The Importance of Cultural Competence in Pain and Palliative Care

Excerpt

Managing pain is often a challenge for health professionals, but this challenge is compounded when the patient in pain is dying. Practicing in an ethnically and culturally diverse society requires healthcare providers to understand, respect, and take into account the particular cultures from which their patients come. Health professionals who learn the nuances of culture rewarded with the knowledge they have are more effective in managing the pain of their patients. Also, they are better able to help the family and friends of their patients adjust to the dying process. Keeping in mind the beliefs, experiences, and values of the patients and their families improves the quality of patient care.

Pain is perceived by the patient and can only be reported by the patient. Pain is, therefore, subjective and, depending on the verbal skills of the patient, can be challenging to describe. Putting pain into words requires a degree of self-awareness and is colored by the cultural background of the patient. Pain is a common symptom of many diseases and is often experienced at the end of life. Studies have shown as much as half of those dying experience moderate to severe pain in the final months of life. For the health practitioner, this highlights the importance of frequent pain assessment, pain management, and adjustment of pain medications.

Palliative care, focusing on symptom control and comfort measures, relieves suffering in patients with life-threatening illnesses and maximizes their quality of life. Palliative care may be necessary for patients diagnosed with cancer, degenerative neurologic diseases, painful neurologic diseases, and those diagnosed with chronic obstructive pulmonary disease to relieve symptoms of breathlessness. Hospice or end-of-life palliative care is often provided to dying patients, particularly during the final months of life.