End-Of-Life Care Planning Among Older Vietnamese and Filipino Americans: A Qualitative Analysis.

Abstract

Racial and ethnic disparities in end-of-life (EOL) care planning persist, particularly due to limited knowledge of culturally sensitive practices among older Vietnamese and Filipino Americans - two of the largest Southeast Asian American subgroups. To address this gap, we used a transcendental phenomenological approach to explore attitudes, barriers, and facilitators toward EOL care planning. Three virtual focus groups were conducted: one Filipino group and two Vietnamese groups (one in English, one in Vietnamese), with nine participants aged 55 or older. This study adhered to the COREQ guidelines to ensure transparency and rigor in qualitative reporting. Thematic analysis, guided by a transcendental phenomenological lens, revealed a shared belief in the importance of EOL care planning in both groups, driven by the desire to honor personal wishes, reduce burden on family, and minimize conflict. Participants also expressed distrust in healthcare systems and emphasized the influence of family dynamics on EOL decisions. Notable differences emerged: Vietnamese participants more often described cultural practices that encouraged open conversations about death, while Filipino participants cited cultural taboos that hindered such discussions. These findings underscore the need for culturally and linguistically responsive approaches to support EOL care planning in Southeast Asian American communities.