Culture, spirituality, religion, and ritual

Author(s):  
Erica Brown ◽  
Mary Ann Muckaden ◽  
Nokuzola Mndende

Culture, religion, and spiritual beliefs can profoundly affect the ways in which families cope with caring for a child living with a life-shortening illness. These patterns and belief systems may also impact how families navigate decisions and make sense of death and dying. People’s attitudes and beliefs affect the way in which they respond to others, particularly those whose views and lifestyles are different from their own. To be effective, caring professions need to be aware of their own social mores, prejudices, and worldview. Cultural sensitivity is required to comprehensively support a child and family especially at the end of life (EOL). The chapter starts by defining key concepts and then describes some common worldviews and religions with particular relevance to children’s palliative care and ends with an example from the traditional perspective from southern Africa.

2018 ◽  
pp. 1-7
Author(s):  
J. Downar ◽  
P. Moorhouse ◽  
R. Goldman ◽  
D. Grossman ◽  
S. Sinha ◽  
...  

We present five Key Concepts that describe priorities for improving end-of-life care for frail older adults in Canada, and recommendations based on each Key Concept. Key Concept #1: Our end-of-life care system is focused on cancer, not frailty. Key Concept #2: We need better strategies to systematically identify frail older adults who would benefit from a palliative approach. Key Concept #3: The majority of palliative and end-of-life care will be, and should be, provided by clinicians who are not palliative care specialists. Key Concept #4: Organizational change and innovative funding models could deliver far better end-of-life care to frail individuals for less than we are currently spending. Key Concept #5: Improving the quality and quantity of advance care planning for frail older adults could reduce unwanted intensive care and costs at the end of life, and improve the experience for individuals and family members alike.


2013 ◽  
Vol 22 (11) ◽  
pp. 2505-2512 ◽  
Author(s):  
Michael King ◽  
Henry Llewellyn ◽  
Baptiste Leurent ◽  
Faye Owen ◽  
Gerard Leavey ◽  
...  

2017 ◽  
Vol 8 (2) ◽  
pp. 194-197 ◽  
Author(s):  
Hibah Osman ◽  
Katia El Jurdi ◽  
Ramzi Sabra ◽  
Thalia Arawi

BackgroundIndividuals have different values and priorities that can have an important impact on their medical management. Understanding this concept can help physicians provide medical care that is in line with the goals of their patients. Communicating this message effectively to students is challenging.ObjectiveTo report our experience with using Go Wish cards in the medical education setting.DesignA thematic analysis of student reflection papers using grounded theory.Setting/SubjectsSecond-year medical students participated in an activity using the Go Wish cards as part of a course module on palliative care. The activity aimed to encourage students to reflect on their own choices at the end of life and to highlight that different people have different priorities.ResultsForty-two students (42%) mentioned the Go Wish activity in their reflections on the module. They reported that the activity demonstrated the different priorities at the end of life, it illustrated the importance of providing personalised care, it promoted self-discovery, it transformed their view of death and dying, and it increased their appreciation of the importance of palliative care.ConclusionGo Wish cards can be used to help illustrate the variability in priorities of patients. They can be used as an effective to teach medical students about the importance of considering patient preferences when illness progresses.


2016 ◽  
Vol 34 (6) ◽  
pp. 559-565 ◽  
Author(s):  
George E. Dickinson

The purpose of this longitudinal study of US medical schools over a 40-year period was to ascertain their offerings on end-of-life (EOL) issues. At 5-year intervals, beginning in 1975, US medical schools were surveyed via a questionnaire to determine their EOL offerings. Data were reported with frequency distributions. The Institute of Medicine has encouraged more emphasis on EOL issues over the past 2 decades. Findings revealed that undergraduate medical students in the United States are now exposed to death and dying, palliative care, and geriatric medicine. The inclusion of EOL topics has definitely expanded over the 40-year period as findings reveal that US undergraduate medical students are currently exposed in over 90% of programs to death and dying, palliative care, and geriatric medicine, with the emphasis on these topics varying with the medical programs. Such inclusion should produce future favorable outcomes for undergraduate medical students, patients, and their families.


Author(s):  
Robert C. Macauley

Communication, cultural sensitivity, and respect for spirituality undergird the practice of palliative care. Clinicians must appreciate the nuance of communicating complex diagnoses and often grim prognoses and know how to respond when patients express a desire to not be fully informed (or their family demands that they not be). Across cultures there is significant variation in how prognosis is communicated, who makes decisions for a patient, and attitudes toward end-of-life care. Many patients and families also rely on their religious or spiritual beliefs in making medical decisions, and expectation of a “miracle” and perceived religious “mandates” for continued treatment demand spiritually-nuanced responses.


Author(s):  
Victoria Metaxa

AbstractCritical care clinicians strive to reverse the disease process and are frequently faced with difficult end-of-life (EoL) situations, which include transitions from curative to palliative care, avoidance of disproportionate care, withholding or withdrawing therapy, responding to advance treatment directives, as well as requests for assistance in dying. This article presents a summary of the most common issues encountered by intensivists caring for patients around the end of their life. Topics explored are the practices around limitations of life-sustaining treatment, with specific mention to the thorny subject of assisted dying and euthanasia, as well as the difficulties encountered regarding the adoption of advance care directives in clinical practice and the importance of integrating palliative care in the everyday practice of critical-care physicians. The aim of this article is to enhance understanding around the complexity of EoL decisions, highlight the intricate cultural, religious, and social dimensions around death and dying, and identify areas of potential improvement for individual practice.


2003 ◽  
Vol 1 (1) ◽  
pp. 3-5 ◽  
Author(s):  
BERNARD LO ◽  
VICKI CHOU

Spiritual and religious issues are often important to people with serious illnesses. Spiritual beliefs and religious ceremonies may help patients near the end of life find meaning and comfort. Comprehensive palliative care ought to address patients' spiritual and religious needs and concerns as well as their physical distress. Puchalski et al. (2003) document the paucity of studies that collect empirical data on spiritual and religious issues in palliative care. They argue convincingly that more studies are essential in order to develop evidence-based standards for appropriate ways to address patients' spiritual and religious needs at the end of life. Such research would help us better understand how spiritual and religious concerns, beliefs, practices, and interventions might impact outcomes of end-of-life care. For instance, routine inquiry by physicians about patients' spiritual and religious concerns might lead to such outcomes as better relief of physical symptoms or improved quality of life. Puchalski et al. (2003) call for more empirical research on these important topics and also the development of better measures. For example, they point out the need for measurements of religiousness that account for more than a patient's denomination. They also found that very few of the available scales had undergone evaluation for internal consistency or test–retest reliability. Moreover, many existing instruments concerning spirituality are not validated for patients near the end of life.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Imane Semlali ◽  
Emmanuel Tamches ◽  
Pascal Singy ◽  
Orest Weber

Abstract Background The linguistic and cultural diversity found in European societies creates specific challenges to palliative care clinicians. Patients’ heterogeneous habits, beliefs and social situations, and in many cases language barriers, add complexity to clinicians’ work. Cross-cultural teaching helps palliative care specialists deal with issues that arise from such diversity. This study aimed to provide interested educators and decision makers with ideas for how to implement cross-cultural training in palliative care. Methods We conducted four focus groups in French- and Italian-speaking Switzerland. All groups consisted of a mix of experts in palliative care and/or cross-cultural teaching. The interdisciplinary research team submitted the data for thematic content analysis. Results Focus-group participants saw a clear need for courses addressing cross-cultural issues in end-of-life care, including in medical disciplines outside of palliative care (e.g. geriatrics, oncology, intensive care). We found that these courses should be embedded in existing training offerings and should appear at all stages of curricula for end-of-life specialists. Two trends emerged related to course content. One focuses on clinicians’ acquisition of cultural expertise and tools allowing them to deal with complex situations on their own; the other stresses the importance of clinicians’ reflections and learning to collaborate with other professionals in complex situations. These trends evoke recent debates in the literature: the quest for expertise and tools is related to traditional twentieth century work on cross-cultural competence, whereas reflection and collaboration are central to more recent research that promotes cultural sensitivity and humility in clinicians. Conclusion This study offers new insights into cross-cultural courses in palliative and end-of-life care. Basic knowledge on culture in medicine, variable practices related to death and dying, communication techniques, self-reflection on cultural references and aptitude for interprofessional collaboration are central to preparing clinicians in end-of-life settings to work with linguistically and culturally diverse patients.


Sign in / Sign up

Export Citation Format

Share Document