title: End-of-Life Decision Making and Communication of Bereaved Family Members of African Americans with Serious Illness.
abstract: OBJECTIVE
  The study objective was to examine factors that influence African American (AA) family members' end-of-life care decision outcomes for a relative who recently died from serious illness.
  
  
  METHODS
  A cross-sectional descriptive study design was used. Binary logistic and linear regressions were used to identify factors associated with decision regret and decisional conflict. Forty-nine bereaved AA family members of AA decedents with serious illness who died two to six months prior to enrollment were recruited from the palliative care program in a safety net hospital and a metropolitan church in the Midwest. Measurements used were the Decisional Conflict, Decision Regret, Beliefs and Values, and Quality of Communication scales.
  
  
  RESULTS
  Family members who reported higher quality of communication with health care providers had lower decisional conflict. Family members of decedents who received comfort-focused care (CFC) had significantly less decision regret than family members of those who received life-prolonging treatment (LPT). Family members who reported stronger beliefs and values had higher quality of communication with providers and lower decisional conflict.
  
  
  CONCLUSIONS
  This research adds to a small body of literature on correlates of end-of-life decision outcomes among AAs. Although AAs' preference for aggressive end-of-life care is well-documented, we found that receipt of CFC was associated with less decision regret. To reduce decisional conflict and decision regret at the end of life, future studies should identify strategies to improve family member-provider communication, while considering relevant family member and decedent characteristics.
authors: 1 NewCourtland Center for Transitions and Health, University of Pennsylvania , Philadelphia, Pennsylvania.|2 School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania.
authors: Esther R
authors: ER
authors: Smith-Howell
authors: 3 School of Nursing, Indiana University , Indianapolis, Indiana.|5 Simon Cancer Center, Indiana University , Indianapolis, Indiana.
authors: Susan E
authors: SE
authors: Hickman
authors: 1 NewCourtland Center for Transitions and Health, University of Pennsylvania , Philadelphia, Pennsylvania.|2 School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania.
authors: Salimah H
authors: SH
authors: Meghani
authors: 4 School of Medicine, Indiana University , Indianapolis, Indiana.|5 Simon Cancer Center, Indiana University , Indianapolis, Indiana.
authors: Susan M
authors: SM
authors: Perkins
authors: 3 School of Nursing, Indiana University , Indianapolis, Indiana.|5 Simon Cancer Center, Indiana University , Indianapolis, Indiana.
authors: Susan M
authors: SM
authors: Rawl
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D001601:Bereavement; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D012720:Severity of Illness Index; D013727:Terminal Care