Enhancing Cultural Congruence in Hospice Care

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DESCRIPTION (provided by applicant): Poor quality patient provider communication contributes significantly to disparities at end of life, particularly among individuals from ethnically diverse or underserved populations. The proposed cluster-randomized trial has three specific aims: (1) Evaluate the effect of a web-based cultural competence communication intervention for hospice nurses on quality of communication as assessed by family caregivers; (2) Evaluate the effect of a web-based cultural competence communication intervention for hospice nurses on family caregiver outcomes of anxiety, caregiver burden, and trust of the nurse; and (3) Evaluate the effect of a web-based cultural competence communication intervention on the processes reflective of hospice nurse's cultural competence. Our interdisciplinary research team will recruit 60 hospice nurse and caregiver dyads. Hospice nurses will be randomized to either a cultural competence communication intervention or to a control program consisting of a comparable length web-based training in a skill relevant to their work but not affecting cultural competence. Caregivers will complete questionnaires assessing the nurse's skill at providing culturally congruent palliative care. This study will provide an important new insight into the effect of culturally congruent care on patients' palliative care experiences as perceived by the patients' family caregivers. This study will generate the knowledge required for a future project that will tailor the cultural competence communication intervention according to the needs of individual nurses based on their cultural competence scores. The results will be instrumental in improving culturally congruent palliative care. Poor quality patient provider communication contributes to disparities at end of life, especially for individuals from ethnically diverse or underserved populations. PUBLIC HEALTH RELEVANCE: This research will evaluate the effect of a web-based cultural competence communication intervention for hospice nurses on quality of communication as assessed by family caregivers. The results will be instrumental in improving culturally congruent palliative care.