers / Q000523:psychology; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000458:organization & administration*
keywords: Latinos/Hispanics; barriers; end-of-life communication; providers; qualitative; safety-net health care