Mixed‐methods systematic review: Cultural attitudes, beliefs and practices of internationally educated nurses towards end‐of‐life care in the context of cancer

Abstract

Aim To identify and analyse the cultural attitudes, beliefs and practices of internationally educated nurses towards end‐of‐life care in the context of cancer. Background Cultural heritage shape beliefs and practices about cancer and end of life, which complicates nursing care delivery. While previous studies centred on diverse patients’ perspectives and cultural competence of healthcare professionals, little analysis available focusing on the cultural attitudes and beliefs of care providers from diverse backgrounds. Design Mixed methods systematic review. Data sources CINAHL, MEDLINE, Embase, PsychINFO and Scopus were searched between January and March 2020. No date limit was applied. Review methods Quality appraisal was conducted using the mixed‐method appraisal tool. Convergent segregated synthesis was undertaken. Findings were thematically synthesised with the final synthesis presented narratively. Results Seven studies were included: three qualitative, two quantitative and two mixed methods. None of the studies focused on the end‐of‐life care experiences of IENs in the context of cancer. One study reported views on cancer, with all studies analysing the cultural attitudes, beliefs and practices of internationally educated nurses towards end‐of‐life care. Three main themes were identified: the philosophy of care, approaches to care and perceptions of death and dying. Conclusion The distinct gap in research on understanding the cultural attitudes and beliefs of internationally educated nurses in end‐of‐life care in the context of cancer demands further research. Several aspects of end‐of‐life care were in conflict with internationally educated nurses’ cultural attitudes, beliefs and practices. As these nurses are integral in achieving culturally competent care, further understanding of this phenomenon is required to advance the delivery of culturally sensitive care to patients. Impact Stakeholders, including the nursing workforce, need to play an active role in providing a culturally inclusive workplace. Support measures are necessary to reduce the impact of cultural conflicts experienced by internationally educated nurses.

Registered Nurses' beliefs about end‐of‐life care: A mixed method study

“…This religious factor may explain why there were differences in nurses' responses about their belief in their ability to preserve patients' dignity until the moment of death (Xiao et al, 2021 ). A systematic review by Balante et al ( 2021 ) confirmed that faith and religion often guide end‐of‐life approaches. Their findings indicated that RNs consider their faith as an integral part of their professional role when providing end‐of‐life care, and they felt satisfied that their faith guided them in their decisions to support patients and their families (Balante et al, 2021 ).…”

Perceptions on the current content and pedagogical approaches used in end-of-life care education among undergraduate nursing students: a qualitative, descriptive study

“…Such a situation is a very good opportunity for students to learn about end-of-life care. Balante J et al thinks stakeholders, such as the nursing workforce, need to play an active role in providing a culturally inclusive workplace to encourage students to experience end-of-life care [ 53 ].…”

Challenges experienced by nurses caring for patients from different cultures: a scoping review of the literature, 2010-2020

“…For example, Chen et al (2017) also indicated that the time to acquire the necessary knowledge and skills and provide culturally competent care was a significant barrier. In the studies we reviewed, a lack of knowledge of the patient's culture resulted in discomfort for both nurses and patients (Balante et al, 2021;Shepherd et al, 2019). Wesołowska et al (2018) suggested that these problems could be solved by developing cultural competencies.…”