title: Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.
abstract: OBJECTIVE
  The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care.
  
  
  METHODS
  Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis.
  
  
  RESULTS
  The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients.
  
  
  CONCLUSIONS
  The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety of challenges and do not seem confident enough that they can provide good quality care when cross-cultural interaction is at stake.
authors.affiliation: Palliative Education & Research Centre, Linköping University, Norrköping, Sweden.|Department of Advanced Home Care and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.|Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
authors.forename: Anna
authors.identifier: http://orcid.org/0000-0001-8828-0702
authors.initials: A
authors.lastname: Milberg
authors.affiliation: Department of Sociology, Uppsala University, Uppsala, Sweden.
authors.forename: Sandra
authors.initials: S
authors.lastname: Torres
authors.affiliation: Department of Sociology, Uppsala University, Uppsala, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Ågård
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological; D013727:Terminal Care; D035501:Uncertainty