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Learning modules

Activity 1: Diversity in Australia health care

Diversity is what makes an individual or group unique. Diversity is not just associated with one’s ethnic background.  Diversity can be reflected in a number of ways including:

  • ethnicity and race
  • language
  • gender
  • sexual orientation
  • age and generation
  • socioeconomic status
  • religion, faith and other beliefs. [1]

This diversity means that health care professionals need an understanding of how social and cultural background can influence health beliefs and practices, including beliefs about dying, death and bereavement.  For example, specific populations who can have unique social and cultural backgrounds that shape health responses include:

  • multicultural groups
  • Aboriginal peoples
  • Torres Strait Islander peoples
  • refugees and asylum seekers
  • Gay, Lesbian, Bisexual, Transgender, Intersex and Queer (GLBTIQ)
  • older people
  • children
  • people who are deaf, Deaf or hearing impaired
  • people with dementia
  • people with physical disabilities
  • people with intellectual disabilities
  • people living in rural and remote areas
  • people living alone
  • homeless people
  • prisoners
  • religious and faith groups and other beliefs. [2, 3]

It is important not to assume a person’s preferences on the basis of their cultural background.  Individualised discussion needs to occur between health professionals and a person about their end-of–life care. [4] People's experiences and responses at end-of-life can be shaped by our cultural background. For example, many of the following experiences can be influenced by culture:

  • language and communication styles
  • expectations of roles and relationships
  • beliefs about ill health
  • previous interactions with health care professionals/system
  • preferred foods
  • preferred methods of decision-making
  • practices in relation to family involvement in care
  • religion, faith groups and other beliefs
  • preferences for involvement of clergy
  • practices/rituals leading up to end-of-life
  • preferences for life support and advance directives
  • meaning of suffering
  • expression of pain and other symptoms
  • attitudes and practices relating to pain relief medications including opioids
  • preferred place of death
  • meaning of life, death, dying and grief
  • practices relating to immediate care after death
  • preferences for autopsy and organ donation
  • beliefs about what happens to the body after death e.g. burial or cremation
  • grief and bereavement responses [5, 6]
  • practices relating to new experimental therapies in clinical trials
  • practices relating to use of complementary and alternative medicines.

Thinking points


REFERENCES

  1. Dreachslin, J., Gilbert, M., & Malone, B. (2012). Diversity and Cultural Competence in Health Care : A systems approach (1 ed.). Hoboken, NJ: Wiley.
  2. CareSearch. (2014). Specific Populations. Managing Symptoms. Retrieved January 27, 2015, from www.caresearch.com.au/caresearch/tabid/1156/ctl/Login/Default.aspx?returnurl=%2fcaresearch%2ftabid%2f1156%2fDefault.aspx
  3. Queensland Health Multicultural Services. (2012). Guidelines for multicultural health policy implementation. Retrieved from www.health.qld.gov.au/qhpolicy/docs/gdl/qh-gdl-080.pdf
  4. Halm, M. A., Evans, R., Wittenberg, A., & Wilgus, E. (2012). Broadening cultural sensitivity at the end of life: an interprofessional education program incorporating critical reflection. Holistic Nursing Practice, 26(6), 335-349.
  5. Kemp, C. (2005). Cultural issues in palliative care. Seminars in Oncology Nursing, 21(1), 44-52.
  6. Wiener, L., McConnell, D. G., Latella, L., & Ludi, E. (2013). Cultural and religious considerations in pediatric palliative care. Palliative & Supportive Care, 11(1), 47-67.