Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-11T09:57:41.839Z Has data issue: false hasContentIssue false
  • English
  • Français

Culturally sensitive palliative care in humanitarian action: Lessons from a critical interpretive synthesis of culture in palliative care literature

Published online by Cambridge University Press:  29 June 2021

C.J. Schuster-Wallace Open the ORCID record for C.J. Schuster-Wallace [Opens in a new window] ,
E. Nouvet Open the ORCID record for E. Nouvet [Opens in a new window] ,
I. Rigby ,
G. Krishnaraj Open the ORCID record for G. Krishnaraj [Opens in a new window] ,
S. de Laat Open the ORCID record for S. de Laat [Opens in a new window] ,
L. Schwartz Open the ORCID record for L. Schwartz [Opens in a new window]  and
M. Hunt Open the ORCID record for M. Hunt [Opens in a new window]
C.J. Schuster-Wallace*
Affiliation:
Department of Geography and Planning, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
E. Nouvet
Affiliation:
University of Western Ontario, London, Ontario, Canada
I. Rigby
Affiliation:
University of Western Ontario, London, Ontario, Canada
G. Krishnaraj
Affiliation:
McMaster University, Hamilton, Ontario, Canada
S. de Laat
Affiliation:
McMaster University, Hamilton, Ontario, Canada
L. Schwartz
Affiliation:
McMaster University, Hamilton, Ontario, Canada
M. Hunt
Affiliation:
McGill University, Montreal, Quebec, Canada
*
Author for correspondence: Corinne J. Schuster-Wallace, Department of Geography and Planning, University of Saskatchewan, 121 Research Drive, Suite 101, Saskatoon, SK, Canada S7N 0X4. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

There is growing recognition of the importance of increasing preparedness for and the provision of palliative care in humanitarian crises. The primary objective of this review is to interpret the existing literature on culture and palliative care to query the recommendation that humanitarian healthcare providers, teams, and organizations integrate palliative care into their practice in ways that are attentive to and respectful of cultural differences.

Methods

A critical interpretive synthesis was applied to a systematic literature review guided by the PRISMA framework. Analysis was based on directed data extraction and was team based, to ensure rigor and consistency.

Results

In total, 112 articles covering 51 countries and 9 major worldviews met inclusion criteria. This literature describes culture as it influences perspectives on death and dying, expectations of palliative care, and challenges to providing culturally sensitive care. A key pattern highlighted in articles with respect to the culture and palliative care literature is that culture is invoked in this literature as a sort of catch-all for non-white, non-Christian, indigenous practices, and preferences for palliative care. It is important that humanitarian healthcare providers and organizations aiming to enact their commitment of respect for all persons through attention to potential culturally specific approaches to pain management, suffering, and dying in specific crisis settings do so without reproducing Othering and reductionistic understandings of what culturally sensitive care in humanitarian crises settings involves.

Significance of results

This paper clarifies and unpacks the diverse influences of culture in palliative care with the goal of supporting the preparedness and capacity of humanitarian healthcare providers to provide palliative care. In doing so, it aids in thinking through what constitutes culturally sensitive practice when it comes to palliative care needs in humanitarian crises. Providing such care is particularly challenging but also tremendously important given that healthcare providers from diverse cultures are brought together under high stress conditions.

Keywords

Culturally sensitive careHumanitarian health carePalliative careRelief workSystematic review
Type
Review Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 582 - 592
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Amir, T, Yantzi, R, de Laat, S, et al. (2020) “Dying alone is hard anywhere in the world”: Palliative care in natural disaster response [Internet]. Available at: https://humethnet.files.wordpress.com/2020/06/natural-disasters-report-and-recommendations.pdf (cited November 2020).Google Scholar
Browne, AJ, Varcoe, C, Smye, V, et al. (2009) Cultural safety and the challenges of translating critically oriented knowledge in practice. Nursing Philosophy 10(3), 167–179.CrossRefGoogle ScholarPubMed
CCGHR Principles for Global Health Research (2015) Canadian Coalition for Global Health Research, Canada [Internet]. Available at: https://www.ccghr.ca/wp-content/uploads/2015/10/CCGHR-Principles-for-GHR-FINAL.pdf (cited November 2020).Google Scholar
Clark, D, Baur, N, Clelland, D, et al. (2020) Mapping levels of palliative care development in 198 countries: The situation in 2017. Journal of Pain and Symptom Management 59(4), 794–807.CrossRefGoogle ScholarPubMed
Coltart, CE, Lindsey, B, Ghinai, I, et al. (2017) The Ebola outbreak, 2013–2016: Old lessons for new epidemics. Philosophical Transactions of the Royal Society B: Biological Sciences 372(1721), 20160297.CrossRefGoogle ScholarPubMed
Dixon-Woods, M, Cavers, D, Agarwal, S, et al. (2006) Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology 6(1), 1–3.CrossRefGoogle ScholarPubMed
Dunn, EC (2012) A gift from the American people. The Iowa Review 1, 37–48.CrossRefGoogle Scholar
Green, A, Jerzmanowska, N, Green, M, et al. (2018) “Death is difficult in any language”: A qualitative study of palliative care professionals” experiences when providing end-of-life care to patients from culturally and linguistically diverse backgrounds. Palliative Medicine 32(8), 1419–1427.CrossRefGoogle ScholarPubMed
Hannon, B, Zimmermann, C, Knaul, FM, et al. (2016) Provision of palliative care in low- and middle-income countries: Overcoming obstacles for effective treatment delivery. Journal of Clinical Oncology 34(1), 62–68.CrossRefGoogle ScholarPubMed
Hiom, SC (2015) Diagnosing cancer earlier: Reviewing the evidence for improving cancer survival. British Journal of Cancer 112, S1–S5.CrossRefGoogle ScholarPubMed
Hunt, M, Chénier, A, Bezanson, K, et al. (2018) Moral experiences of humanitarian health professionals caring for patients who are dying or likely to die in a humanitarian crisis. Journal of International Humanitarian Action 3(1), 12.CrossRefGoogle Scholar
Kagawa-Singer, M (2011) Impact of culture on health outcomes. Journal of Pediatric Hematology/Oncology 33, S90–S95.CrossRefGoogle ScholarPubMed
Kleinman, A and Benson, P (2006) Culture, moral experience and medicine. The Mount Sinai Journal of Medicine 73(6), 834–839.Google ScholarPubMed
Krakauer, EL, Daubman, B, Aloudat, T, et al. (2019) Palliative care needs of people affected by natural hazards, political or ethnic conflict, epidemics of life-threatening infections, and other humanitarian crises. In Waldman, E and Glass, M (eds.), A Field Manual for Palliative Care in Humanitarian Crises. chap. 2. Oxford University Press. doi:10.1093/med/9780190066529.001.0001.Google Scholar
Moher, D, Liberati, A, Tetzlaff, J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine 6(7), e1000097.CrossRefGoogle ScholarPubMed
Nouvet, E, Sivaram, M, Bezanson, K, et al. (2018) Palliative care in humanitarian crises: A review of the literature. Journal of International Humanitarian Action 3(1), 5.CrossRefGoogle Scholar
Permana, I (2015) Surrender: The Influence of Religion, Culture and Access to Health Care on Diabetes Self-Care for Javanese Muslim in Yogyakarta (Doctoral dissertation). University of Salford, Manchester, UK.Google Scholar
Powell, RA, Schwartz, L, Nouvet, E, et al. (2017) Palliative care in humanitarian crises: Always something to offer. The Lancet 389(10078), 1498–1499.CrossRefGoogle ScholarPubMed
Radbruch, L, Knaul, FM, de Lima, L, et al. (2020) The key role of palliative care in response to the COVID-19 tsunami of suffering. The Lancet 395(10235), 1467–1469.CrossRefGoogle Scholar
Smith, J and Aloudat, T (2017) Palliative care in humanitarian medicine. Palliative Medicine. doi:10.1177/0269216316686258.CrossRefGoogle ScholarPubMed
SPHERE Association (2018) SPHERE Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. Geneva, Switzerland: Sphere Standards.Google Scholar
Van Biesen, W, van de Luijtgaarden, MW, Brown, EA, et al. (2015) Nephrologists’ perceptions regarding dialysis withdrawal and palliative care in Europe: Lessons from a European renal best practice survey. Nephrology Dialysis Transplantation 30(12), 1951–1958.CrossRefGoogle ScholarPubMed
World Health Organisation (2014) New WHO Safe and Dignified Burial Protocol - Key to Reducing Ebola Transmission. Note for the Media [Internet]. Available at: https://www.who.int/mediacentre/news/notes/2014/ebola-burial-protocol/en/ (cited November 2020).Google Scholar
World Health Organisation (2018) Integrating Palliative Care and Symptom Relief into the Response to Humanitarian Emergencies and Crises. Geneva: World Health Organisation.Google Scholar
World Health Organisation (n.d.) WHO Definition of Palliative Care [Internet]. Available at: https://www.who.int/cancer/palliative/definition/en/ (cited November 2020).Google Scholar
Yeager, KA and Bauer-Wu, S (2013) Cultural humility: Essential foundation for clinical researchers. Applied Nursing Research 26(4), 251–256.CrossRefGoogle ScholarPubMed
Supplementary material: File

Schuster-Wallace et al. supplementary material

Schuster-Wallace et al. supplementary material

Download Schuster-Wallace et al. supplementary material(File)
File 30.8 KB