American Journal of Hospice and Palliative Medicine
Volume 32, Issue 4, 2015, Pages 372-379

Patient-Centered Care or Cultural Competence: Negotiating Palliative Care at Home for Chinese Canadian Immigrants (Article)

Nielsen L.S.* , Angus J.E. , Howell D. , Husain A. , Gastaldo D.
  • a School of Nursing, York University, North York, ON, Canada
  • b University of Toronto, Toronto, ON, Canada
  • c University of Toronto, Toronto, ON, Canada, Ontario Cancer Institute, Princess Margaret Hospital, Toronto, ON, Canada
  • d Temmy Latner Centre for Palliative Care, Mount Sinai Hospital, Toronto, ON, Canada
  • e University of Toronto, Toronto, ON, Canada

Abstract

The literature about Chinese attitudes toward death and dying contains frequent references to strong taboos against open discussion about death; consequently, there is an assumption that dying at home is not the preferred option. This focused ethnographic study examined the palliative home care experiences of 4 Chinese immigrants with terminal cancer, their family caregivers, and home care nurses and key informant interviews with 11 health care providers. Three main themes emerged: (1) the many facets of taboo; (2) discursive tensions between patient-centered care and cultural competence; and (3) rethinking language barriers. Thus, training on cultural competence needs to move away from models that portray cultural beliefs as shared, fixed patterns, and take into account the complicated reality of everyday care provision at end of life in the home. © The Author(s) 2014

Author Keywords

Chinese immigrants Palliative care Hybridity Postcolonial theory negotiation Home care Cultural competence patient-centered care

Index Keywords

patient care China Caregivers Home Care Services home care neoplasm Neoplasms human epidemiology middle aged Aged Cultural Competency Patient-Centered Care ethnology cultural competence Humans migrant male Canada Emigrants and Immigrants female Aged, 80 and over very elderly organization and management palliative therapy Palliative Care patient comfort caregiver
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84930148762&doi=10.1177%2f1049909114527338&partnerID=40&md5=14792345358af42dfcf2263c92d242a8
DOI: 10.1177/1049909114527338
ISSN: 10499091
Cited by: 7
Original Language: English