Cultural Sensitvity in End-of-life Care

描述（由申请人提供）：随着美国人口老龄化和日益多样化，卫生专业人员面临的最紧迫的问题之一是提供文化敏感的临终关怀。该项目的目的是开发一个多媒体互动教程，将文化问题和临终关怀结合起来，使卫生保健专业人员能够轻松获得。1991年的《病人自决法》保障病人有权参与有关其医疗护理的决定，并拒绝不想要的治疗。向患者告知这些权利并向他们提供有意义地行使这些权利所需的信息需要文化敏感的沟通。 对死亡意义的深刻看法和对家庭角色的文化模式化理解，治疗干预和灵性塑造了患者和临床医生之间的相遇。本教程将使用基于过程的跨文化沟通模型，学习，教卫生保健提供者如何引出病人的文化价值观，信仰和偏好，交互式录音的使用将促进在引发文化理解方面的技能发展，使得临床医生可以在未来的遭遇中敏感地采取行动，无论他们开始是对患者的文化了解还是知之甚少。第一阶段将涉及知情同意以及患者、家属和其他关键个人在临终关怀决策中的作用。第一阶段项目将包括可用性测试和教育效果试点研究。在第二阶段，将开发另外四个模块。这些模块将包括理解死亡的各种方式，如灵性和宗教;对死亡过程和死亡时发生的事情的不同看法;家庭和社区在美国各种文化中的死亡过程中的作用，以及补充治疗干预。在第二阶段，将使用随机对照比较来衡量完成教程的卫生保健提供者的行为变化。第一阶段教程的目标是培训中的医生。第二阶段教程将解决医生和护士的需求，并将感兴趣的医疗保健专业人员以及广泛的。这些教程将通过在我们的目标市场营销教育产品的知名公司分发。

DESCRIPTION (provided by applicant): As the U.S. population ages and becomes increasingly diverse, one of the most pressing issues facing health professionals is providing culturally sensitive end-of-life care. The aim of this project is to develop a multimedia interactive tutorial to integrate cultural issues and end of life care, making both easily accessible to health care professionals. The Patient Self-Determination Act of 1991 guarantees patients the right to participate in decisions about their medical care and to refuse unwanted treatment. Informing patients of these rights and providing them the information necessary to exercise these rights meaningfully requires culturally sensitive communication. Deeply held views about the meaning of death and culturally patterned understandings about the role of the family, therapeutic interventions, and spirituality shape the encounter between patients and clinicians. This tutorial will use a process based model of cross-cultural communication, LEARN, to teach health care providers how to elicit patients' cultural values, beliefs, and preferences, The use of interactive voice recordings will foster skill development in eliciting cultural understandings so that clinicians can act with sensitivity in future encounters whether they begin with knowledge of the patient's culture or know little of it. The emphasis in Phase I will be on informed consent and the role that patients, families, and other key individuals play in decision-making for end-of-life care. The Phase I project will include usability testing and a pilot study of educational effectiveness. In Phase II four additional modules will be developed. These modules will include diverse ways of making sense of death, such as, spirituality and religion; differing views of what happens in the dying process and at the time of death; the role of the family and community in the dying process in various U.S. cultures, and complementary therapeutic interventions. In Phase II a randomized controlled comparison will be used to measure behavioral change in health care providers who complete the tutorial. The Phase I tutorial targets physicians in training. The Phase II tutorial will address the needs of physicians and nurses and will be of interest to a broad spectrum of health care professionals as well. The tutorials will be distributed via established companies that market educational products in our target markets.