2.5 () Ethnic and cultural aspects of pall and EOL care

Question 1

How does WHO define QOL

Answer 1

An individual’s perception of their position in life in context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns

Question 2

Name 3 cross cultural communication issues

Answer 2

1. Traditional medical training is deficient in cross cultural communication education
2. When cultural background of provider differs from patient
3. Lack of translator resources
4. Lack of sensitivity to cultural and religious issues

Question 3

What is the first step to cross-cultural competency?

Answer 3

Healthcare professional becoming aware of inherent beliefs, values and biases AND the influence of the healthcare system in which the case is provided

Question 4

What is the second step to cross-cultural competency?

What is a strategy that can be used to produce information about patient?

What is a strategy to engage with patients?

Answer 4

Communication strategies that are evocative, non-judgmental and considerate

RISK assessment = pt resources, identity, skills and knowledge

Ask tell ask strategy

Question 5

What are 5 key communication skill sets that promote cultural communication?

Answer 5

Non-verbal skill
Verbal skill
Appreciation of cultural differences
Incorporation of an adaptation of cultural knowledge
Negotiation/collaboration

Question 6

How to communication medical information?

Answer 6

Clear language - without medical jargon
Limit to 1-3 piece of information at a time
Ask patient/family to teach base what they heard

Question 7

List 4 reasons why there are unmet needs/disparities in access to pall services by BAME people (Black, Asian, minority ethnic group)

Answer 7

1. Low uptake of services
2. Lack of referrals
3. Lack of knowledge about pall care / hospice
4. Info not available in different language
5. Lack of cultural equivalent for pall care / hospice
6. Pall care conflicting with religion
7. Mistrust by patients and families
8. Misassumptions by patients and care providers
9. Social exclusion and segregation
10. SES factors (e.g. education)

Question 8

List 3 reasons why there are unmet needs/disparities in receipt of pall services by BAME people (Black, Asian, minority ethnic group)

Answer 8

1. Poor communication
   - Lack of sensitivity to cultural/religious values
   - Lack of translation
   - Lack of resources to train health care professionals
2. End of life decisions/interventions
   - Less likely advance care planning
   - Mistrust
   - Influence of religion
   - Western value conflicts
3. Outcome of care
   - Pain control - worse pain outcomes, severity underestimated
   - Less satisfied with care