A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review.
A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review.
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DOI：
10.1186/s12877-016-0282-6
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发表时间：
2016-05-18
期刊：
影响因子：
4.1
通讯作者：
Horst G
中科院分区：
文献类型：
--
作者：
Fang ML;Sixsmith J;Sinclair S;Horst G
多种因素影响着不同文化和精神群体的临终关怀和劣质服务体验。与白色欧洲人群体相比，少数民族很难获得EoL服务，例如在家中或收容所获得保健和社会支助。需要一种工具，使患者和家庭能够获得文化安全的护理。这项审查是由加拿大虚拟临终关怀作为这一工具的基础。探讨态度，行为和模式，利用EoL护理的文化和精神上的不同群体，并确定EoL护理实践和交付方法的差距，范围审查和专题分析的文章内容进行。在2014年6月至8月期间检索了14个电子数据库和网站，以识别2004年至2014年期间发表的英文同行评审出版物和灰色文献（包括报告和其他在线资源）。调查查明了系统、社区和个人/家庭各级的障碍和促进因素。主要障碍包括：医疗保健提供者之间的文化差异;接触EoL的人和家庭成员;未充分利用旨在改善EoL护理的文化敏感模式;语言障碍;缺乏对文化和宗教多样性问题的认识;在决策过程中排除家庭;个人种族和宗教歧视;以及缺乏针对文化的EoL信息以促进决策。这篇评论强调，大多数研究都集中在决策上。有较少的研究探讨不同的文化和精神体验在EoL和干预措施，以改善EoL护理。评价的干预措施主要是教育性质的，而不是面向服务的。本文的在线版本（doi：10.1186/s12877-016-0282-6）包含补充材料，可供授权用户使用。
Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool. To explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June–August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004–2014. The search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making. This review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented. The online version of this article (doi:10.1186/s12877-016-0282-6) contains supplementary material, which is available to authorized users.