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In an increasingly globalized world, multiculturalism has transformed healthcare settings, making cultural diversity an essential component of care. Culture plays a central role in healthcare, delineating values, decisions, expectations, and practices. In the context of end-of-life care, awareness about how culture affects care and its professional practices becomes especially relevant.
This study by Cáceres-Titos et al. (2025) aimed to explore the difficulties perceived by nursing professionals in palliative care when caring for culturally diverse patients. The study used a descriptive phenomenological approach based on in-depth, semi-structured interviews conducted in person with nurses working in palliative care units in South-West Spain. All interviews were recorded and transcribed literally and then discourse analysis was applied.
Key Findings and Themes:
1. Linguistic and Communication Barriers:
– Language barriers emerged as a significant challenge for nurses, hindering the possibility of creating effective therapeutic relationships.
– Non-verbal communication differences, such as gestures and facial expressions, further complicated interactions.
– The lack of resources and tools to facilitate communication, such as 24-hour translators, was noted.
2. Cultural Differences Regarding Health and End-of-Life Processes:
– Cultural beliefs and rituals related to death varied significantly, impacting how patients and their families faced end-of-life situations.
– The “conspiracy of silence,” where patients and families avoid discussing terminal conditions, was identified as a challenge.
– Cultural taboos about death hindered open communication between healthcare professionals and patients.
3. Spirituality:
– Spirituality was highlighted as an important dimension of end-of-life care, with patients seeking to find peace and meaning in their final moments.
– Nurses noted the need for spiritual agents or religious mediators to facilitate communication and care.
4. Support and Care Networks:
– The size and presence of care networks, including family, compatriots, and formal care institutions, played a crucial role in end-of-life care.
– The absence of family members often required nurses to provide additional emotional support and clear communication.
5. Factors Related to Professional Profile:
– Nurses reported a lack of training in cultural competence and communication skills, affecting their ability to provide effective care.
– The emotional challenges of caring for terminal patients were noted, with some nurses experiencing burnout and emotional overload.
6. Communication Environment and Context:
– The physical environment and lack of time were identified as barriers to effective communication.
– The need for private and appropriate spaces for end-of-life discussions was emphasized.
The study highlights the importance of incorporating cultural competence training into nursing education and continuous professional development. Implementing intercultural mediation resources, recognizing social support networks, and addressing the spiritual dimension of care are essential for improving end-of-life care for culturally diverse patients. By fostering a more inclusive and humanized care environment, healthcare professionals can better meet the needs of patients and their families during their final moments.
Source: Cáceres-Titos, M. J., Porras-Santana, J. M., Cabillas-Romero, M. R., & Begoña García-Navarro, E. E. (2025). Managing cultural diversity in end-of-life care: a qualitative study. BMC Palliative Care, 24(1), 124.
