Completion of Advance Directives Among Korean American and Non-Hispanic White Older Adults

This study examines completion of advance directives, highlighting ethnic differences between Korean and non-Hispanic White older adults in relation to health beliefs and knowledge. In this study, 217 community-dwelling older adults (112 Korean Americans and 105 non-Hispanic Whites) were interviewed using structured questionnaires. As compared to only 5.4% (n = 6) of Korean American older adults, more than half of non-Hispanic White older adults (59.2%, n = 61) had completed advance directives. Health beliefs, but not knowledge, significantly mediated the relationship between ethnicity and completion of advance directives; Korean Americans had lower levels of health beliefs toward advance care planning than non-Hispanic Whites, and this in turn led to relatively lower rates of completing advance directives. Thus, it is advised that health care practice needs to encompass older adults' health beliefs, which may be uniquely represented among different ethnic groups.