“Calling the Spirit Back:” Spiritual Needs Among Great Plains American Indians

Isaacson, Mary; Duran, Tinka; Johnson, Gina; Soltoff, Alexander; Jackson, S.; Petereit, Daniel G.; Armstrong, Katrina; Daubman, Bethany‐Rose

doi:10.1016/j.jpainsymman.2022.05.014

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…Palliative care provision and outcomes for racially and culturally minoritized persons (e.g., Black and Native American people) with serious illness are substandard when compared to non-minoritized persons. For instance, care inequities for Black and Native American patients and their caregivers exist across the palliative care spectrum, including but not limited to poorer symptom management, disparate medically indicated treatments for pain (e.g., equitable opioid prescribing and monitoring practices) [ 6 , 7 , 8 , 9 , 10 , 11 ], discriminatory and biased clinician behaviors and communication [ 12 , 13 , 14 ], poor integration of patients’ spiritual and cultural values into care delivery [ 15 , 16 ], less high-quality evidence and documentation of advance care planning [ 17 , 18 , 19 ], and significant mistrust of the health system [ 20 , 21 ] that impacts patients’ decision making and relationships with clinicians. Such disparities lead to poorer clinical outcomes for patients (e.g., pain, goal discordant care) and caregivers (e.g., bereavement).…”

Section: Introductionmentioning

confidence: 99%

Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer

Rosa

McDarby

Buller

et al. 2023

Cancers

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The aim of this study was to examine interdisciplinary clinicians’ perceptions of priorities in serious illness communication and shared decision-making with racially and culturally minoritized persons at end of life. Clinicians (N = 152) read a detailed case study about a patient self-identifying as Black and American Indian who describes mistrust of the healthcare system. Participants then responded to three open-ended questions about communication strategies and approaches they would employ in providing care. We conducted a thematic analysis of participants’ responses to questions using an iterative, inductive approach. Interdisciplinary clinicians from nursing (48%), social work (36%), and chaplaincy (16%), responded to the study survey. A total of four themes emerged: (1) person-centered, authentic, and culturally-sensitive care; (2) pain control; (3) approaches to build trust and connection; and (4) understanding communication challenges related to racial differences. Significant efforts have been made to train clinicians in culturally inclusive communication, yet we know little about how clinicians approach “real world” scenarios during which patients from structurally minoritized groups describe care concerns. We outline implications for identifying unconscious bias, informing educational interventions to support culturally inclusive communication, and improving the quality of end-of-life care for patients with cancer from minoritized groups.

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