Advance care planning engagement among Muslim community-dwelling adults living in the United States of America

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Ghaith Ahmad Bani Melhem (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Debra Wallace

Abstract: The purpose of this study was twofold: (1) to explore advance care planning (ACP) engagement activities, and (2) to examine ACP engagement determinants among Muslim community-dwelling adults living in the United States. Through the Social-ecological Model, ACP contributing factors were conceptualized into intrapersonal, interpersonal, and community factors. This study used a cross-sectional correlational design. A self-administered questionnaire was administered either in-person or online to measure ACP engagement, intrapersonal, interpersonal, and community factors. Convenience and snowball sampling methods were used to recruit Muslim adults from Islamic organizations in a Southeastern state in the United States. A racially diverse sample of 148 Muslim adults with ages ranging from 18 to 79 years participated in the study. The participants’ average scores of engagement in ACP activities were relatively low, and ranged from 1.97 (SD = 1.22) to 2.09 (SD = 1.34). About two-thirds of the participants were in the precontemplation stage. Several intrapersonal and interpersonal factors, but none of the community factors, were associated with ACP engagement. The final analysis showed that 6 intrapersonal factors and 1 interpersonal factor predicted the participants’ mean of ACP engagement. The predicted mean of ACP engagement increased for those who were born in the United States, who self-identified as Asian Americans, who had awareness and knowledge about ACP, who knew a deceased one who received aggressive end of life (EOL) medical treatments, and who acculturated with American culture. The predicted mean of ACP engagement decreased for those who knew a deceased one who received minimal EOL medical treatments. No significant ACP engagement differences were found according to gender and age. New knowledge was developed about ACP among Muslims living in the United States. Understanding the contextual factors that determine Muslim adults’ engagement in ACP behavior is vital to identify culturally appropriate healthcare programs that would assist this minor growing segment of the population in patient-centered health care, as well as to expand efforts to improve wellbeing. Study findings inform implications in the areas of practice, education, health policy, and future research to alleviate disparities in ACP.

Additional Information

Language: English
Date: 2019
Advance care planning, Culture, Decision-making, End of life, Minority, Muslim
Terminal care $x Social aspects
Terminal care $x Decision making
Muslims $z United States
Advance directives (Medical care)

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