End-of-life communication: ethnic differences between Korean American and non-Hispanic White older adults

J Aging Health. 2009 Oct;21(7):967-84. doi: 10.1177/0898264309344179.


Objective: This study examined ethnic differences in end-of-life communication between Korean American and non-Hispanic White older adults using the Health Belief Model as a conceptual framework.

Method: A cross-sectional design was employed to survey 217 community-dwelling older adults (112 Korean Americans and 105 Non-Hispanic Whites).

Results: Half of the participants had never held end-of-life discussions with significant others. Non-Hispanic Whites were more likely to engage in end-of-life communication than Korean Americans, but the ethnicity effect was not evident in a multivariate analysis. Only participants' knowledge, perceived barriers, perceived severity, and experience of illness significantly predicted the likelihood of the end-of-life communication. Higher knowledge, stronger beliefs about the perceived severity and barriers, and greater experience of illness were related to having end-of-life communication.

Discussion: Knowledge and health beliefs play an important role in end-of-life communication which differs by ethnicity. Culturally competent health care practitioners need to consider ethnic variation in advance care planning.

MeSH terms

  • Advance Care Planning*
  • Advance Directives / ethnology*
  • Aged
  • Aged, 80 and over
  • Asian Americans*
  • Communication*
  • Culture
  • Demography
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Status
  • Humans
  • Korea / ethnology
  • Male
  • Socioeconomic Factors
  • United States
  • Whites*