Cultural Beliefs About a Patient’s Right Time to Die: An Exploratory Study

Perkins, Henry S.; Cortez, Josie D.; Hazuda, Helen P.

doi:10.1007/s11606-009-1115-5

Cited by 23 publications

(34 citation statements)

References 62 publications

(67 reference statements)

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“…Moreover, they actively pursue traditional healing practices as part of end‐of‐life care . Religious values may also be diverse, and in some cases promote ideas counter to biomedical conceptions of best practice . As in other areas of medicine, while advanced care planning is primarily based on symptom control and disease‐based issues, sensitivity to cultural and familial values improves the likelihood of effective follow‐up, lower levels of complaints, treatment compliance, and importantly access to timely and effective palliative care.…”

Section: Belief and Values Around Palliative Care And The End Of Lifementioning

confidence: 99%

“…There is a comprehensive literature regarding how cultural values may shape expressions of grief and loss . While people are idiosyncratic in how they express hope, grief and loss, research suggests that cultural groups may reflect particular values and culturally accepted practices, including tendencies towards expressiveness, stoicism, flamboyance, privacy and so on.…”

Section: Expression Of Grief and Emotionmentioning

confidence: 99%

“…While people are idiosyncratic in how they express hope, grief and loss, research suggests that cultural groups may reflect particular values and culturally accepted practices, including tendencies towards expressiveness, stoicism, flamboyance, privacy and so on. While emotion is much more complex than mere manifestations of culture, awareness of cultural norms around receiving bad news or responses to stopping potentially curative treatment, for example, is an important part of clinical practice . In some cultures, for example, digesting bad news or nervousness may beexpressed through smiling, and a clinician may interpret this as reflecting full comprehension or even acceptance.…”

Section: Expression Of Grief and Emotionmentioning

confidence: 99%

“…Given this broader context of cultural and linguistic diversity, negotiations about referral to specialist palliative care present unique and often challenging issues for clinicians. Difficulties often emerge from the presence of (often unrecognised) values around disclosure, care and responsibility, including culturally specific beliefs about the dying process . Indeed, for some CALD populations, formalised palliative care does not exist within their country of origin.…”

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confidence: 99%

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Negotiating palliative care in the context of culturally and linguistically diverse patients

Broom

Good

Kirby

et al. 2013

Internal Medicine Journal

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There is an increasing emphasis on meeting the healthcare needs of culturally and linguistically diverse (CALD) communities in Australia. Negotiating the point of futility and the transition to specialist palliative care requires not only effective communication but also sensitivity to cultural and linguistic specificities. This can be a challenging process for clinicians, patients and families. Here, we outline some of the key challenges currently facing many clinicians in the context of CALD patients, with particular reference to the transitioning of patients to specialist palliative care. We suggest a focus on further research that can systematically document and model existing CALD-specific clinical processes and pathways, which can then support the development of targeted educational interventions. This includes developing a multi-stakeholder understanding of the CALD experience that moves beyond cultural stereotyping and predicting need.

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Section: Belief and Values Around Palliative Care And The End Of Lifementioning

confidence: 99%

Section: Expression Of Grief and Emotionmentioning

confidence: 99%

Section: Expression Of Grief and Emotionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Negotiating palliative care in the context of culturally and linguistically diverse patients

Broom

Good

Kirby

et al. 2013

Internal Medicine Journal

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“…Though content analyses are usually reported qualitatively, percentages have 2 advantages here. 17 First, readers can see the percentages and judge for themselves the important similarities, differences, and patterns in the data. Second, percentages enable researchers to formulate their own questions for further study, say, questions based on the largest percentages or largest percentage differences in the data.…”

mentioning

confidence: 99%

Patients' diverse beliefs about what happens at the time of death

Perkins

Cortez²,

Hazuda

2011

Journal of Hospital Medicine

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BACKGROUND:Beliefs about what happens at the time of death surely affect a patient's whole dying experience and could help guide end‐of‐life care. Yet virtually no research describes those beliefs. This exploratory study begins the descriptive process.METHODS:Assuming culture is key, we interviewed 26 Mexican‐American (MA), 18 Euro‐American (EA), and 14 African‐American (AA) inpatients about their beliefs concerning what happens at the time of death.RESULTS:One belief, that death separates the dead from the living, was widespread. Majorities of all 3 ethnic group samples and of 5 of the 6 gender subsamples expressed this belief, saying the dead “go” or “leave” from this life. Other beliefs differed by ethnic group or gender. For example, more EAs (50%) than others said death is a momentary event, and more MAs (35%) than others said death involves “being taken” by an external force (always God or Jesus). Furthermore, considerably more EA women (45%) than others said some senses persist after death. In contrast, the physiologic signs that participants cited as defining the exact time of death varied from individual to individual with no ethnic or gender pattern, and no one sign predominated.CONCLUSIONS:A few beliefs about what happens at the time of death may characterize Americans in general; many other beliefs may characterize only certain ethnic groups, genders, or individuals. To identify such beliefs and to use them to guide end‐of‐life care, hospitalists and other health professionals may have to elicit them directly from patients or survivors. Journal of Hospital Medicine 2012. © 2011 Society of Hospital Medicine

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Use of artificial nutrition near the end of life: Results from a French national population‐based study of hospitalized cancer patients

et al. 2019

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Background:The use of artificial nutrition, defined as a medical treatment that allows a non-oral mechanical feeding, for cancer patients with limited life expectancy is deemed nonbeneficial. High-quality evidence about the use of artificial nutrition near the end of life is lacking. This study aimed (a) to quantify the use of artificial nutrition near the end-of-life, and (b) to identify the factors associated with the use of artificial nutrition. Methods: This was a retrospective cohort study of decedents based on data from the French national hospital database. The study population included adult cancer patients who died in hospitals in France between 2013 and 2016 and defined to be in a palliative condition. Use of artificial nutrition during the last 7 days before death was the primary endpoint. Results: A total of 398 822 patients were included. The median duration of the last hospital stay was 10 (interquartile range, 4-21) days. The artificial nutrition was used for 11 723 (2.9%) during the last 7 days before death. Being a man, younger, having digestive cancers, metastasis, comorbidities, malnutrition, absence of dementia, and palliative care use were the main factors associated to the use of artificial nutrition. Conclusion: This study indicates that the use of artificial nutrition near the end of life is in keeping with current clinical guidelines. The identification of factors associated with the use of artificial nutrition, such as cancer localization, presence of comorbidities or specific symptoms, may help to better manage its use. K E Y W O R D S artificial nutrition, cancer, end-of-life, health services research, registry database 5 | CONCLUSION This study indicates that the use of artificial nutrition near the end of life is rather low, which is in keeping with current clinical guidelines. The identification of factors associated with the use of artificial nutrition, such as cancer | 539 BAUMSTARCK eT Al.localization, presence of comorbidities or specific symptoms, may help to better manage its use, and may improve communication with patients, families, professionals, and health policy makers.

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Cultural Beliefs About a Patient’s Right Time to Die: An Exploratory Study

Cited by 23 publications

References 62 publications

Negotiating palliative care in the context of culturally and linguistically diverse patients

Negotiating palliative care in the context of culturally and linguistically diverse patients

Patients' diverse beliefs about what happens at the time of death

Use of artificial nutrition near the end of life: Results from a French national population‐based study of hospitalized cancer patients

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