All ETDs from UAB

Advisory Committee Chair

Diane C Tucker

Advisory Committee Members

Virginia G Bradley

Elizabeth A Kvale

Kathryn L Burgio

Edwin W Cook Iii

Document Type

Dissertation

Date of Award

2009

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

An aging population and increased prevalence of chronic illness will demand greater in-volvement by young adults with respect to end-of-life care decisions, and little research has examined opinions about end-of-life care among this population. Exploration of fac-tors influencing opinions about hospice and home death is necessary in order to address potential barriers to available care options and, thus, to improved quality of care at the end of life. The present study first examined a sample of 1035 Caucasian or African American introductory psychology students in order to explore factors affecting opinions about hospice and home death. A subsample of 250 participants was included in a second phase which examined the effects of a brief hospice information intervention on change in opinions about hospice and home death. A significant percentage of the full sample (44%) had prior experience with the death of a loved one from a non-sudden illness and endorsed involvement in their loved one's care. Females and African Americans had a greater prevalence of prior experience with the death of a loved one than did males and Caucasians. Females demonstrated a significantly more positive opinion about hospice and home death than males, and African Americans demonstrated significantly less posi-tive views of home death than Caucasians. The hospice information intervention signifi-cantly increased participants' level of hospice knowledge, though had no independent or interactive effect on opinions about hospice and home death. The nature of prior experi-ence with the death of a loved one that participants endorsed (categorized as either no experience, negative experience, or non-negative experience) significantly influenced change in opinion about home death. The site of care and death of participants' loved one also had an impact on opinions about hospice and home death. In conclusion, young adults' opinions about hospice and home death varied with respect to gender, race, and prior experience with the death of a loved one. Large percentages of neutral opinions highlight the potential to significantly impact opinions about end-of-life care. Findings suggest that interventions intended to increase utilization and reduce barriers to quality end-of-life care could be improved by appropriately addressing individual group differ-ences.

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