Background Providing end-of-life care in the patient’s own environment is challenging, especially if the nurse is from a different ethnic and cultural background from the patient. Evidence shows that people from the Black and Asian Minority Ethnic (BAME) background communities experience poorer end-of-life care in the UK due to the care providers and commissioners not understanding their care needs.
Methods A qualitative approach, using semi-structured interviews, was used to explore the experiences of 16 community nursing staff caring for end-of-life patients from the BAME community in Leicester, Leicestershire, and Rutland. Virtual interviews were audio-recorded, transcribed verbatim and thematically analysed.
Results Family hierarchy meant that the nurses had to deal with large tight-knit families, paternalism and controlling behaviours, and had to establish advocacy processes. There was a strong mistrust and suspicion of Western medicine and a belief that Western medicine speeds up death. There was a desire to hold onto life, continue to have nutrition, and these feelings were influenced by Spiritual beliefs. Consequently, there was low uptake of end-of-life care services for this group. There were also language barriers and challenges faced by the nurses, resulting in difficult conversations with the families. Despite the challenges, nurses tried to build relationships with the families in order to meet the patients’ end of life care needs. Different levels of the nurses’ cultural and religious competencies in caring for BAME patients were also identified. As the research was conducted during pandemic, COVID-19 effects contributed to the above challenges.
Conclusion This research has shed light on the challenges of individualising end-of-life care patients in a culturally diverse community. The nurses’ cultural and religious competencies were challenged as they attempted to ensure their expert healthcare professional philosophy of care met the needs and preferences of the dying patient and their family.
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