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Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer
SIMPLE SUMMARY: Racially and culturally minoritized persons with serious illness receive subpar and potentially harmful care at end of life. Despite health equity initiatives, little is known about how palliative care clinicians perceive and engage in serious illness communication with persons from...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452546/ https://www.ncbi.nlm.nih.gov/pubmed/37627105 http://dx.doi.org/10.3390/cancers15164076 |
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author | Rosa, William E. McDarby, Meghan Buller, Haley Ferrell, Betty R. |
author_facet | Rosa, William E. McDarby, Meghan Buller, Haley Ferrell, Betty R. |
author_sort | Rosa, William E. |
collection | PubMed |
description | SIMPLE SUMMARY: Racially and culturally minoritized persons with serious illness receive subpar and potentially harmful care at end of life. Despite health equity initiatives, little is known about how palliative care clinicians perceive and engage in serious illness communication with persons from racially and culturally minoritized groups. The aim of this study was to explore how 152 nurses, social workers, and chaplains would prioritize communication with a Black, Native American woman with a history of experiencing structural racism and report of severe pain at end of life. Clinicians’ responses were thematically analyzed and reflected the following themes: person-centered, authentic, and culturally-sensitive care; pain control; approaches to building trust and connection; and understanding the communication challenges related to racial differences. Findings support the need for additional interventions that address clinicians’ unconscious biases, better integrate culturally inclusive communication in practice, and improve the quality of end-of-life care for persons from minoritized groups. ABSTRACT: The aim of this study was to examine interdisciplinary clinicians’ perceptions of priorities in serious illness communication and shared decision-making with racially and culturally minoritized persons at end of life. Clinicians (N = 152) read a detailed case study about a patient self-identifying as Black and American Indian who describes mistrust of the healthcare system. Participants then responded to three open-ended questions about communication strategies and approaches they would employ in providing care. We conducted a thematic analysis of participants’ responses to questions using an iterative, inductive approach. Interdisciplinary clinicians from nursing (48%), social work (36%), and chaplaincy (16%), responded to the study survey. A total of four themes emerged: (1) person-centered, authentic, and culturally-sensitive care; (2) pain control; (3) approaches to build trust and connection; and (4) understanding communication challenges related to racial differences. Significant efforts have been made to train clinicians in culturally inclusive communication, yet we know little about how clinicians approach “real world” scenarios during which patients from structurally minoritized groups describe care concerns. We outline implications for identifying unconscious bias, informing educational interventions to support culturally inclusive communication, and improving the quality of end-of-life care for patients with cancer from minoritized groups. |
format | Online Article Text |
id | pubmed-10452546 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104525462023-08-26 Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer Rosa, William E. McDarby, Meghan Buller, Haley Ferrell, Betty R. Cancers (Basel) Article SIMPLE SUMMARY: Racially and culturally minoritized persons with serious illness receive subpar and potentially harmful care at end of life. Despite health equity initiatives, little is known about how palliative care clinicians perceive and engage in serious illness communication with persons from racially and culturally minoritized groups. The aim of this study was to explore how 152 nurses, social workers, and chaplains would prioritize communication with a Black, Native American woman with a history of experiencing structural racism and report of severe pain at end of life. Clinicians’ responses were thematically analyzed and reflected the following themes: person-centered, authentic, and culturally-sensitive care; pain control; approaches to building trust and connection; and understanding the communication challenges related to racial differences. Findings support the need for additional interventions that address clinicians’ unconscious biases, better integrate culturally inclusive communication in practice, and improve the quality of end-of-life care for persons from minoritized groups. ABSTRACT: The aim of this study was to examine interdisciplinary clinicians’ perceptions of priorities in serious illness communication and shared decision-making with racially and culturally minoritized persons at end of life. Clinicians (N = 152) read a detailed case study about a patient self-identifying as Black and American Indian who describes mistrust of the healthcare system. Participants then responded to three open-ended questions about communication strategies and approaches they would employ in providing care. We conducted a thematic analysis of participants’ responses to questions using an iterative, inductive approach. Interdisciplinary clinicians from nursing (48%), social work (36%), and chaplaincy (16%), responded to the study survey. A total of four themes emerged: (1) person-centered, authentic, and culturally-sensitive care; (2) pain control; (3) approaches to build trust and connection; and (4) understanding communication challenges related to racial differences. Significant efforts have been made to train clinicians in culturally inclusive communication, yet we know little about how clinicians approach “real world” scenarios during which patients from structurally minoritized groups describe care concerns. We outline implications for identifying unconscious bias, informing educational interventions to support culturally inclusive communication, and improving the quality of end-of-life care for patients with cancer from minoritized groups. MDPI 2023-08-12 /pmc/articles/PMC10452546/ /pubmed/37627105 http://dx.doi.org/10.3390/cancers15164076 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rosa, William E. McDarby, Meghan Buller, Haley Ferrell, Betty R. Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer |
title | Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer |
title_full | Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer |
title_fullStr | Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer |
title_full_unstemmed | Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer |
title_short | Palliative Care Clinician Perspectives on Person-Centered End-of-Life Communication for Racially and Culturally Minoritized Persons with Cancer |
title_sort | palliative care clinician perspectives on person-centered end-of-life communication for racially and culturally minoritized persons with cancer |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452546/ https://www.ncbi.nlm.nih.gov/pubmed/37627105 http://dx.doi.org/10.3390/cancers15164076 |
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