Abstract：
BACKGROUND:Little is known about the quality of the patient-physician relationship for terminally ill African Americans. OBJECTIVE:To compare the quality of the patient-physician relationship between African-American and white patients and examine the extent to which relationship quality contributes to differences in advance care planning (ACP) and preferences for intensive life-sustaining treatment (LST). DESIGN:Cross sectional survey of 803 terminally ill African-American and white patients. MEASUREMENTS:Patient-reported quality of the patient-physician relationship (degree of trust, perceived respect, and joint decision making; skill in breaking bad news and listening; help in navigating the medical system), ACP, preferences for LST (cardiopulmonary resuscitation, major surgery, mechanical ventilation, and dialysis). RESULTS:The quality of the patient-physician relationship was worse for African Americans than for white patients by all measures except trust. African Americans were less likely to have an ACP (adjusted relative risk [aRR] = 0.66, 95%CI = 0.52-0.84), and were more likely to have a preference for cardiopulmonary resuscitation and dialysis (aRR = 1.28, 95%CI = 1.03-1.58; aRR = 1.25, 95%CI = 1.07-1.47, respectively). Additional adjustment for the quality of the patient-physician relationship had no impact on the differences in ACP and treatment preferences. CONCLUSIONS:Lower reported patient-physician relationship quality for African-American patients does not explain the observed differences between African Americans and whites in ACP and preferences for LST.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Smith AK,Davis RB,Krakauer ELdoi
10.1007/s11606-007-0370-6subject
Has Abstractpub_date
2007-11-01 00:00:00pages
1579-82issue
11eissn
0884-8734issn
1525-1497journal_volume
22pub_type
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