Abstract：
OBJECTIVE:To determine whether any associations exist between cultural (racial/ethnic, spiritual/religious) competence and end-of-life treatment decisions in hospitalized patients and the potential impact of those associations on hospitalists' provision of care. DATA SOURCES AND METHODS:MEDLINE, PubMed, Embase, Psychlnfo, and CINAHL databases were searched using the following search terms: cultural competence, race, ethnicity, minority, African American, Hispanic, end of life, palliative care, advanced care planning, inpatient, religion, spirituality, faith, hospitalist, and hospice. We identified studies in which spirituality/religion or race/ethnicity was used as a variable to study their potential impact on end-of-life treatment decisions in hospitalized patients. RESULTS:In only 13 studies was spirituality/religion or race/ ethnicity used to study its effect on end-of-life decisions in hospitalized patients. African American patients tended to prefer the use of life-sustaining treatments at the end of life, and race/ethnicity did not appear to affect decisions to withhold or withdraw certain types of life-sustaining technology. Specific spiritual needs were identified both within and outside organized religions when members of those religions were hospitalized at the end of life. CONCLUSIONS:End-of-life care may present unique challenges and opportunities in culturally discordant hospitalist-patient relationships. Culturally competent health care in an increasingly diverse population requires awareness of the importance of culture, particularly spirituality/religion and race/ethnicity, in the care of hospitalized patients at the end of life.
journal_name
J Natl Med Assocjournal_title
Journal of the National Medical Associationauthors
Mitchell BL,Mitchell LCdoi
10.1016/s0027-9684(15)31040-3subject
Has Abstractpub_date
2009-09-01 00:00:00pages
920-6issue
9eissn
0027-9684issn
1943-4693pii
S0027-9684(15)31040-3journal_volume
101pub_type
杂志文章,评审abstract：:Sixteen trauma victims with adult respiratory distress syndrome were retrospectively examined. High injury severity score (mean: 44), massive transfusion requirements, and prolonged ventilator days characterize this group. Persistent intra-abdominal infection accounted for two of three deaths in this series. Most of t...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：:Racial disparities in quality of health are major issues affecting healthcare delivery. While substantial studies have been done in adults with end-stage renal disease (ESRD), similar studies are lacking in pediatric patients with ESRD. We retrospectively analyzed our transplant database from 1978-2002 to identify rac...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2006-02-01 00:00:00
abstract：:A necropsy study of the pathological findings in the digestive system of 19 renal transplant recipients revealed that gastrointestinal (GI), hepatobiliary, and pancreatic pathologies are common in renal transplant recipients. Fifteen of the 19 patients studied had GI pathology. Hepatobiliary pathology was the most com...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1986-08-01 00:00:00
abstract：:Previous studies document the importance of religious involvement in African-American communities. This study examines the extent to which religious involvement is associated with health status among African-American males. The data come from a community sample of 537 males residing in a major US urban area. Three ind...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1994-11-01 00:00:00
abstract：:Even though Lyme disease probably existed in Oklahoma prior to 1975 when the disease was first reported in Connecticut and even though ecological conditions favor a high prevalence, an unexpectedly low rate was evidenced in both a serological survey and the number of cases reported to the Oklahoma State Department of ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：:In addition to well known parameters used for measuring in vitro cellular radiosensitivity (mean lethal dose, extrapolation number, quasithreshold dose), there are other, less well known measures that may be more important. The authors recently surveyed the literature and found that mean activation dose (D) has been n...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章,评审
doi：
更新日期：1989-07-01 00:00:00
abstract：:The following is a review of the literature concerning hidradenitis suppurativa with emphasis on aspects of this disease which suggest that it may be a result of altered host-defense mechanisms.Deep fistula formation, anemia, and the development of carcinoma are complications seen only in disease affecting the periana...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1978-05-01 00:00:00
abstract：:Stroke in black Americans is an important health problem that has been understudied. A brief review of the pertinent literature and strategies for evaluating and managing patients with cerebrovascular disease are presented. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:During 2005, a risk assessment tool based on the Gail model was used to calculate the five-year risk of developing breast cancer for 445 women who live in socioeconomically disadvantaged urban communities in western Pennsylvania and who attended health fairs and other community-sponsored activities. This tool allowed ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2007-07-01 00:00:00
abstract：:Chondroectodermal dysplasia is a rare autosomal recessive disorder characterized by short extremities, short stature, polydactyly, and nail hypoplasia. Dental abnormalities, congenital heart defects, and thoracic abnormalities impending respiration are seen in many patients. Virtually all previous reports of the class...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：:A review of the literature on sickle cell trait was completed by Sears in 1978. Since that time, several papers have been published concerning the possible health risks of sickle cell trait. Data presented from these studies show that there is no association with sickle cell trait and overall survival, overall mortali...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章,评审
doi：
更新日期：1982-08-01 00:00:00
abstract：:Primary lymphoma of the central nervous system (CNS) is difficult to diagnose because of the difficulty in differentiating it from multiple sclerosis, sarcoidosis, metastatic disease, chronic granulomatous disease, and cerebral cysticercosis. With the patient presented in this report, no abnormalities were found after...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：:The purpose of this survey of 528 black men in Miami and Fort Lauderdale, FL, was to assess prostate cancer knowledge among African-American, English-speaking Caribbean, Haitian-American, and African men in America. Knowledge levels were assessed by education, ethnicity, age, income, family history of prostate cancer,...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2004-05-01 00:00:00
abstract：:There have been increasing rates of uninsured patients in the United States over the past few decades. Despite this growing problem, little progress has been made to decrease the rate of growth of uninsured patients or to provide affordable insurance coverage to those who are unable to maintain insurance coverage thro...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2006-11-01 00:00:00
abstract：:The association among race, neighborhood socioeconomic status (SES), and chronic pain has not been well examined in older people. Clinical data was obtained from older adults (>50 years old) presenting to a tertiary care pain center. The relative roles of race and neighborhood SES on the chronic pain experienced in ol...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2007-10-01 00:00:00
abstract：:Four hundred ninety-nine nosocomial infections (with 657 isolates) in 288 Surgical Service patients were monitored from February 1986 to June 1987 (17 months) to determine the influence that pathogen or site of infection had on the length of hospital stay. Patients with upper respiratory and skin infections were more ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:In an effort to determine the impact of race on the stage of prostate cancer at presentation, the records of 2102 patients diagnosed in Chicago between 1985 and 1987 were reviewed. For each of three age groups (less than 65, 65 to 75, and greater than 75 years), blacks had a significantly (P less than .05) lower perce...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：:Angiotensin II is a prothrombotic vasoconstrictor. This study proves that many hypertensives are hypercoagulable and at risk for myocardial infarction. The modified recalcification time (MRT) test, used to assess hypercoagulability, incorporates the role of tissue factor in coagulation by activating the monocyte with ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:Adverse drug reactions are defined and examples are given. Four areas of concern are addressed, namely, defining drug reactions, identifying some of the factors contributing to the adverse drug reactions, implications of adverse drug reactions for health-care providers, and preventive measures which impact on the occu...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1978-10-01 00:00:00
abstract：:The links between environmental agents, environmental conditions, and disease and disability among children are receiving increasing attention. Evidence abounds that children are more susceptible than adults to the damaging effects of environmental agents and conditions. This evidence is illuminated by the much-public...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章,评审
doi：
更新日期：2005-02-01 00:00:00
abstract：:Many studies now demonstrate high overall response rates with concurrent chemotherapy and radiation (CCR) for locoregionally advanced or inoperable non-small cell lung carcinoma (NSCLC) but often with severe toxicity and only modest improvement in survival beyond 3 years. We report a simple CCR protocol for NSCLC that...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：BACKGROUND:Compared to whites, African Americans have almost a 2-fold increased risk of first-ever stroke. Our study sought to determine awareness of stroke risk factors and management, symptoms, and risk reduction strategies in African Americans in Mississippi, which is part of the "stroke belt. METHODS:We conducted ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/s0027-9684(15)30495-8
更新日期：2010-02-01 00:00:00
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journal_title：Journal of the National Medical Association
pub_type： 临床试验,杂志文章
doi：
更新日期：1997-11-01 00:00:00
abstract：:This report describes the treatment of a Viet Nam veteran with an α(2)-adrenergic agonist (clonidine) for hypertension which had an additional beneficial effect of allowing withdrawal in ten days from 20 mg of methadone a day with minimal withdrawal symptoms. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：:Case reports concerning rare complications of human bite injuries are uncommon in the literature. Further, rehabilitation of the resultant dysfunction is also hardly reported. A 41-year-old housewife who had had a human bite during an altercation 6 months ago was referred to the rehabilitation department with a nonfun...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/s0027-9684(15)30856-7
更新日期：2009-03-01 00:00:00
abstract：:Comprehensive health care planning can augment the educational programming for children with exceptional health and/or learning needs. The coordination of medical service and education is critically needed to reduce the traditional gulf between these two essential disciplines. Bridging this gulf will enable patients a...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1982-10-01 00:00:00
abstract：INTRODUCTION:Black individuals continue to be underrepresented in clinical trials despite efforts by the National Institutes of Health and the Federal Drug Administration to increase their enrollment. Health care providers play a critical role in the recruitment of patients into clinical trials, as they have establishe...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2018.07.004
更新日期：2019-04-01 00:00:00
abstract：:Perhaps the most significant link in achieving the nation's immunization objectives is the extent of parental knowledge. Admittedly, this is a weak link. The 1990 federal objectives calling for an official format using common guidelines for completion of immunizations, though well-conceived, has not been used exclusiv...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：BACKGROUND:Although several studies have outlined the need for and benefits of diversity in academia, the number of underrepresented minority (URM) faculty in academic health centers remains low, and minority faculty are primarily concentrated at the rank of assistant professor. In order to increase the diversity of th...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2006-09-01 00:00:00
abstract：BACKGROUND:Few studies have characterized ethnic variations in standard ophthalmic measures. We tested the hypothesis that nerve fiber layer thickness would show characteristic differences between white and black individuals. We also examined whether ophthalmic measures would show intraethnic differences. METHODS:Seve...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2007-02-01 00:00:00
