Tag Archives: cultural competency

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

A recently published article from the PRISMA project provides a general overview of cultural issues in end of life care in seven European countries.

The abstract can be found below or the full article can be accessed here.

Aim

Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries.

Methods

We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes.

Results

A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities.

Conclusion

This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

User Consultation: Patients and Carers

The ‘Cultural Issues in End of Life Care Team’ are interested to hear patients, carers and health care professionals’ opinions and experiences of end of life care.

In order to better focus our work, we would like people to share with us their opinions and experiences, particularly the impact of culture and cultural differences in different countries and places of care.

We would also appreciate any general comments about the blog, the work and features posted to the blog, or the focus of our work.

The research carried out by our team has identified a number of important priorities in regard to culture and end of life care. We would be particularly interested to know what patients, carers and health care professionals think about the following two issues:

1. Cultural competence and care for minority ethnic groups

Evidence of low use of end of life care services by minority ethnic groups and some dissatisfaction with care has increased the popularity of ‘cultural competency’ approaches.

‘Cultural competency’ training attempts to make health care professionals sensitive to cultural differences, provide them with knowledge about different cultural traditions and includes specific skills training in areas such as communication.1-3

There have, however, been a number of criticisms raised about such training – that a focus on information about specific cultural groups can lead to stereotyping and that such training serves to routinise the encounter between healthcare professionals and service users from different cultural backgrounds.4 5

What do you think about such training?

Do you think such training can improve the quality of care?

Do you think it will lead to people from minority ethnic groups being treated differently?

Are you a healthcare professional who has undertaken such training? Do you feel that cultural competency training improved your interactions with people from different cultural backgrounds? If not, why not?

Please share your opinions and experiences by posting a comment!

2. Diversity in changing environments

Cultural differences can be as pronounced between people from different generations as people from different cultural backgrounds. In the context of changing cultural identities how should cultural preferences be taken into account in end of life care?

Do you think that cultural competency approaches are useful or even appropriate in a changing society?

Post a comment and let us know what you think!

1. Papadopoulos I, Tilki M, Taylor G. Transcultural care: a guide for health care professionals. 1998.

2. Lister P. A Taxonomy for Developing Cultural Competence. Nurse Education Today 1999;19(4):313-18.

3. Campinha-Bacote J. The process of cultural competence in the delivery of health care services: A model of care. Journal of Transcultural Nursing 2002;13(3):181-84.

4. Gunaratnam Y. Intercultural palliative care: do we need cultural competence? International Journal of Palliative Nursing 2007;13(10):470.

5. Gunaratnam Y. From competence to vulnerability: Care, ethics, and elders from racialized minorities. Mortality 2008;13(1):24-41.

The European Network on Elderly Inter-cultural Care (ENIEC)

The European Network on Elderly Inter-cultural Care (ENIEC) is a Dutch – Danish initiative that has been going since 2007 but has only recently come to our attention.

The network is a non-profit membership association for ‘enthusiastic professionals engaged in care for elderly migrants in Europe’.

Their website states their aims as:

  • to create an informal platform of exchanging ideas and experiences cross borders in today’s Europe
  • to secure that European elderly with a foreign ethnic background can live in an environment of tolerance, intercultural understanding and respect for their needs and for their cultural background

You can follow the network’s activities via their website, facebook or twitter.

Powerpoint Presentations

In response to popular demand we have uploaded the presentations made by both members of our team and external experts at various conferences.

International Meeting on Culture and End of Life Care
Vic, Spain, 17-18 May 2010

17th May

WP1 Work

Culture and end of life care

Key cultural issues in end-of-life care in three Mediterranean countries

Cultural Competency Models

Culture in Different Settings

Culture in Different Settings: Priorities from a UK perspective

Culture in different settings: Priorities from a Belgian perspective

Culture in different setting: Priorities from a Norway perspective

18th May

Spirituality in End of Life Care

Spirituality in End of Life Care

Conscientious objections: a neglected topic in culture and end end-of of-life care

Dignity

Dignity for the frail old

End of Life Decision Making

End-of-life decisions in Belgium: Attitudes and practices

Practices and attitudes regarding end-of-life decisions in Spain

Communication

End of life Cultural, Social, Ethical, Legal perspectives

Telling the truth or conserving hope? An Italian deep-rooted contradiction

Cultural Competency and Minority Ethnic Groups

Cultural Vulnerability, Care and Ethics

Cultural competence and communication in palliative care for Turkish and Moroccan immigrants in the Netherlands

11th Congress of the EAPC
Vienna, Austria, 7-10 May 2009

A call for expertise for the development of a European network of experts on culture and end of life care

Making Culture Relevant to End End-of of-Life Practice: An Overview of Approaches to Cultural Competency

What does culture mean? An analysis of the role of culture in Spanish end- of-life care literature

Some Critical Comments on “Culture” and “Competence”

The Hospice Foundation of America – Culture

The Hospice Foundation of America has its own blog which has a great section on culture. The culture posts mostly deal with disparities in hospice use by ethnic group.

International Meeting on Culture and End of Life (Vic, Spain, 17-18 May 2010)

As many of you will recall, our project includes the organisation of a meeting of experts from across Europe on culture and end of life care.  The details of the meeting have now been finalised and we are pleased to inform you that the ‘International Meeting on Culture and End of Life’ will be held in Vic, Spain (17-18 May 2010).

This will be a two-day meeting which will bring together experts, researchers and practitioners with a particular focus on culture and end of life care. The first day will be an invitation-only PRISMA workshop chaired by Dr Marjolein Gysels from the Barcelona Centre of International Health Research (CRESIB), and will include around 15-20 experts from across Europe. The second day will be an open meeting jointly organised with the Institut Català d’Oncologia, and the University of Vic.

We are glad to invite those who wish to attend to contact Natalie Evans (natalie.evans@cresib.cat) for the programme and registration details.

Diversity and End-of-Life Care – Hospice Foundation of America

Diversity and End-of-Life Care Hospice Foundation of America

The Hospice Foundation of America broadcast the 2009 National Bereavement Teleconference “Diversity and End of Life Care” on April 29th 2009.  For more information about how to access resources produced for the conference, click here.

Together! 2009 – Cultural Connections for Quality Care at the End of Life

The 10th Australian Palliative Care Conference and the 8th Asia Pacific Hospice Conference will merged and called “Together! 2009“.  The theme of this conference is ‘Cultural Connections for Quality Care at the End of Life’. According to the organisers this conference will provide an opportunity for people across the world to come together to address the issues and challenges involved in providing quality care at the end of life for all.