'I tried to get into their shoes and their culture'. Care worker experiences in cultural end-of-life care: Interpretative phenomenological analysis.
Elizabeth Lambert, Jo Gibson, Kasia Bail
PMID 38886985WHAT IT FOUND
Care workers providing end-of-life care to culturally diverse clients described feeling unprepared and unsupported.
They improvised communication by learning languages or using family members as translators, and often formed deep, blurred relationships with clients, leading to significant emotional burden and loneliness.
Key findings
01Care workers reported lacking formal training in cultural and palliative care, leading them to spend unpaid personal time learning clients' languages and cultures to provide adequate care.
02Participants described blurring therapeutic boundaries by viewing clients as family members, which provided emotional support but also led to vulnerability, grief, and vicarious trauma when clients died.
03Communication barriers were a primary challenge, with care workers relying on self-reliance, gestures, or family members for translation due to a lack of access to or awareness of professional interpreters.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was small (n=11) and limited to one region (Australian Capital Territory), so findings may not apply to other locations or healthcare systems. Participants were recruited via social media and snowball sampling, which may bias the sample towards those already connected to specific networks. The interviewer experienced difficulty understanding some participants who spoke English as a second language, which may have impacted the flow and depth of some interviews. Data saturation is not a goal of IPA, but the small sample size limits the transferability of the themes to the wider workforce.
Declared interests
The first author was supported by a University of Canberra Research Degree Honours Scholarship and the Synergy Nursing and Midwifery Research Centre. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the care workers' reliance on family members for translation or their unpaid language learning as acceptable or effective practice. The study explicitly identifies these as signs of systemic failure and lack of support, not as successful strategies. Furthermore, the deep emotional bonds described are presented as a source of vulnerability and vicarious trauma, not as a recommended model of therapeutic relationship.