Question

A 90-year-old client from Thailand is diagnosed with terminal cancer. The family seems unconcerned and, although they do not refuse treatment for the client, they do not assist with treatment. Which of the following is the nurse's likely assessment of this behavior? A. The family believes in the cycle of life and that death is a step into the next cycle. B. The family is in denial concerning the diagnosis and needs further teaching. C. The family is planning to get another opinion regarding the diagnosis. D. The family is not concerned with the treatment and care of the client.

Short answer

Answer: The family believes in the cycle of life and that death is a step into the next cycle.

Step-by-step solution

Understand the cultural context of the family from Thailand

First, we should consider the cultural beliefs and values of the family from Thailand. This will help us understand their attitude towards life, death, and the terminal cancer diagnosis. Thailand's culture is predominantly influenced by Buddhism, which teaches about the cycle of life, death, and rebirth (or reincarnation). Understanding this cultural context will help us determine which answer choice is most appropriate.

Analyze the family's behavior in the context of their cultural beliefs

Now that we understand the cultural context of the Thai family, we can analyze their seemingly unconcerned behavior and lack of assistance with treatment in light of their cultural beliefs. The fact that they do not refuse treatment for the client but do not actively assist may provide insights into their attitudes towards the situation.

Evaluate the answer choices

We have four possible assessments: A. The family believes in the cycle of life and that death is a step into the next cycle. B. The family is in denial concerning the diagnosis and needs further teaching. C. The family is planning to get another opinion regarding the diagnosis. D. The family is not concerned with the treatment and care of the client. Let's evaluate each option: A. Given the cultural background of Thailand and the influence of Buddhism, it is highly likely that the family would see death as a step into the next cycle of life. This choice aligns with our understanding of the cultural context and explains their seemingly unconcerned behavior without implying lack of concern for the client. B. Although the family might appear unconcerned, it doesn't seem that they are in denial, as they don't refuse treatment for the client. C. While not impossible, there is no information suggesting that the family plans to seek another opinion on the diagnosis. D. This option contradicts the information we have, as the family doesn't refuse treatment but also doesn't actively assist.

Choose the most appropriate answer

Based on our analysis and understanding of the family's cultural background, the most likely assessment of their behavior is: A. The family believes in the cycle of life and that death is a step into the next cycle. This choice aligns with their beliefs and explains their behavior without implying a lack of concern for the client.

Key concepts

End-of-Life Care

End-of-life care encompasses the support and medical care given during the time surrounding death. It ensures a sense of comfort, dignity, and respect for the dying and is sensitive to the person's cultural, religious, and personal beliefs.

In practice, quality end-of-life care needs to consider a patient's values and wishes, which may involve discussions about palliative care, preferences for life-sustaining treatment, and the role of family in decision-making.

Importance of Family Involvement

In many cultures, the family plays a central role in end-of-life care. They might, as seen in our textbook scenario, adopt a non-intervening position as a sign of respect for the individual's natural life course. In some cases, what might seem like a lack of concern from a Western perspective can actually be a deep cultural respect for the person's autonomy and the natural process of dying.

Cultural Beliefs in Healthcare

Cultural beliefs dramatically influence how individuals perceive, seek out, and adhere to healthcare. A person’s cultural background can affect their views on illness causation, treatment efficacy, and the healthcare provider-patient relationship.

Healthcare practitioners, like nurses, are encouraged to develop cultural competence, which includes the ability to understand and respect cultural differences and to provide care that is responsive to the cultural beliefs of patients and their families.

Communication and Education

Effective communication in healthcare involves not only language but also an understanding of cultural context. For example, when delivering a diagnosis and discussing treatment options, healthcare providers need to do so in a way that is informed by and sensitive to patients' cultural beliefs. Additionally, education about different health beliefs and practices should be ongoing for healthcare workers to avoid misunderstanding and to provide the most appropriate care.

Buddhist Influence on Health Perceptions

Buddhism, as a spiritual tradition, strongly influences health perceptions and attitudes toward illness and dying in cultures it pervades, such as in Thailand. Central to Buddhist philosophy is the belief in a cycle of life, death, and rebirth, known as samsara, and the quest to achieve nirvana, a state free from suffering and the cycle of rebirth.

Health and illness in Buddhism are seen as part of life's transient nature. Acceptance of this impermanence can lead to a calm and accepting attitude toward end-of-life situations.

Approach to Treatment

A Buddhist's approach to treatment may be characterized by a preference for minimal intervention or a focus on reducing suffering rather than aggressively treating the illness. This cultural understanding is important in clinical settings, where providers must balance medical intervention with the patient's and family’s spiritual needs and beliefs.