End-of-life care among Koreans in critical care and community-dwelling Korean Americans: A cross-cultural scoping review

Objective End-of-life (EOL) care for critically ill individuals is shaped by socioeconomic, legal, and cultural factors for Koreans in South Korea and Korean Americans (KA) in the United States. This scoping review thematically synthesized critical care literature from Korea and community-based literature involving KAs to inform culturally tailored EOL and palliative care research and practice. Methods Following the updated JBI scoping review guidance, we reviewed English and Korean articles across seven databases. Due to the lack of critical care studies involving KAs, the scope of U.S. studies was broadened to all healthcare settings. We conducted a thematic synthesis to identify cross-context cultural insights that are potentially transferable from Koreans in critical care to KAs with similar needs. Results Evidence on EOL care for Koreans in critical care and for KA communities across U.S. settings was limited. Korea-based critical care studies (N = 23) highlighted physician-initiated decision-making, minimal advance care planning, and a lack of direct patient perspectives. U.S.-based studies (N = 26) focused on hypothetical palliative care preferences among older, community-dwelling KAs, with limited attention to critical care. Both contexts revealed shared cultural preferences for family-centered decision-making, physician-led discussions, and indirect communication about diagnosis and prognosis. Further research is warranted to investigate within-group heterogeneity and preference shifts across illness trajectories to inform culturally tailored EOL interventions for KAs. Significance of results Findings highlight the need for culturally and structurally informed approaches to improve EOL care in both Korea and the U.S. This cross-context analysis demonstrates how evidence from the heritage country can inform research and practice for immigrant and minoritized populations when domestic data are sparse. Strength-based approaches grounded in community values, combined with culturally specific insights from Korean literature, may enhance culturally responsive support for KA patients and families.