TY - JOUR
T1 - Living and dying in a disparate health care system
T2 - Rationale and strategies for cultural humility in palliative and hospice care physical therapy
AU - Barnes, Christopher
AU - Mueller, Karen
AU - Fawcett, Lubayna
AU - Wagner, Barbara
N1 - Funding Information:
Although lower skilled health professions largely comprise minority workers, there is a profound lack of diversity in higher skilled professions, reflecting the lack of equity in postgraduate health care education.48,49 According to 2018-2019 DPT program data, there is underrepresentation of Hispanic (6.53%), African American (3.39%), and NA, Native Hawaiian, or Pacific Island (<1%) students in DPT enrollment.50 One effective strategy to improve equity in health professional enrollments is the use of holistic review for admissions, an approach that considers an applicant’s life experiences, fluency in a language other than English, commitment to practice in underserved populations, and self-identification as an underrepresented minority, in addition to test scores and academic performance.51 This approach was used by the Texas Medical and Dental School Application Service to increase the proportion of underrepresented minority internal medicine residents and has been adopted nationwide by 93% of dentistry schools, 82% of public health schools, 78% of pharmacy schools, and 47% of nursing schools.52,53 These initiatives have been successful; 72% of schools that use holistic admissions report increased diversity in the resulting incoming classes. Within the field of PT, the use of holistic admissions by 5 US DPT programs was highlighted in a 2018 APTA Educational Leadership Conference, which encouraged the adoption of holistic admissions throughout PT education. This position is also supported by the American Council on Academic Physical Therapy and the Academy of Physical Therapy Education.54
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Disparities in diversity, equity and inclusivity are endemic in American society, and in the United States (US) healthcare system. As US population diversity increases, physical therapists (PTs) must be able to provide equitable care for all people, regardless of their cultural or personal identity. Culturally-humble Hospice and palliative Care (HPC) PT practice, with vigilant awareness of cultural complexities and commitment to approaching cultural understanding with humility, is essential to provide optimal end of life care for all persons. Purpose: This Perspective paper will 1) provide an overview of the role of PT in HPC, 2) describe culturally-related disparities in HPC, and 3) suggest evidence-based strategies for cultural humility in HPC PT best practice. Specific challenges in the delivery of culturally-humble end of life care will be discussed, including advanced care planning, truth telling, and death beliefs/practices.
AB - Background: Disparities in diversity, equity and inclusivity are endemic in American society, and in the United States (US) healthcare system. As US population diversity increases, physical therapists (PTs) must be able to provide equitable care for all people, regardless of their cultural or personal identity. Culturally-humble Hospice and palliative Care (HPC) PT practice, with vigilant awareness of cultural complexities and commitment to approaching cultural understanding with humility, is essential to provide optimal end of life care for all persons. Purpose: This Perspective paper will 1) provide an overview of the role of PT in HPC, 2) describe culturally-related disparities in HPC, and 3) suggest evidence-based strategies for cultural humility in HPC PT best practice. Specific challenges in the delivery of culturally-humble end of life care will be discussed, including advanced care planning, truth telling, and death beliefs/practices.
KW - cross-cultural care
KW - hospice care
KW - palliative care
KW - physical therapy
UR - http://www.scopus.com/inward/record.url?scp=85079408237&partnerID=8YFLogxK
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U2 - 10.1097/01.REO.0000000000000199
DO - 10.1097/01.REO.0000000000000199
M3 - Review article
AN - SCOPUS:85079408237
SN - 2168-3808
VL - 38
SP - 30
EP - 38
JO - Rehabilitation Oncology
JF - Rehabilitation Oncology
IS - 1
ER -