Tag Archives: cultural competency

Special Issue of Culture, Medicine and Psychiatry: Cultural Competence in Action

We would like to draw your attention to a special issue of the journal Culture, Medicine and Psychiatry that focuses on the issue of cultural competence in healthcare.

The issue examines how concepts of cultural competence are operationalised in teaching interventions. Of particular interest to our international readership is the inclusion of a case study from Canada and an essay from a German clinical educator, illustrating how cultural competency approaches, which originated in the US, can be adapted to different countries and settings.

What are the priorities for developing culturally appropriate palliative and end-of-life care for older people?

A research team from New Zealand has recently published an article on the priorities for developing culturally appropriate palliative and end-of-life care for older people.

Bellamy and Gott (2013) What are the priorities for developing culturally appropriate palliative and end-of-life care for older people? The views of healthcare staff working in New Zealand. Health and Social Care in the Community. 21(1), 26–34

The abstract is reproduced below and the full article can be accessed here.


This paper explores the views of healthcare staff regarding the provision of culturally appropriate palliative care for Māori, PacificIsland and Chinese elders living in Auckland, New Zealand. The ageing population is culturally and ethnically diverse and, along with other developed countries experiencing high levels of migration, the challenge is balancing the rise in numbers of older people from different ethnic and cultural groups with end-of-life care, which reflects personal values and beliefs. Two joint interviews and ten focus groups were conducted with eighty staff across a range of primary, secondary and speciality care settings in 2010. The findings demonstrated that participants viewed the involvement of family as fundamental to the provision of palliative care for Māori, PacificIsland and Chinese elders. For Māori and Pacific Islanders, healthcare staff indicated the importance of enabling family members to provide ‘hands-on’ care. The role of family in decision-making was fundamental to the delivery of and satisfaction with care for older Chinese family members. Care staff highlighted the need to be cognisant of individual preferences both within and across cultures as a fundamental aspect of palliative care provision. The role of family in ‘hands-on’ palliative care and decision-making requires care staff to relinquish their role as ‘expert provider’. Counter to the prioritisation of autonomy in Western health-care, collective decision-making was favoured by Chinese elders. Providing families with the requisite knowledge and skills to give care to older family members was important. Whilst assumptions are sometimes made about preferences for end-of-life care based on cultural values alone, these data suggest that care preferences need to be ascertained by working with family members on an individual basis and in a manner that respects their involvement in palliative care provision.

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.


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.


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.


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.


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 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


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.