Cultural considerations at the end of life : communication of helathcare providers with Native American patients

Abstract

The purpose of this project was to provide information to non-Native-American healthcare providers to help enhance their communication with Native-American patients at the end of life. The end of life can be a distressing time for patients, families, and healthcare providers alike. Cultural differences which may exist among these groups can make the transition even more difficult. Communication may be hindered due to misunderstandings or unclear expectations. This project was an extension of a study focusing on an Indian reservation in north central Montana which identified several areas to focus on for improving end-of-life care including educating the patients and families about palliative care options, helping healthcare providers become more culturally sensitive, and creating a culturally appropriate and sensitive end-of-life program. A pamphlet was developed based on the findings of a literature review and information from a cultural expert to help healthcare providers identify and address communication issues at the end of life. The pamphlet addressed communication issues between non-Native-American healthcare providers and Native-American patients. Madeleine Leininger's Theory of Culture Care Diversity and Universality was used to guide the project, and a modified Delphi method was used to help create a culturally appropriate pamphlet for non-Native-American healthcare providers. By understanding their own cultural influences and taking the time to understand and respect the cultural influences of their patients, healthcare providers can provide quality end-of-life care. Communication at the end of life can be enhanced by recognizing that culture may confound understandings and expectations, and addressing that factor can help remove barriers from quality care. This pamphlet will serve as a device to help prepare APNs for the barriers they may encounter when working with patients from not only the individual tribe in north central Montana, but also to make them aware of the fact that cultural barriers exist among different cultures. Perhaps making APNs aware of the cultural differences will open the way for increasing research about different cultures in the future. APNs should enter into every patient encounter with the knowledge that there are things they can learn from their patient to better provide effective care.