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A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care

BACKGROUND: Cultural factors, including religious or cultural beliefs, shape patients’ death and dying experiences, including palliative and end-of-life (EOL) care preferences. Allied health providers must understand their patients’ cultural preferences to support them in palliative and EOL care eff...

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Autores principales: Singh, Hardeep, Haghayegh, Arta Taghavi, Shah, Riya, Cheung, Lovisa, Wijekoon, Sachindri, Reel, Kevin, Sangrar, Ruheena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337104/
https://www.ncbi.nlm.nih.gov/pubmed/37434238
http://dx.doi.org/10.1186/s12904-023-01214-4
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author Singh, Hardeep
Haghayegh, Arta Taghavi
Shah, Riya
Cheung, Lovisa
Wijekoon, Sachindri
Reel, Kevin
Sangrar, Ruheena
author_facet Singh, Hardeep
Haghayegh, Arta Taghavi
Shah, Riya
Cheung, Lovisa
Wijekoon, Sachindri
Reel, Kevin
Sangrar, Ruheena
author_sort Singh, Hardeep
collection PubMed
description BACKGROUND: Cultural factors, including religious or cultural beliefs, shape patients’ death and dying experiences, including palliative and end-of-life (EOL) care preferences. Allied health providers must understand their patients’ cultural preferences to support them in palliative and EOL care effectively. Cultural humility is a practice which requires allied health providers to evaluate their own values, biases, and assumptions and be open to learning from others, which may enhance cross-cultural interactions by allowing providers to understand patients’ perceptions of and preferences for their health, illness, and dying. However, there is limited knowledge of how allied health providers apply cultural humility in palliative and EOL care within a Canadian context. Thus, this study describes Canadian allied health providers’ perspectives of cultural humility practice in palliative and EOL care settings, including how they understand the concept and practice of cultural humility, and navigate relationships with patients who are palliative or at EOL and from diverse cultural backgrounds. METHODS: In this qualitative interpretive description study, remote interviews were conducted with allied health providers who currently or recently practiced in a Canadian palliative or EOL care setting. Interviews were audio-recorded, transcribed, and analyzed using interpretive descriptive analysis techniques. RESULTS: Eleven allied health providers from the following disciplines participated: speech-language pathology, occupational therapy, physiotherapy, and dietetics. Three themes were identified: (1) Interpreting and understanding of cultural humility in palliative and EOL care (i.e., recognizing positionality, biases and preconceived notions and learning from patients); (2) Values, conflicts, and ethical uncertainties when practicing cultural humility at EOL between provider and patient and family, and within the team and constraints/biases within the system preventing culturally humble practices; (3) The ‘how to’ of cultural humility in palliative and EOL care (i.e., ethical decision-making in palliative and EOL care, complexities within the care team, and conflicts and challenges due to contextual/system-level factors). CONCLUSIONS: Allied health providers used various strategies to manage relationships with patients and practice cultural humility, including intra- and inter-personal strategies, and contextual/health systems enablers. Conflicts and challenges they encountered related to cultural humility practices may be addressed through relational or health system strategies, including professional development and decision-making support. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-023-01214-4.
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spelling pubmed-103371042023-07-13 A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care Singh, Hardeep Haghayegh, Arta Taghavi Shah, Riya Cheung, Lovisa Wijekoon, Sachindri Reel, Kevin Sangrar, Ruheena BMC Palliat Care Research BACKGROUND: Cultural factors, including religious or cultural beliefs, shape patients’ death and dying experiences, including palliative and end-of-life (EOL) care preferences. Allied health providers must understand their patients’ cultural preferences to support them in palliative and EOL care effectively. Cultural humility is a practice which requires allied health providers to evaluate their own values, biases, and assumptions and be open to learning from others, which may enhance cross-cultural interactions by allowing providers to understand patients’ perceptions of and preferences for their health, illness, and dying. However, there is limited knowledge of how allied health providers apply cultural humility in palliative and EOL care within a Canadian context. Thus, this study describes Canadian allied health providers’ perspectives of cultural humility practice in palliative and EOL care settings, including how they understand the concept and practice of cultural humility, and navigate relationships with patients who are palliative or at EOL and from diverse cultural backgrounds. METHODS: In this qualitative interpretive description study, remote interviews were conducted with allied health providers who currently or recently practiced in a Canadian palliative or EOL care setting. Interviews were audio-recorded, transcribed, and analyzed using interpretive descriptive analysis techniques. RESULTS: Eleven allied health providers from the following disciplines participated: speech-language pathology, occupational therapy, physiotherapy, and dietetics. Three themes were identified: (1) Interpreting and understanding of cultural humility in palliative and EOL care (i.e., recognizing positionality, biases and preconceived notions and learning from patients); (2) Values, conflicts, and ethical uncertainties when practicing cultural humility at EOL between provider and patient and family, and within the team and constraints/biases within the system preventing culturally humble practices; (3) The ‘how to’ of cultural humility in palliative and EOL care (i.e., ethical decision-making in palliative and EOL care, complexities within the care team, and conflicts and challenges due to contextual/system-level factors). CONCLUSIONS: Allied health providers used various strategies to manage relationships with patients and practice cultural humility, including intra- and inter-personal strategies, and contextual/health systems enablers. Conflicts and challenges they encountered related to cultural humility practices may be addressed through relational or health system strategies, including professional development and decision-making support. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-023-01214-4. BioMed Central 2023-07-12 /pmc/articles/PMC10337104/ /pubmed/37434238 http://dx.doi.org/10.1186/s12904-023-01214-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Singh, Hardeep
Haghayegh, Arta Taghavi
Shah, Riya
Cheung, Lovisa
Wijekoon, Sachindri
Reel, Kevin
Sangrar, Ruheena
A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
title A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
title_full A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
title_fullStr A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
title_full_unstemmed A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
title_short A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
title_sort qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337104/
https://www.ncbi.nlm.nih.gov/pubmed/37434238
http://dx.doi.org/10.1186/s12904-023-01214-4
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