End-of-life care for ethnic minority groups

Siriwardena, Aloysius Niroshan; Clark, David H.

doi:10.1016/s1098-3597(04)90006-3

Cited by 15 publications

(7 citation statements)

References 28 publications

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“…2,7,30,31 Individuals within each ethnic group will have different religions, requirements and preferences for end-of-life care, including how to handle the body after death. 2,32 Professionals may lack detailed knowledge and understanding of these differing cultural and religious needs and therefore not know how to provide for them adequately and consequently fear getting it wrong. 7,31 Linguistic barriers may also limit the opportunity of referral to specialist care, the portrayal of what hospices have to offer and the ability to carry out an in-depth open discussion with the patient.…”

Section: Discussionmentioning

confidence: 99%

Does place of death from cancer vary between ethnic groups in South East England?

et al. 2011

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There is growing evidence that the palliative care needs of certain people, such as those from minority ethnic groups, are not being met. The aim of this study was to investigate whether place of death from cancer differs between ethnic groups. A total of 101,516 patients resident in South East England and who died from lung, colorectal, breast or prostate cancer between 1998 and 2006 were extracted from the Thames Cancer Registry database. Ethnicity data were available for 68,804 patients (68%). The odds ratios (ORs) of death from cancer in a hospice, at home or in hospital were calculated. The results were adjusted for age at death, deprivation, cancer network of residence and time between diagnosis and death. Following adjustment, death in a hospice was significantly less likely for Pakistani patients (OR=0.47 95% CI [0.30-0.74]), Indian patients (0.68 [0.55-0.84]) and Bangladeshi patients (0.33 [0.19-0.56]). Death at home was significantly less likely in Black African patients (0.48 [0.36-0.65]), Black Caribbean patients (0.78 [0.67-0.90]) and Chinese patients (0.46 [0.28-0.76]). Pakistani, Indian, Bangladeshi, Black African, Black Caribbean and Chinese patients were all significantly more likely than White patients to die in hospital. The results were not substantially altered by recoding the unknown ethnicity group to White or using multiple imputation to assign those with a missing ethnicity an ethnic group. Place of death varies between ethnic groups. This may reflect differences in preferences for place of death or barriers to accessing specialist care in different settings. More detailed prospective qualitative studies are urgently required to determine reasons for this variation.

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Section: Discussionmentioning

confidence: 99%

Does place of death from cancer vary between ethnic groups in South East England?

et al. 2011

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“…Thus, culture influences the use of healthcare at the end-of-life. Issues influenced by culture that create barriers to palliative care include language and communication barriers, religion and spirituality, responses to inequities in care, and family involvement with decision making (Kagawa-Singer & Blackhall, 2001; Laguna, Enguídanos, Siciliano, & Coulourides-Kogan, 2012; Siriwardena & Clark, 2004). Several factors contributing to limitations in language differences include limited use of medical interpreters and paucity of patient-centered and culturally aligned literature regarding hospice or palliative care in other languages.…”

Section: Introductionmentioning

confidence: 99%

Methods for overcoming barriers in palliative care for ethnic/racial minorities: a systematic review

Mayeda

Ward

2019

Pall Supp Care

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ObjectivesEthnic/racial minority groups are less likely to discuss issues involving end-of-life treatment preferences and utilize palliative care or hospice services. Some barriers may be differences in language, religion, lower levels of health literacy, or less access to healthcare services and information. The purpose of this article is to conduct a systematic review on interventional studies that investigated methods to overcome the barriers faced by ethnic/racial minorities when accessing end-of-life services, including completing advanced directives, accepting palliative care, and enrolling in hospice.MethodsLiterature searches using four standard scientific search engines were conducted to retrieve articles detailing original research in an interventional trial design. All studies were conducted in an outpatient setting, including primary care visits, home visits, and dialysis centers. Target populations were those identified from ethnic or racial minorities.ResultsNine articles were selected to be included in the final review. All were full-text English language articles, with target populations including African Americans, Hispanic or Latinos, and Asian or Pacific Islanders. Measured outcomes involved level of comfort in discussing and knowledge of palliative care services, desire for aggressive care at the end-of-life, completion of advance directives, and rate of enrollment in hospice.Significance of ResultsThree main avenues of interventions included methods to enhance patient education, increase access to healthcare, or improve communication to establish better rapport with target population. Studies indicate that traditional delivery of healthcare services may be insufficient to recruit patients from ethnic/racial minorities, and outcomes can be improved by implementing tailored interventions to overcome barriers.

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“…99,100 The U.S. legal system allows people to designate advance directives and assign a power of attorney for end-of-life care consistent with their cultural beliefs; however, some cultures do not complete these forms.…”

Section: Cultural Competence and Moralitymentioning

confidence: 99%

“…In terms of end of life, at least four major areas are influenced by culture: communication of terminal illness, locus of decision making, use of advance directives and hospice care, and transition to next phase (i.e., pain-penancecleansing before death, heaven, reincarnation, etc.). 99,100 The U.S. legal system allows people to designate advance directives and assign a power of attorney for end-of-life care consistent with their cultural beliefs; however, some cultures do not complete these forms.…”

Section: Cultural Competence and Moralitymentioning

confidence: 99%

Cultural Competence in Health Care and Its Implications for Pharmacy

O’Connell¹,

Korner²,

Rickles³

et al. 2007

Pharmacotherapy

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Pharmacists are caring for more individuals of diverse age, gender, race, ethnicity, socioeconomic status, religion, sexual orientation, and health beliefs than in previous decades. Not all residents of the United States equally experience long life spans and good health. Health disparities in various cultures have been documented. One critical aspect of reducing health disparities is moving health care providers, staff, administrators, and practices toward increased cultural competence and proficiency. Effective delivery of culturally and linguistically appropriate service in cross-cultural settings is identified as cultural competence. Culture is a dynamic process, with people moving in and out of various cultures throughout their lives. The failure to understand and respect individuals and their cultures could impede pharmaceutical care. Incongruent beliefs and expectations between the patient and pharmacist could lead to misunderstandings, confusion, and ultimately to drug misadventures. Models and frameworks have been developed that provide descriptions of the process by which individuals, practice settings, and organizations can become culturally competent and proficient. This article, the first in a five-part series, presents an overview of issues related to cultural competence in health care with an emphasis on the pharmacy profession. Also provided are definitions for cultural competence and related terms, a brief overview of health disparities and challenges to the common morality, and a discussion of models and frameworks that describe pathways to cultural competence and proficiency.

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End-of-life care for ethnic minority groups

Cited by 15 publications

References 28 publications

Does place of death from cancer vary between ethnic groups in South East England?

Does place of death from cancer vary between ethnic groups in South East England?

Methods for overcoming barriers in palliative care for ethnic/racial minorities: a systematic review

Cultural Competence in Health Care and Its Implications for Pharmacy

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