{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:42:32Z","timestamp":1791636152662,"version":"4.3.4"},"reference-count":53,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chinese American adults experience health disparities at the end of life. Culturally tailored advance care planning (ACP) may promote goal-concordant care across the continuum of serious illness. However, seriously ill Chinese Americans' preferences for ACP remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To explore barriers and facilitators to ACP among Chinese patients with advanced cancer and their caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Informed by socioecological theory, we conducted an exploratory qualitative study using semistructured interviews that were thematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants:<\/jats:title>\n                    <jats:p>We recruited participants at one U.S. comprehensive cancer center. Of 27 eligible patients approached, we recruited 20 patients (74.1%) and 8 accompanying caregivers. Overall, participants were middle aged (55.6\u2009\u00b1\u200913.5 years), 60.7% female, 85.7% partnered\/married, 89.3% college educated, and had low acculturation (mean Suinn-Lew Asian Self-Identify Acculturation\u2009=\u20092.0\u2009\u00b1\u20091.6\/5.0). More patients were privately insured (35%) than self-pay (30%), Medicare (25%), and Medicaid (10%). Caregivers were split between \u201cspouse\u201d and \u201cchild.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Findings highlight participants' trust in their clinicians and the study institution as primary supports for clinicians to lead ACP. However, participants' preconceptions of clinicians' professional responsibilities and participants' belief in an uncertain future may hinder an open discussion of goals and values for future medical care. A key moderating factor in how participants view ACP may be their level of acculturation to local care, behavioral, and communication norms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Chinese patients may prefer a routinized clinician-led ACP approach that supports their actionable priorities in the present by leveraging patient\u2013clinician trust, gauging acculturation level, and using indirect communication strategies. Future studies should investigate preferred communication strategies to support in-the-moment care planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2021.0404","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:45:51Z","timestamp":1638319551000},"page":"774-782","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Barriers and Facilitators to Advance Care Planning among Chinese Patients with Advanced Cancer and Their Caregivers"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8156-5553","authenticated-orcid":false,"given":"Zhimeng","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert S.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-0453","authenticated-orcid":false,"given":"James A.","family":"Tulsky","sequence":"additional","affiliation":[{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Leiter","sequence":"additional","affiliation":[{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.12.331"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.04.013"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.05.016"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16801"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318809582"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530100066036"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1043659619859055"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.4657"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.2583"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2019.0120"},{"key":"e_1_3_4_12_2","unstructured":"Pew Research Center: Chinese in the US fact sheet. www.pewsocialtrends.org\/fact-sheet\/asian-americans-chinese-in-the-u-s. 2017. 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