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BMJ Support Palliat Care 3:266 doi:10.1136/bmjspcare-2013-000491.102
  • ACPEL abstracts
  • Morning Breakout 1—Paediatrics and Adolescents

ASSOCIATION OF TREATMENT PREFERENCES, SPIRITUAL BELIEFS AND RELIGION AMONG ADOLESCENTS INFECTED WITH HIV/AIDS PARTICIPATING IN FAMILY CENTERED (FACE) ADVANCE CARE PLANNING (ACP)

  1. J Wang1
  1. 1Division of Adolescent and Young Adult Medicine, Children's National Medical Center/Children's Research Institute/Center for Translational Science, Washington, District of Columbia., USA
  2. 2Gundersen Lutheran Medical Foundation, Inc., La Crosse, Wisconsin, USA

Abstract

Background Among adults religious beliefs are associated with treatment preferences at the end-of-life (EOL). This is unknown for adolescents with HIV/AIDS.

Aim To determine if spiritual beliefs, religious practices or religion are correlated with treatment preferences for end-of-life (EOL) care among adolescents with HIV/AIDS.

Methods Adolescents (N=53) aged 14 to 21 were enrolled in a 3-site, controlled, randomised clinical trial. Data were collected between 7/2011–10/2012. FACE-ACP consists of weekly, 60-min sessions: (1) Lyon Advance Care Planning Survey©; (2) Respecting Choices Interview; (3) Five Wishes©. Measures were Brief Multidimensional Measurement of Religiousness/Spirituality and Statement of Treatment Preferences. Six subjects had missing data.

Results Mean age was 18 years; 57% male; 94% African-American; 74% perinatally infected. In Situation 1 (long hospitalisation, low chance survival) 53% of adolescents reporting religion and 100% of non-religion group chose to continue treatment (p=0.0317). In Situation 2 (physical impairment) 74% of adolescents who ‘felt God's presence most days’ chose to continue treatments; 45% who did not ‘feel God's presence’ chose to continue (p=0.0426). In Situation 3 (mental impairment), there was no significant associations. Combining the three situations, 28% of religion group choose to continue treatment; 71% of non-religion group chose to continue (p=0.0364). Belief in miracles, HIV is a punishment from God, feeling abandoned by God, religious practices were not associated with treatment preferences.

Conclusion/Discussion Religious beliefs were associated with decisions to continue treatment, depending on the situation. These data begin to fill the gap in understanding the complexities of the influence of spirituality/religion on treatment preferences.

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