The objective of this systematic review was to investigate the roles culture and acculturation play on end-of-life care planning for first generation Asian Continental Immigrants to the United States. We included studies which focused on Asian Continental Immigrants which evaluated the role acculturation affected aspects of end-of-life care planning, such as the appointment of decision makers or completion of conversations surrounding end-of-life treatment. Studies published outside of the United States or in languages other than English were excluded from the study. The databases PubMed and SCOPUS were searched by a reviewer on March 19th, 2020 using search terms modeled off the PICO criteria. Risk of bias was assessed regarding incomplete outcome data, selective outcome reporting and other biases. In total, 5 studies were included in this review (n= 2,400) which evaluated the role of acculturation in different cultural populations and how this may impact awareness, attitudes, communication and appointment of decision makers with end of life care. Four out of the five studies assessed showed there to be a direct positive relationship between the level of acculturation one has and the level of engagement in end-of-life care planning. It was shown that although overall acculturation has an effect, there are cultural differences between groups on measures such as attitudes and appointment of decision makers. While all studies met the search criteria, imprecision due to sample size and sampling methods were limitations of evidence. These results point to a heightened need for further analysis of immigrant populations and end-of-life care planning.
Mupo, MPH(c), Binjil; Leader, DrPH, MPH, Amy; and Frasso, PhD, CPH, Rosemary, "Effects of Culture and Acculturation on End-of-Life Planning in Asian Immigrants" (2020). Master of Public Health Capstone Presentations. Presentation 346.