Sixth National Conference on Quality Health Care for Culturally Diverse Populations: Peer-to-Peer Practice Advancement Sessions Child & Women's Health Diversity Program, Calgary Health Region

D-4 Integrating cultural sensitivity into palliative and end of life care

Child & Women's Health Diversity Program, Calgary Health Region
Wednesday, September 24, 2008: 8:30 AM-10:30 AM, Minn Marriott, 4th Floor - Pine/Cedar/Birch
Diversity Rx Conference:
Quality Health Care for Culturally Diverse Populations
Peer to Peer Practice Advancement Session
Linda Kongnetiman: Child and Women’s Health Diversity Program
Introduction to the program and current research
The Child and Women’s Health Diversity Program under the umbrella of the Southern Alberta Child and Youth Health Network, in the Calgary Health Region came into being six years ago.  This was as a result of the increasing number and diversity of immigrants and refugees in Southern Alberta, and the health care system’s inability to accommodate the health care needs of these newcomers.  Canada has a long history of immigration and two-thirds of Canada’s population growth between 2001 and 2006 was fuelled by recent immigrants. The city of Calgary is the fourth receiving city of immigrant and refugee families who migrate to Canada, in hopes of a better life and more opportunities.  Calgary, when compared to Toronto or Vancouver, has relatively few immigrants (the ratio in Toronto will reach 1:1 by 2017, and currently in Calgary the ratio is 1:5).  In Calgary, the five most prevalent ethno-cultural groups are Chinese, South Asians (India and Pakistan), Filipino, and Koreans, and 21% of the Calgary population are culturally diverse children under the age of 17.  The experiences faced by new immigrants to Calgary often do not satisfy their expectations, and sometimes they face unexpected challenges when accessing the health care system.  These challenges are even more daunting when the family has a child with a disability, when the child is seriously ill, or when a child has died.
The migration of immigrants who have different cultural and religious values, beliefs, and traditions than North Americans is pressuring Health Care Professionals and services to become more culturally competent when providing pediatric palliative care.  Within the health care setting, there was a recognized need for cultural competence on the part of healthcare professionals.  This need required that professionals be able to respond appropriately and in a timely fashion to people of all cultures, backgrounds and religions in a manner that recognized, affirmed and valued cultural differences and similarities.
In conjunction with the University of Calgary and the Grief and Palliative Care Team, the Child and Women’s Health Diversity Program conducted research on the topic of understanding cultural competency in pediatric palliative care.  The purpose of the study was:
·        To gain knowledge and increase understanding of the values and beliefs of the ethno-cultural community when a child is palliative or has died;
·        To examine the level of care received as perceived by parents from the ethno-cultural community;
·        To understand the role and functioning of the ethno-cultural specific organizations as social supports for families;
·        To examine the level of understanding of health care professionals working with these families and their learning needs.
Both individual and group interviews were conducted among families, key informants, religious leaders, and Health Care Professionals.  The ethno-cultural communities involved included Chinese, Filipinos, Sudanese, Middle-Easterners, South Asians and Hutterites.
Innovations and Findings
            The role of the Child & Women’s Health Diversity Program is to support, enhance and develop culturally competent services.  The program strives to facilitate and promote culturally competent care which acknowledges and respects different cultural beliefs, values and perceptions of health and illness.  There are several ways we do this:
  • We offer clinical consultation with Health Care Professionals and, less frequently, families, regarding diagnosis, care, treatment and other issues as requested or needed in situations where cross-cultural beliefs or practices are present and are not well-understood by staff
  • We offer cultural competency training and workshops to educate staff and to enhance cross-cultural sensitivity and culturally competent service delivery.  Education sessions are experiential and interactive and focus on skill-building, small group activities, role playing and case study discussions.  A complete training includes four, three-hour modules which are entitled:
    • Self Assessment and World Views on Health and Illness
    • Personal Cultural Values, Biases and Stereotypes
    • Culturally Responsive Assessment and Diagnosis
    • Cultural Competency in My Program/Clinic
  • We offer families, professionals and community partners access to resources which include a wide variety of clinical and community resources, many in translated versions, regarding child health conditions and treatment options.  We have also developed several of these resources, which include:
    • Enhancing Cultural Competency: A Resource Kit for Health Professionals
    • The training modules already referred to
    • Cultural Competency Check Card
    • Immigrant and Refugee Women’s Cultural Health Practices
    • Community Resources for Newcomers
    • We are in the process of developing more resources (FAQ document, Counseling Practices Around the World, Cultural Competence in Pediatric Palliative Care)
    • The program also works closely with the Interpretation and Translation Service of the Calgary Health Region to ensure that children and families have access to medically trained interpreters during their health care experience.
Lessons learned/challenges overcome
Incorporating ethno cultural communities who are usually not accessed into the development of programs and research.
Finding different research methodologies that meet the needs of the communities involved.
Continuing to find creative ways of having upper level management as well as front line workers interested in ongoing training and education.

Presentation Information:

Program: Peer-to-Peer Practice Advancement Sessions
Primary Category: Research
Subtopics: Access in underserved communities, eg, rural, urban, Assessing learning/performance on cultural competence/disparity reduction, Clinical interactions, Patient education, Observational/descriptive studies, Methods - patient and staff surveys, organizational and patient measures, data collection and analysis, Research on death and dying, Quality improvement, Partnerships with community organizations

Region Addressed by Presentation: International
Organization: Health Care System
Population/Demographic: diverse ethnic groups
Keywords: Values and beliefs, death and dying, cultural competency

Linda Kongnetiman, MSW, RSW , Social Work, Calgary Health Region, Calgary, AB, Canada
    Child and Women's Health Diversity Program Coordinator
    Calgary Health Region
    Social Work
    2888 Shaganappi Trail NW
    Calgary AB, Canada T3B 6A8

    Phone: 403-955-7742
    Fax: 403-955-2444
    Email Address:

    Biographical Sketch:
    Linda Kongnetiman MSW, RSW Linda Kongnetiman is currently the Diversity Program Coordinator for the Child and Women’s Health Portfolio of the Calgary Health Region. Her training and research interest focus on preparing professionals for working in global contexts. She conducts training and workshops in cultural competency, values/beliefs of newcomers in regards to health and other areas, settlement of newcomers, impact of culture and health among a few. In collaboration with Elaine Eskow she put together a manual entitled: “Enhancing Cultural Competency: A Resource Kit for Health Care Professionals” as well as a Cultural Competent Check Card that serves as a quick reference guide. Linda has worked with organizations such as the Anton the Kom University in Suriname, the Calgary Catholic Immigration Society, Native Services as well in the Down Syndrome and Fetal Alcohol Syndrome Clinic at the Alberta Children’s Hospital. She delivered training in Brooks, Medicine Hat, Edmonton and Calgary. Throughout her career she has worked extensively with immigrants/refugees and evacuees and has developed a great interest in working with this population. She also serves as an Adjunct Professor for the Psychology Association and Adjunct Field Professor for the Faculty of Social Work at the University of Calgary. Linda is also a recipient of the Peoples First award in the Calgary Health Region. She holds a Bachelor of Social Work degree from the Academy for Higher Education in Arts and Culture in Suriname and a Master of Social Work degree from the University of Calgary.