Abbreviations and Acronyms:RS (religious/spiritual)
- 1.Read the activity.
- 2.Complete the online CME Test and Evaluation. Participants must achieve a score of 80% on the CME Test. One retake is allowed.
Defining the Problem
Challenges to Providing Cross-cultural and RS Care
A Framework for Providing Goal-Concordant Care to Religious and Ethnic Minorities
|Key concept||Example questions|
|Elicit the patient's explanatory model of illness|
|What do you understand about your illness?|
What do you think caused your illness?
What kind of treatment are you hoping for?
|Address the patient's religious or spiritual values||Are you at peace?|
Do you find comfort in religious or spiritual beliefs?
|Determine the patient's desired approach to truth telling||What kind of information about your health would help you make difficult decisions?|
|Understand how the patient's family is involved in the care||Do you make decisions collectively with your family?|
|Negotiate cultural conflicts when they arise||What matters the most to you as we think about your illness?|
Can you tell me more about your values?
Elicit the Patient's Explanatory Model of Illness
Address the Patient's RS Values
Determine the Patient's Desired Approach to Truth Telling
Understand How the Patient's Family Is Involved in the Care
Negotiate Cultural Conflicts
Applying the Framework
Supplemental Online Material
- Health disparities and access to health.JAMA. 2007; 297: 1118-1121
- Cultural competence in end-of-life care: terms, definitions, and conceptual models from the British literature.J Palliat Med. 2012; 15: 812-820
- Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population.Psychooncology. 1999; 8: 378-385
- Evidence on patient-doctor communication.Cancer Prev Control. 1999; 3: 25-30
- Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death.J Clin Oncol. 2010; 28: 445-452
- Religion, spirituality, and health in medically ill hospitalized older patients.J Am Geriatr Soc. 2004; 52: 554-562
- Factors considered important at the end of life by patients, family, physicians, and other care providers.JAMA. 2000; 284: 2476-2482
- Why is spiritual care infrequent at the end of life? spiritual care perceptions among patients, nurses, and physicians and the role of training.J Clin Oncol. 2013; 31: 461-467
- Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life.J Clin Oncol. 2007; 25: 555-560
- Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients.Support Care Cancer. 2012; 20: 2269-2276
- Whose role? oncology practitioners' perceptions of their role in providing spiritual care to advanced cancer patients.Support Care Cancer. 2015; 23: 2543-2550
- Physicians' observations and interpretations of the influence of religion and spirituality on health.Arch Intern Med. 2007; 167: 649-654
- Discussing religion and spirituality is an advanced communication skill: an exploratory structural equation model of physician trainee self-ratings.J Palliat Med. 2012; 15: 63-70
- Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.Public Health Rep. 2003; 118: 293-302
- Patient-centered care: the key to cultural competence.Ann Oncol. 2012; 23: 33-42
- Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research.Ann Intern Med. 1978; 88: 251-258
- “Are you at peace?”: one item to probe spiritual concerns at the end of life.Arch Intern Med. 2006; 166: 101-105
- Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy—Spiritual Well-being Scale (FACIT-Sp).Ann Behav Med. 2002; 24: 49-58
- Taking a spiritual history allows clinicians to understand patients more fully.J Palliat Med. 2000; 3: 129-137
Rising ML. Truth telling as an element of culturally competent care at end of life [published online September 20, 2015]. J Transcult Nurs. pii:101177/1043659615606203.
- Palliative care in Jordan: culturally sensitive practice.J Palliat Med. 2008; 11: 1292-1293
- Cultural aspects of communication in cancer care.Support Care Cancer. 2008; 16: 235-240
- A three-dimensional model of cultural congruence: framework for intervention.J Soc Work End Life Palliat Care. 2010; 6: 256-270
- Approaching patients and family members who hope for a miracle.J Pain Symptom Manage. 2011; 42: 119-125
- A practical approach to the family that expects a miracle.Chest. 2009; 135: 1643-1647
Potential Competing Interests: Dr Ingram has a consultant relationship with Medtronic.