[Migration-sensitive hospice and palliative care in Germany: a qualitative interview study with healthcare workers]

Migration-sensitive hospice and palliative care in Germany: a qualitative interview study with healthcare workers Abstract: Background: Migrants often do not receive hospice and palliative care tailored to their needs. Migration-sensitive strategies are often either not implemented or applied in an unsystematic manner. Objective: The study aimed to identify barriers and facilitators for the implementation of migration-sensitive care in hospice and palliative care facilities in Germany. Methods: Seventeen topic guided telephone interviews with staff from relevant facilities were conducted and analyzed using Mayring's summarizing qualitative content analysis. Results: Low acceptance by facility operators, financial and staffing shortages, and structural barriers hinder implementation in everyday care. Differing values between patients and facility operators can further complicate care provision. While ad-hoc measures provide temporary relief, they result in increased workloads and disrupted workflows. Factors that facilitate implementation include multilingual staff, enabling consideration of culture-specific needs. Partnerships and networks can support strategy implementation and enhance care quality. Conclusions: Failure to address patient needs can lead to conflict and complicate care delivery. Reactive measures provide only limited solutions. Proactive strategies, institutional and financial support, and fostering acceptance of diverse values among facility operators are essential.