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Background: Appropriate holistic nursing care encompasses the recognition and acknowledgement of each patient’s culture, ethnicity and race. Nurses need to have the knowledge and skill to recognize the cultural identity of their patients and to integrate this into their daily practice. Aim: Definition of the issues that critical care nurses encounter when caring for an increasingly multicultural population. Method: A review was made of articles from 1994 to 2010 collected through the PubMed, Cinahl, Medline, Google, Wikipedia and IMEPO databases. Significant articles were also located in Academic Institution Libraries. The evidence used in the study met the following specific criteria: it had to concern patients aged over 16 years suffering from serious or incurable diseases needing critical or emergency care and with religious, cultural, ethnic and racial differences from the local population. Secondary characteristics such as educational and socioeconomic status, political beliefs, marital status, sexual orientation and reasons for migration were not taken into account in the review. Results: International research has focused on four issues encountered by critical care nurses when caring for patients who differ culturally from the majority population, namely: (a) communication with the patient and his/her family, which is impaired by cultural differences in verbal and non-verbal contact, with consequent difficulties in the announcement of bad news to them, and also the diverse ways of expression of their emotions by family members, (b) issues of decision making, which may be either a patient’s matter and/or that of his/her family and/or the attending physician, (c) conflicts over patient autonomy and self-determination which are mapped out from advance directives (ADs) and may concern “do-not-resuscitate” orders, organ donation and euthanasia, and (d) the end-of-life care determined by the religious and cultural beliefs of the patient and his/her family, which should be deeply respected by critical care nurses without the interference of their personal beliefs concerning death and care of the dead body. Conclusions: Nurses should be adept at offering nursing care to critical patients with cultural diversity. They need to develop competencies, skills and practices that respect culture, a universal viewpoint and multicultural philosophy.
|Category:||Volume 50, N 1|
|Authors:||Maria Kalafati , Dimitra Paikopoulou|