Family Conflict, Acculturation, and Older Chinese Americans’ Self-Efficacy in End-Of-Life Care Planning

Objectives:This study examines the association between family conflict and self-efficacy in discussing end-of-life (EOL) care with family members and whether such an association differs by acculturation levels among older Chinese Americans. Method:Data were collected from 213 Chinese Americans ages 65–102 in Phoenix, AZ, and Germantown, MD. We conducted ordinary least squares regression to examine the association between family conflict, acculturation, and self-efficacy in discussing EOL care with family. Results:Family conflict was negatively associated with older adults’ self-efficacy in discussing EOL care with family. The negative association between family conflict and self-efficacy in discussing EOL care with family was more pronounced for those with higher levels of acculturation. Conclusions:As one of the first research efforts to study advance care planning among older Chinese Americans, our findings highlight differential effects of family conflict on self-efficacy of EOL care plan discussion within the context of acculturation levels. Geriatric and health social workers should assess and address acculturation to develop family-centered interventions that improve EOL care planning for older Chinese Americans.