Palliative care for patients with a migration background: a tool
Germany is a country with an open immigration policy. This has been shown in the past and this is shown in the present in a dramatic manner. Additionally, the question of the migration appears to be a European task. Therefore, in Germany we have to expect an increasing number of people from different cultural backgrounds in present and future health care, especially in the different facilities of palliative care. According to this background, in 2012 and 2013, a version of an anamnesis questionnaire on transcultural care was created. The current standard enquiry on the day of admission and in the further course of care is often not sufficient. Key questions are either not asked or certain topics are given too little consideration.
For the adequate use of this tool, the process of implementation is required.
The aim was to create a guideline for the implementation of a tool developed for palliative care teams in different inpatient and outpatient services of palliative care.
The tool deals with an anamnesis (case history) questionnaire on transcultural care for patients with a migration background. This tool intends to improve transcultural competence for the employees (the knowledge and the understanding of terminally ill and dying patients with a migration background) compared to teams without a guideline.
To achieve the aim, the following steps (milestones) were set out:
• The agreement of the heads of seven different inpatient and outpatient services of palliative care in North Rhine-Westphalia was sought and the contacts (project team) determined;
• the teams were trained;
• the questionnaire was to be used and tested by the teams within a period of 6 months;
• the (altered) tool found consent as a kind of standard in the different services and facilities;
• the guideline for implementation of the tool was written;
• an evaluation “loop” of the guideline was conducted (by the respective teams and also the external advisors);
• the final version of the guideline was finished.
The formulated guideline is the result of the project. It contains the steps for the processes of implementation.
A well accompanied process of the implementation of the tool, as the guideline suggests, develops transcultural competence which is important for the care of people with a migration background. Thus it is desirable and recommendable for the different facilities and forms of organisation of palliative care to perform the process in accordance with the guideline.