Cultural challenges in end-of-life care: reflections from focus groups' interviews with hospice staff in Stockholm

During the past few decades, Swedish society has changed from a society wit h a few ethnic groups to one with over a hundred groups of different ethnic backgrounds, languages and religions. As society is becoming increasingly multicultural, cultural issues are also becoming an important feature in he alth care, particularly in end-of-life care where the questions of existent ial nature are of great importance. However, cultural issues in health care , especially at hospices, have not been studied sufficiently in Sweden. The purpose of this study was to gather reflections about cultural issues a mong hospice staff after a 3-day seminar in multicultural end-of-life care, by using a qualitative focus groups method. The 19 participants (majority nurses) were divided into three groups, one per hospice unit. A discussion guide was developed with the following themes: 1) post-training experiences of working with patients with multicultural background; 2) experiences gai ned by participating in the course of multicultural end-of-life care; 3) po st-training reflections about one's own culture; 4) ideas or thoughts regar ding work with patients from other cultures arising from the training; and 5) the need for further training in multicultural end-of-life care. One of the study's main findings was that to better understand other cultures it i s important to raise awareness about the staff's own culture and to pay att ention to culture especially in the context of the individual. The findings from focus groups provide insight regarding the need for planning flexible training in cultural issues to match the needs of the staff at the hospice units studied.