The effects of culture on the provision of end-of-life culture on African American patient.
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September 15, 2020Tsunami
September 15, 2020The effects of culture on the provision of end-of-life culture on African American patient.
Research problem
| Culture has been identified as a very important aspect to consider when giving end-of-life care (Ball et a., 2010; Steinberg, 2011; Ganz e al., 2006; Schim & Doorenbos, 2010). During their end-of-life days, many patients are affected by their values, societal beliefs, religious beliefs and personal beliefs (Hern et al., 1998). Steinberg (2011) identifies that, for many clinicians, the discussion and consideration of culture in a palliative patient are a difficult area.Considering that culture has some effect on the outcomes of care (Steinberg, 2011), adhering to the demand of respecting culture is likely to be a challenge in a multicultural setting, as the United States, where people share. Coolen (2012) observes that the problem is worse when the care provider and the patient are of different cultural backgrounds. The care of African Americans in a society dominated by the whites poses a great challenge. According to Coolen (2012), the American values emphasize autonomy in decision-making during end of life care, while African-Americans view the
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What is already known
| Several researches have been conducted, and they agree on one thing: that culture has a significant effect on the end of life care (Coolen, 2012; Raghavan, Smith & Arnold, 2008). The values and attitudes of African Americans towards end of life care differ greatly compared with those of the entire American population (Raghavan, Smith & Arnold, 2008). Searight and Gafford (2005) agree that patient dissatisfaction, ineffective communication and poor patient-goal outcomes have been realized due to cultural differences between African American patients and white care providers. According to Steinberg (2011), a complicated challenge arises further because cultural differences exist even within the African American communities. Coolen (2012) posits that clinicians have always made a mistake by assuming that the values and beliefs of all African Americans are similar. The assumptions eventually lead to undesirable patient outcomes. Steinberg (2010) argues that culture affects not only the patient that are being nursed, but also the relatives and the healthcare workers that are attending the patients. Thus, culture should not be considered on the part of the patient alone. The beliefs of the nurse and the other members of the health care team are very likely to affect the outcome of care, as influenced by their cultural beliefs (Koening & Williams, 1995; Kwak & Harley, 2006). In relation to informal family care-giving, Herbert and Schultz (2006) argue that the family cares for the palliative patient with a lot of reference to their beliefs.According to Raghavan, Smith & Arnold (2008), African Americans are less likely to be satisfied with end of life care, enroll in hospice, and receive appropriate symptom management. Additionally, they are more likely to stop hospice care, and receive very aggressive treatment at their end of life. According to Valente (n.d), African Americans tend to associate hospice care with giving up, while the whites have a preference for hospice care. They do not take directives from care providers very serious. Rather, they verbalize their situations with family members. According to Steinberg (2011), these behaviors are not rooted in the lack of education, because they have also been observed in African American physicians. It is thus clear that these behaviors are rooted in strong cultural beliefs among his African Americans. The behavior also reflects a strong faith on the part of African Americans, in that they believe strongly that death is controlled by God. |
Gap in knowledge
Research question
| The research seeks to provide a solution to the existing gap in knowledge concerning the relationship between the culture of African Americans, and the outcomes of end of life care. The research question would thus be: What are the impacts of culture on the provision of end of life care among African Americans? |
What needs to be known
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Project aims and expected benefits
| The aim of this research is to investigate the impacts of culture on the provision of care among minority African Americans in the dominant white population of the US. The reviewed articles in this area reveal that, although some information is known about the topic, cases of assumptions have been reported, which lead to poor patient outcomes. Poor understanding of African American culture leads to inappropriate management and ineffective communication, thus dissatisfaction of the patient. The results of this research paper will be beneficial in correcting this problem, thus improving the provision of end of life care. |
References
Ball, G. C., Navsaria, P., Kirkpatrick, W. C., Velcler, C. Dikson, E., Zink, J., … & Feliciano, V. D. (2010). The impact of country and culture on end of life care from injured patients: Results from an international survey. Journal of Trauma, 69(6), 1323-33.
Coolen, R. P. (2012). Cultural relevance in end of life-care. Retrieved from ethnomed at http://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care
Ganz, D. F., Bembenishty, J., Hersch, M., Fischer, A., Gurman, G., & Sprung, C. L. (2006). The impact of regional culture on intensive care end of life decision making: An Israeli perspective from an ETHICUS study. Journal of Medical Ethics, 32(4), 196-199.
Herbert, S. R., & Schulz, R. (2006). Care-giving at the end of life. Journal of Palliative Medicine, 9(5), 1174-1187.
Hern, E. H., Koenig, A. B., Moore, L. J., & Marshal, A. P. (1998). The difference that culture can make in end-of-life-decision making. Cambridge Quarterly of Health-Care Ethics, 7(1), 27-40.
Koenig, B. A., & Williams, J. G. (1995). Understanding cultural differences in caring for dying patients. Western Journal of Medicine, 163(3), 244-249
Krakauer, E. L., Crenner, C., & Fox, K. (2002). Barriers to optimum end of life care for minority patients. Journal of the American Geriatrics Society, 50(1), 182-190.
Kwak, J., & Haley, E.W. (2005). Current research findings on end-of –life decision making among racially and ethnically diverse groups. The Gerontologist, 45(5), 634-641.
Phillip, L. D., & Charles, L. S. (2003). Cultural differences at the end of life. Critical Care Medicine, 31(5), 354-357.
Raghavan, M., Smith, A., & Arnold, R. African Americans and end of life. Retrieved online from http://www.eperc.mcw.edu/EPERC/FastFactsIndex/ff_204.htm
Schim, M.S. & Doorenbos, A.Z. (2010). A three dimensional model of cultural congruence: Framework for intervention. Journal of Social Work End Life Palliative Care, 6(3-4), 256-270.
Searight, R. H., & Gafford, J. (2005). Cultural diversity at the end of life: Issues and guidelines for family physicians. American Family Physician, 71(3), 515-522.
Steinberg, M. S. (2011). Cultural and religious aspects of palliative care. International Journal of Critical Illness and Injury, 1(2), 154-156.
Valente, S. (n.d). Culturally diverse communities and end of life care. American Psychological Association. Retrieved from http://www.apa.org/pi/aids/programs/eol/end-of-life-diversity.pdf
Werth, J. L., Blevins D., Toussant K., & Dhurham M. (2002). The influence of cultural diversity on end of life care. American Behavioral Scientist 46(2), 204-219.
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