The 'right story' to the 'right person'. communication issues in end-of-life care for indigenous people

Objectives: To explore communication issues faced by health care workers and indigenous patients and their families in a palliative care setting. Effective communication with Aborigines is especially important because Aboriginal beliefs of health and sickness are so different from Western views. Method: Data were collected from 72 qualitative interviews conducted throughout the regional, rural and remote areas of the Northern Territory with Indigenous patients and carers and the health professionals who care for them. Results: Participants highlighted the struggle associated with effective communication when working in a cross-cultural setting at the interface of indigenous and Western health care. The findings record the wisdom and insight from pracitioners who have extensive experience dealing with communication difficulties. What is known about the topic? Communication among people from different cultures around health care issues is often difficult. What does this study add? This study provides the perspectives of Aboriginal people and health care workers on the important communication issues, including communicating difficult news, cultural shyness, information being taken literally, difficulty in understanding Western medical concepts, language barriers and talking to the right person. What are the implications for practice? This paper highlights the importance of communicating the right story (full and culturally appropriate information, appropriately translated and with opportunity for feedback to ensure comprehension) to the right person (recognising the importance of relationship, family and community).