Understanding the Influence of Culture on End-of-Life, Palliative, and Hospice Care: A Narrative Review

Cultural beliefs and values significantly shape end-of-life care decisions, including palliative and hospice care approaches. These cultural influences affect how patients and families view death, pain management, and medical decision-making. This narrative review examines how cultural factors impact care delivery for patients with terminal diagnoses, with particular attention to improving patient-provider communication and trust across diverse populations. A search of the current literature was conducted from March 1, 2022, to May 1, 2022, through the following databases: PubMed, ScienceDirect, Google Scholar, Directory of Open Access Journals, JSTOR, PsycINFO, ERIC Database (via EBSCOhost), and Academic Search Complete. The following key terms were used with Boolean operations: culture, demographic, end-of-life care, hospice, palliative care, terminal illness, and truth disclosure. A combination of qualitative, quantitative, mixed methods, and review studies was included in the review. The Mixed Methods Appraisal Tool was used to appraise quantitative and qualitative literature critically, and the Risk of Bias in Systematic Review was used to appraise reviews critically. This narrative review included 25 relevant publications related to influence of culture and patient demographics on end-of-life care, hospice, and palliative care. As each culture has its own unique views on death and dying, it is crucial to note these cultural differences when assisting with end-of-life care to best align with patients' beliefs and values. Themes such as cultural barriers, communication preferences and family roles emerged from the publications. The findings of this review highlight the critical role that cultural beliefs and values play in shaping end-of-life care experiences. However, gaps remain in the literature regarding how specific cultural nuances influence care decisions, communication preferences, and family dynamics. Future research should focus on exploring underrepresented ethnic and cultural groups to better understand their unique perspectives on death, dying, and medical decision-making. Additionally, there is a need to develop and evaluate culturally tailored interventions that promote patient-centered care, enhance provider-patient communication, and build trust in end-of-life care settings. Addressing these gaps will help ensure that care is respectful of and responsive to the diverse cultural contexts in which patients and families make these deeply personal decisions.