More knowledge, more action: Palliative care for people with a migration background

We are delighted to publish a new series with a selection of posters that caught our attention at the 9th World Congress of the EAPC Research Network in Dublin last year. Conference posters are an important feature of every European Association for Palliative Care Congress – presenting the key messages of a project in a creative, informative and eye-catching way. 

This series also offers an opportunity for discussion of these interesting and challenging posters, and makes them visible beyond the (sometimes rather small) range of readers in front of the poster billboards. Maybe this is an interesting new approach to scientific presentations using social media . . .

Here, Maximiliane Jansky, Sonja Owusu-Boakye and Friedemann Nauck, Palliative Medicine, University Medical Center, Gottingen, Germany, explain the background to their poster. 

Maximiliane Jansky

Maximiliane Jansky

maxsowu-4

Sonja Owusu-Boakye

Friedemann Nauck

Friedemann Nauck

There is an ongoing public discussion in Germany on how to improve participation of people with a migration background in the healthcare system. This encompasses those who have immigrated to Germany, hold a foreign citizenship or have received German citizenship, or for whom one of the former applies to one parent. This topic is also discussed in palliative care.

When searching the literature in 2012, there was no empirical evidence about palliative care provision for patients with a migration background (MB) in Germany. All knowledge was derived from international literature or other fields of health care. We therefore conducted a pilot study on palliative care for people with a Turkish and Arabic MB. In phase 1, we sent out a questionnaire to specialized palliative care providers in Lower Saxony (article in print). We asked about their experience with this patient population, characteristics of their last patient with a Turkish or Arabic MB, and institutional resources. In phase 2, we interviewed healthcare experts from both palliative care and adjacent fields specialized in care for people with a MB.

eapc_poster-mig_finBoth care providers and experts agreed that there are probably access barriers to palliative care for patients with a MB. About 20 per cent of the participating institutions had not cared for a patient with a Turkish or Arabic MB in the last year. However, we noted differences in the attribution of assumed reasons: While those mentioned by care providers lay mostly in patients and families (e.g. “don’t need palliative care because of family support”), experts had a holistic view mentioning interrelated reasons on various levels, societal, healthcare system and patient/family. (See links to abstract below).

Both care providers and experts identified communication as an important challenge. Care providers found it difficult to care for patients who spoke little or no German. Interestingly, although 20 per cent of participants had access to interpreters, their use was not mentioned in the reports on the last patient. Experts stressed the importance of adequate communication with the patient and pointed out that difficulties in verbal communication may also lead to impaired non-verbal communication (e.g. by avoiding contact with the patient). Using skilled interpreters was highly recommended for medical and decision-making processes. Even patients who seem to understand German well should have access to an interpreter, as they may not be able to follow medical terms in stressful situations. In daily care, experts preferred an open and respectful approach to communication.

In our study, access and communication were only two relevant aspects. This was, however, a small pilot study, focusing on one region, a specific patient group, and the care professionals’ point of view. To provide equal access and good end-of-life care for all patients is our responsibility as palliative care providers. To do so, we need both more knowledge and more action when it comes to patients with a migration background. This must be a joint effort of research, practice, education, and healthcare policy.

View the abstract for this poster in the online Book of Abstracts. 

“An Odyssey Without Receiving Proper Care”, Expert Opinions on Under-representation of Migrants in Palliative Care by Jansky, Maximiliane; Owusu Boakye, Sonja and Nauck, Friedemann, Abstract number: P328.

Abstracts of the 9th World Research Congress of the European Association for Palliative Care (EAPC), Dublin, Ireland, 9-11 June 2016’ published online on the Palliative Medicine website.

Follow the EAPC Blog for a weekly post in this series.  Next week’s post will feature Aurélie Godard Marceau and Aline Chassagne from France who ask if palliative care is possible in prisons . . .

new-new-eapc17_header_960x211There are just 102 days before the 15th EAPC World Congress. Early Bird offer – up to 25% saving if you book by 15 February 2017

Click here to register now before the Early Bird offer closes on 15 February. Please share so that others can take advantage of the Early Bird Offer. After 15 February, registration is still possible via the congress website but at a higher fee. Book your accommodation via the congress website. The 15th EAPC World Congress – Progressing Palliative Care – takes place in Madrid 18 to 20 May 2017. To register and find out more, visit the congress website. Follow us on Twitter @EAPCOnlus – our official congress hashtag is #EAPC2017

This entry was posted in EAPC ACTIVITIES, EAPC World Research Congresses, Minority Communities and tagged . Bookmark the permalink.

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