CULTURAL AWARENESS IN THE CONTEXT OF TERMINAL ILLNESS

While cultural awareness provides direction for planning effective nur sing interventions at all stages of health and illness, this article s pecifically addresses applications for patients who are terminally ill . Professional nurses encounter unique challenges in caring for termin ally ill patients. Assisting patients to achieve an ''appropriate deat h'' requires communication and collaboration among patients, family me mbers, and professional caregivers. Since patients and their families represent many systems of complex beliefs and values, nurses must be a ware of the impact of cultural pluralism on nursing assessment and int ervention in terminal illness. Reordering priorities and redistributin g resources have been identified as new approaches in caring for termi nally ill patients and their families. Two concepts that cut across al l cultural boundaries are loss and grief Expressions of loss and grief take on a variety of forms among members of diverse cultures. It is c ritical that nurses recognize, understand, and respect each family's c ulture-specific patterns with regard to terminal illness. Understandin g the culture will lead to the design of culturally appropriate nursin g care for patients and families. Culture brokerage is defined as an a ct of translation, where messages, instructions, and belief systems ar e exchanged between cultural groups. This strategy has the potential t o increase understanding among those with diverse cultural backgrounds , resulting in increased patient/family satisfaction within the suppor tive care setting. Consonance between patients' needs and nurses' unde rstanding of those needs will lead to more culturally appropriate inte rvention strategies.