Support Network Factors Associated With Naming a Health Care Decision-Maker and Talking About Advance Care Planning Among People Living With HIV

被引:6
作者
Cruz-Oliver, Dulce M. [1 ]
Tseng, Tuo-Yen [2 ]
Mitchell, Mary M. [3 ]
Catanzarite, Zachary [2 ]
Budhathoki, Chakra [4 ]
Smith, Thomas J. [5 ]
Rushton, Cynda H. [6 ]
Knowlton, Amy R. [7 ]
机构
[1] Johns Hopkins Univ Hosp, Palliat Med Program, Baltimore, MD 21287 USA
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Behav & Soc, Baltimore, MD USA
[3] Friends Res Inst, Baltimore, MD USA
[4] Johns Hopkins Univ, Sch Nursing, Baltimore, MD USA
[5] Johns Hopkins Univ Hosp, JHMI, Palliat Med Program, Baltimore, MD 21287 USA
[6] Johns Hopkins Sch Nursing, Berman Inst Bioeth Res Program, Baltimore, MD USA
[7] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
基金
美国国家卫生研究院;
关键词
Support network; HIV/AIDS; advance care planning; naming decision-maker; family or informal caregiver; African American or black; palliative care; INJECTION-DRUG USERS; SOCIAL SUPPORT; OF-LIFE; INTERVENTION; SUPPRESSION; DIRECTIVES; ADHERENCE; QUALITY;
D O I
10.1016/j.jpainsymman.2019.08.019
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Context. Little attention has been given to social environmental factors associated with advance care planning (ACP) among African Americans or people living with advanced HIV (PLHIV). Objectives. The present study aimed to identify support network factors that affect the likelihood of naming a decision-maker and of talking to family/friends and doctors about ACP among vulnerable PLHIV. Methods. PLHIV were recruited from a large urban HIV clinic. A social support network inventory was used to calculate number of persons available for various types of support. Characteristics of network members were also collected. Multivariable logistc regression models were fit to examine associations between social network factors and ACP discussion, adjusting for age, sex, education, and total number of network members. Results. The sample (N = 370) was mostly African American (95%), male (56%), and 48% had less than a high school education. Almost half the sample (48%) had talked to their family/friends or doctor about ACP, and 34% had named a medical decision-maker. Adjusted analysis revealed that talking about ACP with family/friends was associated with female sex and a larger closer support network who provided health information and physical assistance. Talking to doctors about ACP was associated with larger support networks who provided physical assistance but lower numbers from whom emotional support was received. Naming a decision-maker was associated with greater numbers of network members who provided emotional support, health information, and medication adherence reminders. Conclusion. The findings revealed aspects of family/support network structures and caregiving function associated with ACP in a population with often vital yet vulnerable networks. (C) 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:1040 / 1047
页数:8
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