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Cross-cultural serious neurological illness communication: qualitative analysis of multidisciplinary perspectives.
Wu, Adela; Giannitrapani, Karleen F; Ruiz Colón, Gabriela D; Adams, Alyce S; Li, Gordon; Lorenz, Karl A.
Afiliación
  • Wu A; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA; VA Health Services Research and Development Center for Innovation to Implementation, VA Palo Alto Health Care System, U.S. Department of Veterans Affairs, Palo Alto, CA, USA.
  • Giannitrapani KF; VA Health Services Research and Development Center for Innovation to Implementation, VA Palo Alto Health Care System, U.S. Department of Veterans Affairs, Palo Alto, CA, USA; Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
  • Ruiz Colón GD; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
  • Adams AS; Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
  • Li G; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
  • Lorenz KA; VA Health Services Research and Development Center for Innovation to Implementation, VA Palo Alto Health Care System, U.S. Department of Veterans Affairs, Palo Alto, CA, USA; Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
Ann Palliat Med ; 13(5): 1172-1182, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39129523
ABSTRACT

BACKGROUND:

Cultural competence is important in approaching serious illness communication with diverse patients about goals of care. Culture colors patients' perspectives on many healthcare issues, including end-of-life care, and impacts how clinicians make decisions with patients. Communication about serious neurological illnesses can be additionally challenging due to disease impact on patients' cognition and decision-making abilities. We aim to understand provider experiences regarding cross-cultural serious neurological illness communication with diverse patients and families.

METHODS:

Using non-stratified purposive and snowball sampling, we conducted semi-structured interviews with 17 multidisciplinary participants, including neurosurgeons, neurologists, and social workers, who provide care for patients diagnosed with serious neurological disorders, at three hospital settings between 2021 and 2022. We used standard qualitative content analysis methods with dual review.

RESULTS:

Five themes reflected provider perspectives about serious neurological illness communication with diverse patients and families. Theme 1 providers recognize that patients' personal biases and lived experiences impact attitudes about healthcare and communication. Theme 2 challenges in communication can arise when providers miss chances to identify important cultural values. Theme 3 understanding how to engage with family members is important for effective communication about serious neurological illness. Theme 4 providers want to accommodate patients. Theme 5 cultivating trust builds a strong patient-provider partnership, even when racial or cultural discordance is present.

CONCLUSIONS:

Our study highlights elements of cross-cultural communication and opportunities for providers to approach diverse patients and families within a racial or culturally discordant context. Effective communication, fostered through respecting individual experiences and variation, eliciting cultural perspectives, engaging family, and cultivating trust reflects processes and learned skills required of high-quality teams caring for patients with serious neurological conditions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Investigación Cualitativa / Enfermedades del Sistema Nervioso Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Palliat Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: China
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Investigación Cualitativa / Enfermedades del Sistema Nervioso Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Palliat Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: China