Culturally sensitive communication at the end-of-life in the intensive care unit: A systematic review

Brooks, Laura; Bloomer, Melissa; Manias, Elizabeth

doi:10.1016/j.aucc.2018.07.003

Cited by 55 publications

(47 citation statements)

References 38 publications

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“…The results show that almost half of the parents on the pediatric palliative care unit speak a mother tongue other than the local language. This finding demonstrates on the basis of concrete data that language barriers seem to be pervasive in pediatric palliative care and is therefore generally consistent with other research [ 15 , 26 , 35 , 36 ]. At the same time, this implies the need for culturally sensitive communication in the health care sector and in the field of pediatric palliative care [ 22 , 30 , 37 , 38 , 39 ].…”

Section: Discussionsupporting

confidence: 92%

“…In the clinical routine in general and particularly in pediatric palliative care, different strategies such as the involvement of (professional) translators are used to overcome language barriers between care providers and patients/families [ 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. The importance of the awareness and education of cultural characteristics is acknowledged by many healthcare providers, but is perceived as insufficient [ 26 , 27 , 28 ]. However, successful intercultural communication can only be achieved if providers develop culturally sensitive skills and hence act on the same linguistic and superordinate cultural level as parents and patients with a different ethnic background [ 22 , 29 , 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

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Quantifying the Language Barrier—A Total Survey of Parents’ Spoken Languages and Local Language Skills as Perceived by Different Professions in Pediatric Palliative Care

2020

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To date, there are no specific figures on the language-related characteristics of families receiving pediatric palliative care. This study aims to gain insights into the languages spoken by parents, their local language skills and the consistency of professional assessments on these aspects. Using an adapted version of the “Common European Framework of Reference for Languages”, the languages and local language skills of parents whose children were admitted to an inpatient pediatric palliative care facility (N = 114) were assessed by (a) medical staff and (b) psychosocial staff. Nearly half of the families did not speak the local language as their mother tongue. The most frequently spoken language was Turkish. Overall, the medical staff attributed better language skills to parents than the psychosocial staff did. According to them, only 27.0% of mothers and 38.5% of fathers spoke the local language at a high level while 37.8% of mothers and 34.6% of fathers had no or rudimentary language skills. The results provide important information on which languages pediatric palliative care practitioners must be prepared for. They sensitize to the fact that even within an institution there can be discrepancies between the language assessments of different professions.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Quantifying the Language Barrier—A Total Survey of Parents’ Spoken Languages and Local Language Skills as Perceived by Different Professions in Pediatric Palliative Care

2020

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“…With increasing cultural diversity because of global mobilization, and Islam being the fastest growing religion worldwide, this study highlights the need for nurses to have access to educational opportunities that focus on the use of culturally sensitive communication, particularly at the end of life in critical care settings . Education about Islam and the potential implications for NICU and PICU care is essential, not just for an expatriate workforce in Saudi Arabia but also for NICU and PICU nurses worldwide who may be called upon to provide care for a Muslim child and family.…”

Section: Discussionmentioning

confidence: 99%

Supporting Muslim families before and after a death in neonatal and paediatric intensive care units

Mutair

Ammary

Brooks

et al. 2019

Nursing in Critical Care

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Background: The death of a child is regarded as one of the most devastating events for a family. Families are reliant on nurses to not only provide end-of-life care but also to support and care for grieving families in a way that is sensitive to their cultural and religious needs and preferences.Aims: The aim of this study was to explore the perceived impact and influence of cultural diversity on how neonatal and paediatric intensive care nurses care for Muslim families before and after the death of infants/children.Design: A qualitative descriptive approach was used in this study, conducted in Saudi Arabia.Methods: Semi-structured interviews were used to gather data from a convenience sample of registered nurses working in neonatal and paediatric intensive care, with experience in providing end-of-life care. Interviews were conducted between July and November, 2018. Interviews were audio-recorded and transcribed for analysis. Results: Thirteen registered nurses participated; all were born overseas, identified with various faiths and spoke English in the workplace. A respect for diversity and care of the family was prioritized yet impacted by communication challenges. Caring and respect was demonstrated by facilitating important cultural and religious practices important in the Muslim faith. Self-care was identified as important, transcending the culturally diverse nature of the nursing workforce.Conclusions: Significant challenges exist for a culturally diverse nursing workforce in providing care to a Saudi Muslim population of infants/children and families, before and after a death. Their overriding commitment to respect for others, and an openness to cultural diversity and difference, aided in overcoming the inherent challenges in providing culturally sensitive end-of-life care that meets the needs of Muslim families. These findings provide valuable insights for intensive care clinicians in other countries to address challenges associated with cultural diversity. K E Y W O R D S bereavement, cultural diversity and family needs in intensive care unit, end-of-life care, neonatal intensive care, paediatric intensive care

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“…Yet critical care nurses may face multiple challenges associated with end-of-life care on a daily basis [ 15 ]. These challenges include coordinating communication between the treating team and next of kin [ 16 ] and ensuring communication is culturally sensitive [ 17 ]. Critical care nurses are also known for their role in preparing next of kin and families for treatment withdrawal [ 18 , 19 ], creating space and privacy [ 16 ], and focusing on what is important to the patient, next of kin, and family before and after death [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Australian College of Critical Care Nurses and Australasian College for Infection Prevention and Control position statement on facilitating next-of-kin presence for patients dying from coronavirus disease 2019 (COVID-19) in the intensive care unit

Bloomer

Bouchoucha

2021

Australian Critical Care

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The coronavirus disease 2019 (COVID-19) pandemic is challenging healthcare systems worldwide, none more so than critical and intensive care settings. Significant attention has been paid to the capacity of Australian intensive care unit (ICUs) to respond to a COVID-19 surge, particularly in relation to beds, ventilators, staffing, personal protective equipment, and unparalleled increase in deaths in ICUs associated with COVID-19 seen internationally. While death is not uncommon in critical care, the international experience demonstrates that restrictions to family presence at the end of life result in significant distress for families and clinicians. As a result, the Australian College of Critical Care Nurses and the Australasian College for Infection Prevention and Control supported the development of a position statement to provide critical care nurses with specific guidance and recommendations for practice for this emerging priority area. Where possible, position statements are founded on high-quality evidence. However, the short time period since the first recognition of a cluster of pneumonia-like cases in China in January, 2020, meant that an integrative approach was required to expedite timely development of this position statement in preparation for a COVID-19 surge in Australia. This position statement is intended to provide practical guidance to critical care nurses in facilitating next-of-kin presence for patients dying from COVID-19 in the ICU.

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Culturally sensitive communication at the end-of-life in the intensive care unit: A systematic review

Abstract: The findings of this systematic review show that clinicians lack the knowledge to enable effective interaction with culturally diverse patients and families at the end-of-life.

Cited by 55 publications

References 38 publications

Quantifying the Language Barrier—A Total Survey of Parents’ Spoken Languages and Local Language Skills as Perceived by Different Professions in Pediatric Palliative Care

Quantifying the Language Barrier—A Total Survey of Parents’ Spoken Languages and Local Language Skills as Perceived by Different Professions in Pediatric Palliative Care

Supporting Muslim families before and after a death in neonatal and paediatric intensive care units

Australian College of Critical Care Nurses and Australasian College for Infection Prevention and Control position statement on facilitating next-of-kin presence for patients dying from coronavirus disease 2019 (COVID-19) in the intensive care unit

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