The paradox of palliative care nursing across cultural boundaries

Abstract

The purpose of this qualitative study, using a modified grounded theory approach, was to investigate how palliative care nurses care for people from cultural backgrounds other than their own. Ten palliative care nurses were interviewed. The semi-structured interviews were tape-recorded and transcribed verbatim. Analysis commenced as soon as data began to emerge. The findings show that palliative nursing across cultural boundaries is paradoxical. In endeavouring to treat everyone equally, nurses treated everyone as individuals. They made intense efforts to transcend both cultural and language barriers. The nurses gave of themselves when caring for the patients, but their endeavours were impeded by limited resources and a lack of education. The theory of cross-cultural endeavour in palliative nursing was developed to explain how palliative care nurses care for patients from cultures other than their own.

Transcultural Nursing: Current Trends in Theoretical Works

“…Among 21 selected articles, four [50,51,53,54] used the grounded theory approach; one [55] used the modified grounded approach; 11 [52,56,57,59e66] used concept analyses; two [43,67] used both thematic and content analyses; and three [58,68,69] did not specify the types of methods used for theorizing. Among four articles that used the grounded theory methodology, two specified their use of Glaser's methodology [53,54].…”

“…For example, the framing sexual risk behavior model was presented with the purpose of exploring the lesser known phenomenon of an urban, adolescent American Indian young female's sexual risk behaviors [54]. Also, the theory of Cross-Cultural Endeavor in Palliative Care Nursing was developed with the purpose of investigating how palliative care nurses care for people from diverse cultural backgrounds [55]. Five (23.8%) studies aimed at defining and clarifying the concepts by using phrases of "to define" [56], "to enhance clarity" [57], or "to present a detailed explanation" [58].…”

An Exploration of Specialist Palliative Care Nurses’ Experiences of Providing Care to Hospice Inpatients from Minority Ethnic Groups—Implication for Religious and Spiritual Care

“…Additionally within palliative care religion and religious beliefs can influence preferences for management of symptoms, sometimes adversely [10]. For example some rreligious beliefs can lead to the rejection of medication to manage symptoms causing practical and ethical challenges for staff [10,11]. In the growing diversity of the ROI, staff face unfamiliar practices and customs which can make them protective of other patients [11] and lead to uncertainty, apprehension, discomfort, and fear of causing offence [12].…”

“…For example some rreligious beliefs can lead to the rejection of medication to manage symptoms causing practical and ethical challenges for staff [10,11]. In the growing diversity of the ROI, staff face unfamiliar practices and customs which can make them protective of other patients [11] and lead to uncertainty, apprehension, discomfort, and fear of causing offence [12]. Although the particular spiritual and religious needs of ethnically diverse patients in healthcare in the ROI have received little attention, small localised studies have identified gaps in service provision, with patients leaving the hospital situation feeling distressed because their religious and spiritual needs may not have been met [6].…”

“…At the same time the national provision of chaplaincy services is under review [15]. In order to meet the religious needs of patients from minority ethnic groups it has been recognised that factual knowledge is required [12,16] in addition to education and training [11,[17][18][19]. For healthcare professionals involved solely in the provision of palliative care, the aforementioned issues are of particular relevance.…”