The need for cultural competency is an essential part of professional practice in health care. Cultural competence encompasses a set of behaviors, knowledge, attitude, skills, and values that enable HealthCare providers to provide respectful and inclusive care to patients.  Cross-cultural competence begins with an attitude and a sincere interest in participating in learning opportunities about diversity in cultures (Rine, 2018). Pain management is a central component of hospice care, and nurses are accountable for relieving suffering and pain throughout the dying process. With the current increasing diversity in cultures and ethnicity, healthcare providers experience rising challenges in the process of caring for patients with diverse cultural values.

Cultural competence is vital in end-of-life care since cultural values, beliefs, and experiences define every patient’s perception of “good death.”  A cultural belief that surrounds pain and death influences the attitude of a patient and preferences in end-of-life care. In certain cultures, the discussion of death is not a typical issue and hence loathed by members of the society.  Certain cultural groups can prefer that a nurse holds a disclosure of a terminal diagnosis so that the patient is protected (Rine, 2018). In Asian cultures, withholding information from the patient is preferred since they believe that this is a way to preserve hope and to prevent emotional suffering in a dying patient.  In hospice care, nurses are compelled to consider such cultures and beliefs before proposing any news of poor prognosis to a patient. Beliefs sometimes can become significant barriers in initiating proper pain management among dying patients. The growing diversity in healthcare compels most healthcare systems through their hospice care nurses to be culturally competent and responsive to individual’s needs. Healthcare providers must often be culturally relevant so that they effectively and professionally deal with different cultures to diagnose and implement healthcare strategies in a match with the preferences of the patients.

Cultural Competence in Relation to Hospice Care

Cultural belief on the origin, role, and meaning of pain can affect individual perception. Numerous beliefs about pain are dictated by the spiritual and religious beliefs of the patients. For example, certain patients may possess a belief that “no pain no gain” and tend to view pain as a sign of positive progress.  Cultural beliefs affect how patients express their pain. Some cultures abhor expressing pain outwardly; for example, the case is common among the black American who are very reluctant to complain of pain because of their strong cultural beliefs. Therefore, cultural belief affects how patients make healthcare decisions (Cort, 2004). It is hence imperative that nurse practitioners who are responsible for hospice care be aware of the diverse cultural beliefs that surround end-of-life care.

Before providing care to a patient, it is essential to consult from the patient on their preferences for decision making. Culturally competent healthcare practitioner can deliver appropriate care to a patient since they can understand the cultural perception of the patient before proposing a care practice. The desires of the patient should be given priority so that they can recover and avoid a more extended hospital stay. A caregiver must be able to express a common language so that they can assess their patients and issue appropriate care (Cort, 2004). Even among the hospice caregivers, they are required to be aware of their cultures and beliefs which can affect quality care so that they can consider appropriate care for the patients. A nurse should understand how people behave while they are in pain and other people reactions concerning cultural differences.  Exhibiting a right behavior towards pain encourages hospice caregivers to consider symptoms and give necessary care positively. Hospice care nurses can inculcate reasons why certain patients will not be willing to take specific medication while undergoing pain.

Recommendation

Improving cultural competence in end-of-life pain management is vital in hospice care. As a nurse practitioner, it is essential to discuss pain management with the patient and family members to understand their preferences towards decision making. Nurses should consider using validated pain assessment tools to examine the efficiency of pain management interventions. Nurse practitioners must ensure that the patient understands how to handle pain management tools appropriately (Boucher, 2016). The pain scores should be rightly interpreted concerning the cultural belief of the patient.  Nurses should not neglect to assess the spiritual belief of the patients so that they can collaborate with spiritual advisors to assist the patients and families make peace with their death in any case that are what the patient desires. Nurses must accommodate all the desires and beliefs of the patients together with the one from family members so that they can provide space for praying, performing rituals and medication.  Hospice care nurses must pursue further education in delivering end-of-life care through supporting initiatives that increase public awareness of the benefits of hospice. Education is significant in improving cultural competence, and hospice care require that specialized training is provided to encourage constant end-of-life care to culturally diverse populations. Specific training is needed to allow secure communication with patients about proper end-of-life decisions.

 
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