title: Providing palliative care for cardiovascular disease from a perspective of sociocultural diversity: a global view.
abstract: OBJECTIVE
  This article discusses the available information on providing palliative care for cardiovascular disease (CVD) for individuals from culturally and linguistically diverse populations, and argues the need for cultural competence and awareness of healthcare providers.
  
  
  RESULTS
  The burden of CVD is increasing globally and access to palliative care for individuals and populations is inconsistent and largely driven by policy, funding models, center-based expertise and local resources. Culture is an important social determinant of health and moderates health outcomes across the life trajectory. Along with approachability, availability, accommodation, affordability and appropriateness, culture moderates access to services. Health disparities and inequity of access underscore the importance of ensuring services meet the needs of diverse populations and that care is provided by individuals who are culturally competent. In death and dying, the vulnerability of individuals, families and communities is most pronounced. Using a social-ecological model as an organising framework, we consider the evidence from the literature in regard to the interaction between the individual, interpersonal relationships, community and society in promoting access to individuals with cardiovascular disease.
  
  
  CONCLUSIONS
  This review highlights the need for considering individual, provider and system factors to tailor and target healthcare services to the needs of culturally diverse populations. Beyond translation of materials, there is a need to understand the cultural dimensions influencing health-seeking behaviors and acceptance of palliative care and ensuring the cultural competence of health professionals in both primary and specialist palliative care.
authors.affiliation: aJohns Hopkins University School of Nursing, Baltimore, Maryland, USA bCentre for Cardiovascular and Chronic Care Faculty of Health, University of Technology Sydney, Ultimo, New South Wales cWestern Australia Centre for Rural Health, University of Western Australia, Crawley-Nedlands, Western Australia dPalliative and Supportive Services, Flinders University, Adelaide, South Australia.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Jane L
authors.initials: JL
authors.lastname: Phillips
authors.forename: Cheryl
authors.initials: C
authors.lastname: Dennison-Himmelfarb
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Thompson
authors.forename: Tim
authors.initials: T
authors.lastname: Luckett
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
mesh_terms: D002318:Cardiovascular Diseases / Q000208:ethnology*; D054521:Cultural Competency; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D010166:Palliative Care / Q000458:organization & administration*; D064890:Social Determinants of Health; D012931:Social Environment