University of Virginia School of Medicine, Charlottesville, Virginia, USA.
University of Virginia School of Medicine, Charlottesville, Virginia, USA; Department of Family Medicine, University of Virginia, Charlottesville, Virginia, USA.
J Pain Symptom Manage. 2020 Aug;60(2):476-486. doi: 10.1016/j.jpainsymman.2020.03.011. Epub 2020 Mar 20.
After over a decade of resettlement of ethnic Nepali refugees in the U.S., a significant population of seriously ill refugees will require palliative care and hospice care. The refugee experience and culturally specific factors affect the end-of-life care of this population. Challenges in the end-of-life care of Nepali refugees include challenges related to social and health inequities, such as significant chronic respiratory disease burden; lack of protocols for deferral of illness disclosure; lack of support for group decision making; unfamiliarity with spiritual, religious, and traditional health practices; and difficulty with cross-cultural communication. Culturally competent care of ethnic Nepali refugees can be accomplished through respectful exploration of patients' and families' preferences regarding the challenges identified. This article presents recommendations that can guide primary and specialist palliative care for this population.
经过十多年的美国尼泊尔族难民重新安置，大量重病难民将需要姑息治疗和临终关怀。难民经历和文化特定因素会影响这一人群的临终关怀。尼泊尔难民临终关怀面临的挑战包括与社会和健康不平等相关的挑战，如严重的慢性呼吸道疾病负担；缺乏推迟告知疾病的协议；缺乏对集体决策的支持；不熟悉精神、宗教和传统健康实践；以及跨文化交流困难。通过尊重地探讨患者和家属对所确定的挑战的偏好，可以实现对尼泊尔族难民的文化上有能力的关怀。本文提出了可以指导为这一人群提供初级和专科姑息治疗的建议。
