title: Cultural influences on palliative family caregiving: service recommendations specific to the Vietnamese in Canada.
abstract: BACKGROUND
  Much of what is known about family caregiving at end-of-life in Canada has been studied within the context of various disease categories or across different care settings, rather than in relation to specific ethnic/cultural identities. Such homogeneity belies the impact of cultural and social factors on the experiences and outcomes of palliative and end-of-life (P/EOL) care. We know little about the end-of-life experiences of Vietnamese-Canadian families. Consequently, there is a lack of understanding around how to best meet the needs of Vietnamese care recipients, caregivers, and their families via the health service system, whose services of which we know they have limited access.
  
  
  RESULTS
  To determine a set of service recommendations for health care settings (including the home) specific to caring for Vietnamese (P/EOL) care recipients, caregivers and their families, a qualitative instrumental case-study design was employed. The perspectives of 18 adult Vietnamese family caregivers (FCGs) were obtained. In addition, seven semi-structured key informant interviews were implemented with a range of personnel from community service providers to front-line health care professionals. The ways in which caregiving was perceived and expressed were reflected in three thematic findings: (1) Natural: identity and care work; (2) Intentional: whole person care; and (3) Intensive: standards, struggle, and the context of care. Ten main recommendations have been vetted with service provider leaders and confirmed as being appropriate for uptake.
  
  
  CONCLUSIONS
  The ten service recommendations for health care settings (including the home), if implemented, would contribute to improved P/EOL services for the Vietnamese population. Further research involves the evaluation of these policy and programs.
authors.affiliation: School of Geography and Earth Sciences, McMaster University, General Science Building, 209, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. awill@mcmaster.ca.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Williams
authors.affiliation: Wilfrid Laurier University, Brantford Campus, RCE 216, 73 George Street, Brantford, ON, N3T 2Y3, Canada. rdonovan@wlu.ca.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Donovan
authors.affiliation: School of Nursing, University of Victoria, R Hut 129, Victoria, BC, V8W 2Y2, Canada. kis@uvic.ca.
authors.forename: Kelli
authors.initials: K
authors.lastname: Stajduhar
authors.affiliation: Faculty of Social Science, Institute of Women's Studies, University of Ottawa, Room 5034, 120 University Street, Ottawa, ON, K1N 6N5, Canada. denise.spitzer@uOttawa.ca.
authors.forename: Denise
authors.initials: D
authors.lastname: Spitzer
mesh_terms: D000328:Adult; D002170:Canada / Q000208:ethnology; D017028:Caregivers / Q000523:psychology*; D065246:Culturally Competent Care / Q000208:ethnology*; D006296:Health Services / Q000592:standards*; D006801:Humans; D010166:Palliative Care / Q000523:psychology*; D017410:Practice Guidelines as Topic / Q000592:standards*; D036301:Qualitative Research; D013727:Terminal Care / Q000523:psychology*; D014744:Vietnam / Q000208:ethnology