Leadership and End-of-Life Planning Among Elderly Patients With End-Stage Renal Disease

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 decisionmaking 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.