Making a difference: Responsiveness of palliative care practice & research to diversity - PhDData

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Making a difference: Responsiveness of palliative care practice & research to diversity

The thesis was published by Torensma, M., in January 2023, University of Amsterdam.

Abstract:

The aging of migrant populations in The Netherlands calls for consideration of the palliative care needs of older migrants. Responsive palliative care addresses medical needs as well as other factors influencing well-being during different types of interactions people have with the healthcare system, e.g. at a healthcare service or when participating in healthcare research. The objectives of this thesis are to gain insight into end-of-life care and decision-making of migrant patients living in The Netherlands; and to assess ways in which research contributes to responsive palliative care for migrant patients living in The Netherlands. The findings show that migrant patients compared to Dutch patients are more likely to be admitted to and die in the hospital; less likely to receive morphine and continuous deep sedation; and more likely to receive care that, according to physicians, is directed at curation too long. End-of-life decisions (ELDs) are made less frequently for migrant patients. Findings also show that differences in preferences and experiences with end-of-life care and decision-making are shaped by the intersection of ethnicity, religion and gender and its impact on migrant patients’ social position. Researchers’ efforts to contribute to responsive palliative care are subject to the awareness, experience, and perceptions on what it takes to improve responsiveness; and to scientific standards that limit the flexibility needed for responsive research. To help palliative care researchers find ways to improve responsiveness a self-assessment instrument was developed and tested. In the discussion of findings, the decolonization of research is considered as a way forward.



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