A Qualitative Assessment of African Americans' Knowledge, Attitudes and Beliefs about Hospice Care

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Capstone Committee Chair: Nancy Chernett, Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, PA


In 2010, 1.58 million patients received services from hospice in the United States; of these patients only 8.9% were African American (African Americans make up 12.6% of the US population), compared to 77.3% Caucasians. The purpose of this study was to assess African Americans’ knowledge, attitudes and beliefs about hospice care. Three 3 focus groups were conducted with a total of 27 people participating (12 males and 15 females).All focus groups were audio taped and transcribed. Transcripts were coded using an apriori coding scheme and entered into an Excel file. Consensus and triangulation methods were used to help investigators assess themes based on strength within and across focus groups. Five major themes emerged: 1) knowledge of hospice 2) attitudes and beliefs 3) decision making process 4) barriers to hospice use and 5) raising awareness about hospice in the African American community. This study supports findings from previous literature that examines the key factors that contribute to the underuse of hospice services by members of the African American community. A new barrier to hospice use, “family discord” also emerged in the focus group discussions In order to overcome hospice barriers the unanimous recommendation is to increase knowledge, awareness and access to culturally appropriate educational materials. Based on the thematic analysis findings, the next step is to develop a culturally tailored hospice photonovel to raise awareness about hospice care among African Americans. An initial meeting has already been conducted with an advisory committee that was formed from participants from the three focus groups. The 1st draft of the phot novel script has been written based on the advisory committee’s decisions. Work will continue with the advisory group and funding to be sought for creation and printing of the photonovel.

Presentation: 29 minutes