Problematizing “Planning Ahead”: A Cross-Cultural Analysis of Vietnamese Health and Community Workers’ Perspectives on Advance Care Directives

Nguyen, Nga Thanh; Zivkovic, Tanya; Haas, Rachael de; Faulkner, Debbie

doi:10.1177/10497323211023453

Cited by 4 publications

(3 citation statements)

References 58 publications

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“…Social workers in the field of child protection creatively “remade” key aspects of their practice, by recognizing inequalities and providing material help, through digital casework, movement, and walking encounters, and by going into homes and taking the risk of getting physically close to children and parents (Ferguson et al, 2022). Health and community workers had to cope with difficulties carrying out their professional intervention programs during COVID-19, especially in terms of trust relationships with the community (Nguyen et al, 2021). The main challenge for community practitioners was that community social work is based on being with people in their surroundings, and having broad group meetings and close relationships with community members (Sadan, 2009).…”

Section: Discussionmentioning

confidence: 99%

“No matter what, I will not give up”: Community practice on the front lines of COVID-19.

Itzhaki-Braun¹,

Feldman²,

Frankenburg³

et al. 2023

American Journal of Orthopsychiatry

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The COVID-19 pandemic has required frontline health care workers to cope with an unexpected and almost unprecedented emergency situation. Community social workers had played a crucial role during the pandemic, working to alleviate its adverse effects on marginalized communities. The present study investigated community social workers’ experiences and hardships in coping with the “age of COVID-19.” Drawing on in-depth interviews with 30 frontline community social workers in Israel, the findings highlighted three main themes: (a) the hope for recognition and the reality of underutilization; (b) the impact of the dysfunctional state on community social workers; and (c) realizing the core values and activities of community social work practice during the pandemic. Findings pointed to community social workers’ professionalism and integrity despite the hardships they endured at the local and national levels. Committing on an altruistic level seemed to be an adaptive coping style, alongside facing “the politics of pandemics.” Implications for community practice are outlined.

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Section: Discussionmentioning

confidence: 99%

“No matter what, I will not give up”: Community practice on the front lines of COVID-19.

Itzhaki-Braun¹,

Feldman²,

Frankenburg³

et al. 2023

American Journal of Orthopsychiatry

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“…154 However, the relevance of individual autonomy to the way most people live their lives, and in particular in isolation of their relationships with other people, is being called into question: the consumerist notion of autonomous 'choice' has limited relevance, particularly in relation to patients from ethnically diverse groups for whom individual autonomy may not be the predominant underpinning to decisions. 72,136,138,156,158,163,164 The limited and ethnocentric stance of current policy is underlined by consideration of the alternative approaches that have been identified in research from ethnically and culturally diverse groups. Respect for persons is manifest in the desire to protect the patient from an unwelcome truth, in the desire for the family or elders to assume responsibility for making decisions about treatment and in the commitment to care by family members, particularly of adult children for their parents.…”

Section: Understanding and Engaging With End-of-life Care Planningmentioning

confidence: 99%

“…137,138,159,[185][186][187] This collectivist model of decision-making is recognised to be particularly relevant to patients from culturally and ethnically diverse backgrounds. 60,132,136,[156][157][158]163 In these contexts, the locus of decision-making is often a joint responsibility, vested in the family group, and sometimes requiring concurrence from elders or respected non-family community or faith leaders, rather than the individual.…”

Section: Models Of Carementioning

confidence: 99%

Thinking ahead about medical treatments in advanced illness: a qualitative study of barriers and enablers in end-of-life care planning with patients and families from ethnically diverse backgrounds

Islam

Pollock

Patterson

et al. 2023

Health Soc Care Deliv Res

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Background This study explored whether or not, and how, terminally ill patients from ethnically diverse backgrounds and their family caregivers think ahead about deterioration and dying, and explored their engagement with health-care professionals in end-of-life care planning. Objective The aim was to address the question, what are the barriers to and enablers of ethnically diverse patients, family caregivers and health-care professionals engaging in end-of-life care planning? Design This was a qualitative study comprising 18 longitudinal patient-centred case studies, interviews with 19 bereaved family caregivers and 50 public and professional stakeholder responses to the findings. Setting The study was set in Nottinghamshire and Leicestershire in the UK. Results Key barriers – the predominant stance of patients was to live with hope, considering the future only in terms of practical matters (wills and funerals), rather than the business of dying. For some, planning ahead was counter to their faith. Health-care professionals seemed to feature little in people’s lives. Some participants indicated a lack of trust and experienced a disjointed system, devoid of due regard for them. However, religious and cultural mores were of great importance to many, and there were anxieties about how the system valued and enabled these. Family duty and community expectations were foregrounded in some accounts and concern about being in the (un)care of strangers was common. Key enablers – effective communication with trusted individuals, which enables patients to feel known and that their faith, family and community life are valued. Health-care professionals getting to ‘know’ the person is key. Stakeholder responses highlighted the need for development of Health-care professionals’ confidence, skills and training, Using stories based on the study findings was seen as an effective way to support this. A number of behavioural change techniques were also identified. Limitations It was attempted to include a broad ethnic diversity in the sample, but the authors acknowledge that not all groups could be included. Conclusions What constitutes good end-of-life care is influenced by the intersectionality of diverse factors, including beliefs and culture. All people desire personalised, compassionate and holistic end-of-life care, and the current frameworks for good palliative care support this. However, health-care professionals need additional skills to navigate complex, sensitive communication and enquire about aspects of people’s lives that may be unfamiliar. The challenge for health-care professionals and services is the delivery of holistic care and the range of skills that are required to do this. Future work Priorities for future research: How can health professionals identify if/when a patient is ‘ready’ for discussions about deterioration and dying? How can discussions about uncertain recovery and the need for decisions about treatment, especially resuscitation, be most effectively conducted in a crisis? How can professionals recognise and respond to the diversity of faith and cultural practices, and the heterogeneity between individuals of beliefs and preferences relating to the end of life? How can conversations be most effectively conducted when translation is required to enhance patient understanding? Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. X. See the NIHR Journals Library website for further project information.

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“The clock is ticking”: (dis)orientations to ageing and end-of-life care in advanced capitalism and care directives

Zivkovic,

Marino

2024

Journal of Sociology

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This article engages Italian migrant experiences and enactments of futurity to problematize neoliberal anticipatory approaches to ageing and care. Stepping beyond the focus on atomized and agentic individuals and a singular imagined future defined by notions of advancement and progress, sistemazione (home, future, and security) offers ways of building alternative and relational futures within times and spaces of shared precarity. We draw on ethnographic fieldwork and interviews with Italian migrant families living in Adelaide, and a critical analysis of objects as “orienting devices,” to consider how a family heirloom, a 26-face handmade Italian clock made from the physical remnants of World War II, offers new ways of imagining care within spaces of ruin.

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Problematizing “Planning Ahead”: A Cross-Cultural Analysis of Vietnamese Health and Community Workers’ Perspectives on Advance Care Directives

Cited by 4 publications

References 58 publications

“No matter what, I will not give up”: Community practice on the front lines of COVID-19.

“No matter what, I will not give up”: Community practice on the front lines of COVID-19.

Thinking ahead about medical treatments in advanced illness: a qualitative study of barriers and enablers in end-of-life care planning with patients and families from ethnically diverse backgrounds

“The clock is ticking”: (dis)orientations to ageing and end-of-life care in advanced capitalism and care directives

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