Preference Importance Ratings among African American and White Nursing Home Residents

ABSTRACT

Objectives

The Preferences for Everyday Living Inventory (PELI-NH) assesses psychosocial preferences of nursing home (NH) residents. This study explored the association of race with importance ratings of self-dominion preferences (i.e., preferences for control).

Methods

PELI-NH interviews were conducted with 250 NH residents. Tests of mean differences compared African American (n = 57) and White (n = 193) residents on demographic (age, gender, education, length of stay) and clinical attributes (self-rated health, depressive symptoms, anxiety, functional limitations, hearing, vision, cognition). Stepwise multiple regression accounted first for associations of demographic and clinical attributes then for the unique association of race with total importance of self-dominion preferences to determine whether African American and White residents differ. For between group demographic/clinical differences, interaction effects were tested.

Results

African Americans were younger and more functionally impaired. After accounting for the effects of gender (female), age (younger), anxiety (greater), and functional impairment (less) with higher reports of importance of self-dominion preferences, race was significant. There were no significant moderating effects.

Conclusions

African American residents reported greater importance of self-dominion preferences than Whites.

Clinical Implications

Cultural sensitivity is critical; it may be more important to provide opportunities for autonomous decision-making for African American than for White residents.

KEYWORDS:

• Person-centered care
• long-term care
• race

Acknowledgments

We would like to thank Karen Eshraghi and Christina Duntzee, the research team members who worked diligently to collect these data, and the older adults who participated in the project.

Data availability

Data are available upon request from authors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was made possible by generous funding from an NINR grant ([R21NR011334]: PI Van Haitsma). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.