Date of Conferral

2020

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Suzanne Richins

Abstract

More than 8-million people in the United States possess no kidney function. The purpose of this quantitative casual-comparative research study is to examine the relationship between ethnicity status of African American and European American patients suffering from end-stage renal disease, and advanced care planning and end-of-life decision-making among patients who are 55 years of age and older. The health belief model is the selected explanatory framework used to examine (a) whether ethnicity status is a significant predictor of whether decedents had written end-of-life care instructions, (b) whether ethnicity status is a significant predictor of whether treatment decisions were made, and (c) whether ethnicity status is a predictor of whether patients 55 years of age and older were able to participate in these decisions during the final days of life. The quantitative causal-comparative research design utilized a secondary data set with 4,172 European Americans, of whom 1,010 (24.2%) died from kidney disease, and 1,013 African American in the sample with 289 (28.6%) who died from kidney disease. The logistic regression resulted in the rejection of the null hypothesis for each of the three research questions. The study results may be used by executive leaders to understand factors of patient safety, value-based care, medical technology, health care resources for family, and caregivers that ultimately increase the quality of life of the patient and care needs at the end of life.

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