Cultural Perceptions of End-of-Life Communication

Cultural Perceptions of End-of-Life Communication

Patient Advocacy
Jan 30, 2021
Christina Sit

Palliative and end of life care discussions are significant and essential, yet sensitive and challenging. Cultural perceptions of pain and end of life can filter nuances in provider communication in ways that may impact team trust, acceptance, and care for the patients. 

In their WCLC abstract, Bonnie Leung, NP, and colleagues explored this topic with a group of patients with NSCLC who were based in Vancouver, Canada. Vancouver is home to many ethnic backgrounds. More than one-half of the population speaks a language other than English as their first language. This makes Leung et al.’s research very significant in the delivery of care and maximizing patient quality of life. 

Presented during MA10: Assessing and Managing Supportive Care Needs, Ms. Leung did a retrospective chart audit of 186 patients to study the end-of-life resource utilization between patients who were English proficient (EP) or limited in their English proficiency (LEP). Although no statistical differences between EP and LEP groups were observed, several trends are worth noting. LEP patients were more likely (24% LEP vs 19% EP) to die in a tertiary palliative care unit and in acute care (23% LEP vs 14% EP) than at home (14% LEP vs 26% EP). It is also important to note that all the LEP patients had access to interpreters. 

These trends are worth further study. Cultural differences in perceptions of pain and death have been well documented.2 These perceptions are likely to have influenced decision making and may have played a role in place-of--death decisions. It is also important to understand the role of the interpreter. How much does language of delivery affect patient decision making and quality of care? 

Leung et al. have begun study into an important aspect of care excellence during a difficult time for patients with NSCLC and their families. Culture is a significant social determinant of health and plays a large role in perceptions of health, decisions, and outcomes. I would like to thank the researchers, the patients, and the family members who participated in this study for turning our attention to this important topic, and I look forward to continued findings from your study. 


  1. World Population Review: Vancouver Population 2021. Accessed January 26, 2021.
  2. Givler A, Bhatt H, Maani-Fogelman PA. The Importance Of Cultural Competence in Pain and Palliative Care. [Updated 2020 Dec 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan.)