X

Cultural Considerations for Health Professionals

Irrespective of any individual’s cultural background, dealing with the potential loss of one’s child is a catastrophic experience across cultures (1)

In our growing multicultural society, health professionals need to recognise that applying only] traditional westernised medical practices may no longer be appropriate for many patients and families. Health professionals must have an awareness of and sensitivity to the different cultural practices and spiritual beliefs that shape a family’s life. This should incorporate beliefs and traditions around death and dying.

Recognising and separating our own individual perceptions and preferences is an imperative component in being culturally sensitivite. For health professionals this can be challenging as they work within the framework of accepted medical and health care practices and procedures.

Cultural factors that should be considered for children and their families receiving palliative care include:

  • Language barriers
  • Unfamiliarity with the concept of palliative care/hospice settings
  • Distrust of health care services/clinicians
  • Personal experiences/past trauma
  • Religious differences
  • Belief in alternative medicines
  • Fear of the unknown

Family differences in beliefs and traditions can affect decision making and medical choices during a child’s illness and throughout end life care. Some examples where goals of care will differ between cultural backgrounds when providing paediatric palliative care are:

  • Meaning of death and dying
  • The role of the child in decision making-this can often be based on gender of the child
  • The role of extended family members in decision making
  • Meaning of pain and suffering
  • Intensity of medical interventions to prolong life or hasten death 
  • Location of end of life care

While considering cultural factors, it is also critical that the individual needs and personal preferences of the parent/carer are also considered. These may differ depending on their traditional cultural and religious practices. Asking family members about their preferences and rituals will help health providers understand their individualised needs and reduce the likelihood of stereotyping.

In conclusion, it is necessary to use effective communication to increase understanding about individual, cultural and spiritual beliefs and practices. The challenge will always exist for health professionals to put aside their own personal values, education and training in order to work alongside families with differing perceptions and beliefs. Debriefing within a health care team can help to maintain focus on the family and meeting their goals of care. “Respecting beliefs, customs and traditions with a focus on preserving the integrity and sanctity of the parent/child relationship is of utmost importance in paediatric palliative care” (2)


References

  1. De Trill M, Kovalcik R (1997) The child with cancer. Influence of culture on truth-telling and patient care. Annals of the New York Academy Science. Feb 20; 809:197-210.
  2. Weiner L, McConnell G G, Latella L & Ludi E (2013). Cultural and Religious Considerations in Paediatric Palliative Care. Palliative and Supportive Care(11): 47-67