Background Palliative care is a holistic approach aiming to improve quality of life of those with life-limiting illness and their caregivers. Care should be individualised in line with what is important to the patient/their family. To meet these needs an understanding of the cultural preferences of an individual is essential. Despite this, results from a national audit show that less than a third of families feel we meet the spiritual/religious needs of their loved one at the end-of-life.
Aims A service evaluation of current practice in a large teaching hospital in the UK, to determine whether the cultural needs of patients were assessed during their final admission to hospital.
Method A retrospective case note review of 200 patients who died between August-October 2021 in a large teaching hospital in the UK. We examined whether discussions had been had with the patient or family regarding cultural requirements. Frequencies/percentages were reported for categorical variables and chi-square statistics calculated to explore the relationship between variables and any discussion.
Results 104 (52%) were male, median age 82. Demographic characteristics were not routinely recorded. Ethnicity was recorded for 143 (71.5%) patients, religion for 82 (41%), and nationality for 136 (68.0%). Where it was documented, 88.1% were white and 98.5% were British. Discussions were only documented in 34 (17.0%) cases. If specialist palliative care input was sought, cultural preferences were more likely to be discussed (p<0.001). When discussions were documented, patients were more likely to be referred to chaplaincy (p<0.001).
Conclusion/Discussion In this service evaluation, cultural preferences at the end-of-life were often not documented and possibly not being discussed with patients and families. Education is needed on the importance of assessing and addressing these needs.
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