Multicultural Dying in UAE
Students Name: Malak Omran Eid
Student Number: 7102562
Institution:: the University of Wollongong in Dubai
Course: Cultural Competence in Health Care
Instructor: Ms. Rola
Date:01-November-2020
Diversity in Dying across Cultures in the UAE
Introduction
Dying is a process that involves the cessation of physical, psychological, social, and spiritual one’s life. Before a person dies, there are a series of events that are collectively known as the dying process. Death and grief are universal processes that affect everyone at some point in life. How people handle dying and death varies in different cultures. Care provided to patients during their final hours will be memorable by the family members who were present. One of the essential things that can be offered to dying patients is providing them and their families with the best car during the last phase of life through death. The mortality rate of children with cancer in India is high. Indians have different views of the actuation of death. Hindu patients have their beliefs about treatment, death, and dying. Cultural competence allows the nurses to have a closer interaction and attend to their special needs better. While caring for cancer patients, the nurses must have the cultural awareness of the patients they are caring for. This paper will discuss multicultural dying in a healthcare setting, which requires nurses to be culturally competent and respect their clients’ beliefs and spirituals. In precise, Hindu culture has various approaches to dealing with death and the end of life. This includes cremation and the Karma effect; thus, it is good for the nurse to have a good understanding while caring for them.
As a nursing practitioner in the hematology department and cancer, we came across several deaths of children with cancer. Blood cancer has been considered a potent type of cancer that spreads rapidly in children. Almost a third of children with cancer require marrow transplants, but most cannot afford it. Notably, the bone marrow transplants cure rate is about 50% (Gupta et al., 2016). The cost and lack of donors discourage the patients, leading to more deaths of cancer patients.
The ideas of the Hindus regarding the afterlife is different from that of the Muslims and Christians. Indians have traditional healing and teaching methods, which is dated back to more than two centuries ago. Hindu patients do not prefer their patients’ treatment if it is only meant to extend the last phase of the terminal illness. In such circumstances, Hindus are allowed to disconnect the support system of the patient who is suffering. They support the acceptance of pain because they believe it is a consequence of Karma. It affects the monitoring of the pain levels among patients with cancer because they see it as a means of progressing spiritually.
Hindus cremate or bury the bodies of their dead loved ones, while those who are very poor may decide to bury the deceased. They cremate their bodies because they believe that the spirits rise after death. Reincarnation varies based on previous life, good or bad things they did before they die. India is home to many ethnic groups, but the patient in this case study is a Hindu. The Indians usually are more hospitable, even in poor conditions. Hindus believe that death and dying are determined by the destiny of an individual. Notably, they acknowledge that illness and death are part of life.
The central belief in Hindu is Karma’s doctrine, which is a law of cause and effect. However, some Hindu believes that some illnesses that cannot be cured entirely, such as cancer, result from Karma. Based on reincarnation, Hindus believe that what happened in the past may affect the current events in life, including an individual’s health. Nurses and healthcare practitioners need to understand that a firm belief in Karma’s cause and effect may affect healthcare delivery decisions.
Case Study
Soheil is an 8-year-old boy who was brought to the oncology ward by his parents. He was seven years old when he was diagnosed with Acute Lymphocytic Leukemia. He has been undergoing chemotherapy for one year. In Hinduism, it is the mother’s responsibility to take care of the young child and siblings. Most of the time, the mother accompanies Soheil to the chemotherapy sessions. Soheil has one younger brother, and his father is currently working at a butcher shop. They have been participating in the child’s treatment for a year, but the father claims the child is in pain, which he believes is a consequence of Karma. It took us time educating the parents on how to accept the reality of childhood cancer.
Soheil’s father was not ready to accept the idea of losing his child due to his illness. However, he was willing to let his child die as dictated by culture. The patient’s condition was critical, in which the decision was made to put the child on a mechanical ventilator. The parents’ response was surprising since they refused the treatment option offered, especially the child’s father. He felt that we were only trying to prolong the onset of death. On the other hand, parents will go for all treatment options that may extend beloved life in my culture.
The case was discussed with one of our Indian colleagues, where she explained how the use of a ventilator would only extend the stage of terminal death, which is against their beliefs in Karma. This gave me a full understanding and respect for their decision. Later, a family meeting was arranged with the medical team to discuss the family’s wish to sign for their decision. As a consequence, the treatment plan was moved to palliative care, allowing natural death. This case was a great opportunity to read and explore more about this culture to support and care for this family.
As a nurse, my role was to provide the family and friends special permission to practice their rituals; including, bringing the Hindu priest to pray with the dying patient and parents to help his soul travel into another body. They used to recite hymns from their holy books. Additionally, they were allowed to bring clothes and coins for the patient to touch before giving the poor to symbolize the dead person’s generosity. Furthermore, they were permitted to place a sacred thread around the neck or wrist, and holy water sprinkled over the child, and wet his lips.
In a couple of days, we came to an end, and the child sadly passed away; however, the family was comfortable and satisfied that they could implement their beliefs during the last moments of their son’s life. Embalming was unnecessary because, in Hindus culture, the body’s viewing takes place within 24 hours before the child is buried since cremation, according to Hindus culture for young children below 14 years old or unmarried, is not required.
While on the other hand, in Jordanian culture, the body should be cleaned and preserved before the burial and no embalming.
Cultural competence is crucial because it is allowed to communicate with the clients effectively. It entails understanding the relationship between a nurse and the client, ensuring that a positive attitude is displayed towards different cultures. Nurses become more useful when they understand the perspective and beliefs of dying and death among the clients based on their culture—having someone on the team who speaks the patient’s language may soothe the family when they are agitated. The case study above accentuates that a nurse should understand the patient’s cultural diversity and treat them based on the cultural perspective. A significant factor of the nurses in the hematology and cancer department when caring for dying, death, and bereaved is culture (Pentaris, 2011).
In caring for the cancer patient, I realized that competence in culture requires knowing and tolerating the patient’s cultural practices. It entails acknowledging the culture and solving the issues that exist when trying to personalize the cancer patient’s care. Nurses should always learn to respect the patients’ culture while caring for (Sneha et al., 2017). Cultural competence affects the quality of the services delivered to the patients. One of the mistakes made early while caring for the patient is asking direct questions instead of exploring health-related issues. It was realized it’s increasing the gap between the family and me, which could be avoided by reading about the culture or asking friends and colleagues from a similar background. Nevertheless, I treated the client effectively and respected their decisions during treatment and end of life phase.
In oncology, cultural awareness among nurses is an essential skill that enhances quality care delivery to cancer children. Notably, the integration of cultural competency, nursing skills, and client attitudes is critical in cancer patients (Sharifi et al., 2019). Making decisions that are centered on the family is valuable to the Hindu culture.
Conclusion
In conclusion, healthcare settings are increasingly becoming multicultural. Cultural competence is required to deliver quality services. Cultural competence needs to be adopted in nursing curricula and the research programs to prepare nurses adequately for multicultural environments and care. Hindus are the largest population in India, a large group of the United Arab Emirates (UAE) residence. For this reason, nurses should have adequate knowledge of their culture. Nurses should understand how cultural values and beliefs sensitively relate to health care varies among cultures. The delivery of high-quality health services is based on a holistic approach and transcultural nursing care. It is the nurse’s responsibility to educate the parents on the child’s condition and the implications of the disease so that they make a family-based decision.
References
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Gupta, S., Morris, S. K., Suraweera, W., Aleksandrowicz, L., Dikshit, R., & Jha, P. (2016). Childhood cancer mortality in India: direct estimates from a nationally representative survey of childhood deaths. Journal of global oncology, 2(6), 403-411.
Pentaris, P. (2011). Culture and death: A multicultural perspective. Hawaii Pacific Journal of Social Work Practice, 4(1), 45-84.
Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. (2019). Cultural competence in nursing: A concept analysis. International journal of nursing studies, 99, 103386.
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