“Achieve the best while rushing against time”: A grounded theory study on caring for low-income immigrant cancer patients at end of life

Abstract

Background: Between 2000 and 2020, Europe experienced an annual net arrival of approximately 1.6 million immigrants per year. While having lower mortality rates, in the setting of severe diseases, immigrants bear a greater cancer-related burden due to linguistic and cultural barriers and socio-economic conditions. Professionals face a two-fold task: managing clinical conditions while considering the social, economic, cultural, and spiritual sphere of patients and their families. In this regard, little is known about the care provision to low-income immigrant cancer patients in real contexts. Aim: To investigate the perspective of professionals, family members, and stakeholders on the caring process of low-income immigrant cancer patients at the end of life. Design: A Constructivist Grounded Theory study. Setting/participants: The study, conducted at a Hospital in Northern Italy, involved 27 participants among health professionals, family caregivers, and other stakeholders who had recently accompanied immigrant cancer patients in their terminal phase of illness. Results: Findings evidenced that professionals feel they were not adequately trained to cope with immigrant cancer patients, nonetheless, they were highly committed in providing the best care they could, rushing against the (short) time the patients have left. Analyses evidenced four main categories: “providing and receiving hospitality,” “understanding each other,” “addressing diversity,” and “around the patient,” which we conceptualized under the core category “Achieve the best while rushing against time.” Conclusions: The model reveals the activation of empathic and compassionate behavior by professionals. It evidences the need for empowering professionals with cultural competencies by employing interpreters and specific training programs.

“Do the Best You Can with Resources You Have to Offer”: Community stakeholder views on supporting immigrant families

“…The impact of these stakeholders can vary, and literature has shown evidence that stakeholders play an important role in the well‐being of immigrant families (e.g., Van Ngo et al, 2017). For instance, although healthcare providers may not fully understand immigrant populations, they can offer a culturally sensitive and accessible system of care by demonstrating empathy and compassion (Higginbottom et al, 2015; Lightfoot et al, 2019; Sacchi et al, 2021). Similarly, mental health professionals can provide school‐based therapy to immigrant children who would otherwise have limited resources and access to psychological services (Cummings et al, 2021).…”

The end-of-life needs of Aboriginal and immigrant communities: a challenge to conventional medical models

“…For migrant communities, there is particular concern about the marginalization of those with limited English. Some examples are Barwise et al (5) and Abedini et al (6) in the U.S.; Elkan et al (7) in the U.K.; Six et al (8) in Belgium; Nowara et al (9) in Germany; and Sacchi et al (10) in Italy. First Nations peoples in developed countries have reduced life expectancies, particularly from chronic diseases, and the lack of access to and take up of palliative care services is an ongoing concern [Shahid et al (11), cross-national; Gebauer et al (12), U.S.; Canadian Virtual Hospice (13); Gott et al (14), N.Z.].…”