Themes

Our research group has identified 3 main interconnecting theme areas. These themes cross health care boundaries (community, long term care and acute care) and include persons with life limiting illnesses such as Cancer and Chronic Obstructive Pulmonary Disease (COPD).

1.1. Culturally Competent Care: Culturally competent care involves a partnership with the patient and family in which there is systematic integration of cultural understanding into acceptable and appropriate actions. These actions must be culturally sensitive, relevant, appropriate, and acceptable. Non- culturally competent care has resulted in barriers such as communication difficulties, discrimination, and institutional structures which interfere with traditional kinship responsibilities, to the detriment of quality of care provided. The barrier of language and culture is an impediment to accessing health services and has a negative impact on quality of care, especially in vulnerable populations such as people who are palliative living in a minority situation.

1.2. Timely Access to Appropriate Care: Evaluating access to care has been described as the first step to quality of care. Bierman et al defines three components of access: primary (entering the health care system), secondary (structure within the system such as difficulty getting admitted to inpatient palliative care facilities when needed) and tertiary (addressing the patients’ specific needs). Several of our group members are actively involved in research in this theme.

1.3. Supporting Informal Care: Family care giving is what sustains patients at the end of life and with changing demographics and diminishing resources there is a likelihood that every Canadian will be an informal caregiver at some time.There is an urgent need for supportive programs for informal caregivers, as the caregiver burden increases when patients are in the last three months of life. The research focus for this theme is the development and evaluation of supportive programs for family caregivers and bereaved family caregivers.

1.4. Innovative Approaches for Research and Knowledge Transfer (KT): This theme is not a content area of research focus but a theme related to the uniqueness of methodological approaches required to conduct quality studies with persons at the end of life. For example, there are difficulties with missing data and in recruitment and retention of study subjects when subjects are critically ill and near death. Visual technologies are emerging as innovative approaches to understanding health experiences.