\u27Death is difficult in any language\u27: A qualitative study of palliative care professionals\u27 experiences when providing end-of-life care to patients from culturally and linguistically diverse backgrounds

Background: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care. Aim: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture. Design: An emergent qualitative design, informed by theoretical and procedural direction from grounded theory research. Setting/participants: Four focus groups held with palliative care staff (n=28) in a single specialist palliative care service in Australia. Results: The following themes emerged: 1) determining the rules of engagement around discussion of diagnosis and prognosis; 2) navigating the challenge of language to patient understanding; 3) understanding migration experiences to establish trust; 4) maintaining the balance between patient safety and comfort care; 5) providing a good death experience through accommodation of beliefs; and 6) navigating the important role of family members while privileging patient preferences. Conclusion: Underlying provider perceptions of caring for patients was that death is difficult in any language. Care was conceptualised as considering cultural and linguistic backgrounds within individualistic care. Understanding the migration experience and building trust were key elements of this individualised approach. Acknowledgement of the key role played by families in patient care and safety are strategies to minimise barriers and understand the concerns of this patient group

Contributors.

List of Contributors

Editor's Introduction

The journal begins with Dougal McNeill's article on Harry Holland, the socialist parliamentary leader of the Labour Party from 1919 to 1933. This is particularly appropriate as we approach the centenary of the New Zealand Labour Party in 2016. Holland has often received a less than sympathetic reading by historians. Challenging the teleology of earlier historical narratives McNeill draws our attention to the place of 'conflict, contestation, and ideas in Labour's formation and in political history'

Introduction

With the passing of the editorial baton, this seems a good moment to reiterate the aims of the journal and review some of the changes. First of all, however, may I thank the editorial committee of Lydia Wevers, Richard Hill and Brad Patterson, and the journal administrator Deborah Levy, who collectively provided invaluable assistance in the process of transition to a new editor; and welcome the members of our new multidisciplinary and national/international journal board

Editor's Introduction

In this issue of the journal we include articles that encompass social, literary and political history

Editor's Introduction

An underlying theme in this issue is that of place and environment, but the articles build upon a wide range of conceptual approaches, locations, human activities and agency. We begin with Jonathan West’s article on New Zealand lakes. An environmental historian, and J.D. Stout Fellow at the Stout Research Centre in 2019, West’s research comes at a critical juncture when the declining quality of freshwater is the focus of intense national debate and argument. As West points out, the pollution in our lakes is the result of the farming practices and the residential uses of the land around them and resolving or mitigating problems decades in the making is going to pose very difficult questions for us all