title: Programmatic barriers to providing culturally competent end-of-life care.
abstract: Despite many efforts to increase access to end-of-life care, culturally diverse groups are still not being served. Interviews of 22 hospice and palliative care program directors in one southeastern state indicated that directors overestimated how well programs are doing in meeting the needs of diverse groups but were very interested in implementing cultural diversity training for their staff Those who were more concerned about such issues had recruited more diverse volunteers into their programs. The presence of diverse staff or volunteers predicted a more diverse patient population. A number of efforts were underway to develop cultural competence and provide culturally competent care. Several directors reported no efforts in this direction, however Directors described programmatic barriers and resources needed. The authors concluded that directors should provide leadership in their agencies in welcoming diversity. Implications for further research and work within the larger end-of-life care field are discussed.
authors.affiliation: School of Social Work, University of Arkansas, Fayetteville, Arkansas, USA.
authors.forename: Dona J
authors.initials: DJ
authors.lastname: Reese
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Melton
authors.forename: Karen
authors.initials: K
authors.lastname: Ciaravino
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003144:Communication Barriers; D003159:Community-Institutional Relations / Q000592:standards; D018864:Cultural Diversity; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D007857:Leadership; D008913:Minority Groups; D020380:Needs Assessment; D010560:Personnel Selection; D008486:Physician Executives / Q000523:psychology*; D010819:Physician's Role; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*; D015144:Southeastern United States; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000592:standards*; D014838:Volunteers