Community Education for a Dignified Last Phase of Life for Migrants: A Community Engagement, Mixed Methods Study among Moroccan, Surinamese and Turkish Migrants.

Xanthe De Voogd,Bregje Onwuteaka-Philipsen,Jeanine L Suurmond,Marieke Torensma,Dick L Willems

doi:10.3390/ijerph17217797

Abstract

Community engagement and -education are proposed to foster equity in access to care and to ensure dignity of migrant patients in the last phase of life, but evidence is lacking. We evaluated nine community educational interactive meetings about palliative care (136 participants totally)- co-created with educators from our target groups of Moroccan, Surinamese and Turkish migrants—with a mixed methods approach, including 114 questionnaires, nine observations, nine interviews with educators, and 18 pre- and post- group- and individual interviews with participants. Descriptive and thematic analysis was used. 88% of the participants experienced the meetings as good or excellent. Educators bridged an initial resistance toward talking about this sensitive topic with vivid real-life situations. The added value of the educational meetings were: (1) increased knowledge and awareness about palliative care and its services (2) increased comprehensiveness of participant’s wishes and needs regarding dignity in the last phase; (3) sharing experiences for relief and becoming aware of real-life situations. Community engagement and -education about palliative care for migrants effectively increases knowledge about palliative care and is a first step towards improved access to palliative care services, capacity building and a dignified last phase of life among migrants.

Highlights

Equality and equity in access to care are generally agreed to be needed to preserve human dignity of all persons [1]
We evaluated the added value of the educational meetings we co-created with the target groups, on the three preferred outcomes—increased knowledge about palliative care, increased comprehensiveness of descriptions of wishes and needs regarding dignity in the last phase of life and increased insight into the importance of talking about your wishes—of which the first two were effectively increased among participants and the third one partly
Community education about palliative care for migrants is effective when developed in collaboration with, and carried out by, educators with the same ethnic backgrounds who know their communities well

Summary

Introduction

Equality and equity in access to care are generally agreed to be needed to preserve human dignity of all persons [1]. Across Europe, including in The Netherlands, studies show that access to palliative care services is unequal and hampered for migrant patients and their families [2,3]; they make less use of palliative care services or services in which palliative care is provided, such as hospice care, nursing home care and home care [4,5,6]. Studies show a combination of factors relate to this limited use of palliative care services, namely a lack of capacity of home care services and hospices to address needs of migrants. I would like to shortly evaluate the educational meeting and how you experienced it. C. Amount of Age Range Female/Male Ratio. 54–60 (+ one of age 16) Turkish Dutch Berber/Arabic

Methods

Results

Discussion

Conclusion