ObjectiveThe academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals’ understandings of cross-cultural interaction during end-of-life care.MethodsSixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis.ResultsThe health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, ‘unusual’ emotional and pain expressions, the expectation that these patients’ families would be ‘different’ and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting “the unknown”. In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients.ConclusionsThe study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as “the unknown” since they anticipate a variety of challenges and do not seem confident enough that they can provide good quality care when cross-cultural interaction is at stake.
Previous research into cross-cultural interactions in health care settings shows that care providers experience communicating with elderly ethnic minority patients as problematic. According to the social constructionist framework upon which this presentation draws, people negotiate the characteristics they ascribe to the world around them through talk. It is against this backdrop that the presentation – which is based on a focus group study with end-of-life care providers (n=60) – sets out to explore how care providers talk about communication difficulties with elderly ethnic minority patients. The presentation demonstrates how the study of communication difficulties can illustrative the challenges of cross-cultural interaction in end-of-life care settings. Through the attention on how communication difficulties are discussed, this presentation shifts the focus from the elderly ethnic minority patients and the reasons for why they are experienced as problematic when it comes to communication, to the actual process where these problems are negotiated.
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