Inclusive Nursing Care Assignment Sample

Introduction of Inclusive Nursing Care Assignment

Palliative care as a speciality involves comprehensive care for patients with life-limiting illnesses and their families to enhance the quality of their remaining lives (Radbruch et al., 2020). However, knowledge of the patient’s cultural, religious, and personal values must be observed to deliver palliative care efficiently. In today’s world, various cultures of different people live together, and those patients who belong to some cultures could have entirely different expectations than others (Taylor and Davies, 2024). Palliative care involves every aspect of the patient’s care, including physical, psychological, social, and even spiritual needs for those patients with life-threatening diseases. Palliative care is offered differently across cultures regarding healthcare infrastructure, cultural beliefs, and family roles. This paper aims to compare the palliative care goals and actions of Nigeria and the United Kingdom and their respective plans and issues of cultural competencies. Nigeria lacks widespread availability of palliative care, and end-of-life support often depends on a family member with the help of traditional herbal treatments and spiritual guidance. Opioid usage for pain relief has been restricted very tightly by psychotic regulations, and therefore, effective pain management has been somewhat challenging. Moreover, many of these conversations about death and dying are regarded as taboo (Wilson et al., 2022). By contrast, however, in the United Kingdom, there is an advanced system of palliative care in the NHS that includes hospice care, advance directives and more patient autonomy (National Health Service, 2022). In the UK, end-of-life care follows a structured, biomedically focused approach. In contrast, in Nigeria, end-of-life care includes biomedical treatments and traditional African healing practices consistent with culturally embedded support that unites spirit and community with biomedical patients. This paper will compare how cultural beliefs regarding death, control of pain, decision-making and organizational features influence palliative care in the two countries. Knowledge of these differences will ensure that nurses respect the patient’s cultural beliefs and practices in decision-making and the patient’s desire to maintain comfort and dignity when dying. As depicted by Claeys et al. (2020), cultural knowledge is a concept that describes various cultural beliefs and practices as well as perceived health practices. This knowledge is also essential in palliative care because different cultural meanings of pain, suffering, and death may exist. Cultural competence is thus defined as being able to recognize cultural variations, accept the variations, and refrain from imposing a personal cultural lens. In palliative care, it entails understanding the patient’s spiritual needs, any dietary requirements she or he may have, the language the patient understands, and the relations he or she has with other family members. A culturally competent nurse speaks patiently, tests knowledge with questions with general answers, and includes patients and their relatives in the decision process (Hsu Jui-Chin et al., 2024). The model which has received relatively high acclaim among different approaches to education for cultural competence is the Papadopoulos, Tilki, and Taylor Model of Cultural Competence (PTT Model). This model emphasizes four key stages:

• Cultural Sensitivity – Understanding and acknowledging one’s culture or prejudice.
• Cultural information – how and why different cultures do things the way they do.
• Ethical Standards – Promotion of culture.
• Social Cultural Sensitivity – Universal appraisal of interpersonal aspects within the social culture of the patient.

By adhering to this model, nurses can acquire essential qualities that enhance the delivery of palliative care that is sensitive to culture and individualized to the patient’s wants and needs.

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My Cultural Background and Palliative Care

Cultural Perspectives on Illness and End-of-Life Care

Self-cultural perception about palliative care: A significant feature of my cultural perspective regarding formulating policies in the terminally ill patient’s care is that the family unit forms the backbone of the decision-making and caregiving system (Thompson et al., 2021). Nigerians’ perception of illness and death is likely to be influenced by traditional beliefs or culture. Some people to this day think that sickness and pain can be because of a curse, or due to the ancestral curses or even the wrath of the gods. For these reasons, traditional healers and religious leaders are involved in patients’ treatments, and their spiritual support involves prayers and herbal medications (Oguntola-Laguda, 2022). As in many cultures of the world, there is a taboo against talking about death and dying (Wilson et al., 2022). Furthermore, some cultures fear discussing death as it is believed that the act of uttering it calls for its occurrence and thus, where a patient is terminally ill, families may deny them the fact to avoid such an occurrence. While making decisions regarding the type of care a patient receives at the end of life, families make those decisions for the patient and choose hope, prayer, divine intervention, and a miracle over pain control and sedation.

Tissue Viability and Cultural Considerations

Skin and tissue viability plays an essential role in the patient receiving palliative care, where skin breakdown, infection and complications arising from a long-term bedridden state are the order of the day (Koumaki et al., 2023). In Nigeria, family members play a central role in palliative care, often providing around-the-clock support at home. However, some families may not want procedures like inserting feeding tubes or changing dressings since those are medical interventions. A significant number of patients with terminal illnesses stay at home, and addressing skin and tissue viability is difficult (Pastor-Orduña et al., 2025). Restricted admission to hospitals and procurement of pressure-relieving mattresses and wound care items raise the possibility of pressure ulcer infection and skin damage. It is important to note that many cultural treatments like shea butter, application of herbal pastes, and natural oils, among others, are used to treat wounds, and their efficacy is an issue of debate (Hoang, Moon and Lee, 2021).

Comparison with Another Cultural Group

Cultural Perspectives on Illness and End-of-Life Care

The Nigerian and UK governments also agree that palliative care is not only the effective control of a patient’s physical manifestations of distress but also a broader concept. Emotional, social, and spiritual care is important in treating a patient (Miller, Addicott and Rosa, 2023). In Nigeria, faith and herbal healers have primary responsibility, while in the UK, it is the chaplains and psychological services for the terminal patients. In all the countries, family members take the lion's share in providing patient care (Schofield et al., 2020). Nigerian families are the primary caregivers at home, and in the UK, families are more comfortable giving to patients in hospices or hospitals. Both cultures appreciate symptom control in palliative care but stress the management of pain regardless of the availability of pain medication. The UK has free access to opioids, while on the other hand, Nigeria has limited access, even cultural resistance to the use of strong analgesics. Despite cultural differences, Nigerians and British patients search for dignity, respect, and palliation at the end of their lives (Glyn-Blanco, Lucchetti and Badanta, 2023). Both cultures of nurses seek to make the patient as comfortable as possible by giving them dignified and person-centred terminal care.

Tissue Viability and Cultural Considerations

High clinical standards are applied in Western palliative care, and wound management and tissue viability address universal protocols, NHS Modern Dressing, Wound Vaccum, and Repositioning Schedules to prevent pressure ulcers and infections. Nurses are primarily responsible for skin assessment and monitoring, and various technologies, such as pressure-relieved mattresses and moisture barrier creams, are used (Li et al., 2022). On the other hand, in my cultural setting, different family members are assigned the roles of skincare givers, and some of the skincare practices practised include using herbal balms and massages. These practices may be complementary to Western medicine. Further, since patients have cultural inclinations, the nurses must honour the cultural ideals as long as they are treated clinically to manage their wounds (Li et al., 2022).

Care Plan Considerations and Cultural Competence

Care Plan in Nigeria Nigerian patients have restricted access to specialized palliative care treatments because its services remain limited throughout rural healthcare facilities. Across its national healthcare system, the UK implements palliative care through its established NHS system while maintaining hospice and specialist services throughout the country. In Nigeria, healthcare decisions are ultimately determined by families that make decisions on behalf of the patient. Healthcare providers must interact with families when discussing care preferences while concentrating on the patient's needs (Kwame and Petrucka, 2021). Since talking about death is not easy to speak directly to nurses and doctors, introducing end-of-life care discussion should be done through culturally sensitive language. Because of strict opioid regulations and limited availability of opioids, pain management is based on mechanisms other than opioids, namely paracetamol, herbal pain remedies, and spiritual means. The education of healthcare providers and families on how to safely and effectively use pain relief medications while integrating non-pharmacological pain management techniques like massage therapy and prayer should also be incorporated in culturally competent care plans for pain control, as proposed by Oga et al. (2022). For many Nigerians, end-of-life experiences are guided by pastors, imams, or traditional healers. Palliative care providers should respect religious beliefs and rituals, but concerning competent, evidence-based clinical interventions, providers should work with spiritual and community leaders. The palliative care plan should include spiritual counselling and prayer sessions (Abiodun et al., 2020). Care Plan in the United Kingdom Through advance care planning, the NHS enables patients to select their preferred care locations, choose their resuscitation preferences, and make preferences regarding pain management. The decision-making power regarding healthcare treatment belongs solely to patients in the UK system since the country does not follow the Nigerian practice of family-dependent medical choices (Anderson et al., 2021). The healthcare team must help diverse cultural patients grasp their rights and choices in the UK healthcare system. Palliative care treatment in the UK includes holistic symptom and pain management through available medical prescription opioids alongside sedation therapy and a range of nondrug pain interventions such as counselling and relaxation therapies (Sandvik et al., 2020). Healthcare providers need to apply culturally adapted pain assessment techniques to patients from ethnic minority backgrounds who want assurance their pain relief strategy matches their cultural beliefs and personal preferences. Medical professionals within the NHS enable patients to receive proper spiritual support through religious-based counselling and chaplaincy services regardless of their religious background (Gunawardena et al., 2024).

Skin and Tissue Viability Meaning

The skin and its tissues are essential in evaluating palliative care because most patients are bedridden, increasing their susceptibility to pressure ulcers, infections, and skin breakdown (Glyn-Blanco, Lucchetti and Badanta, 2023). The skin is the body’s largest organ, composed of three layers: the epidermis, dermis and hypodermis. The epidermis acts as a shield, and the dermis contains blood vessels, soothing sensations, and connective tissues for controlling temperature and rates of skin repair. The hypodermis comprises of the fat and connective tissues, which act as shock absorbers and insulators (Glyn-Blanco, Lucchetti and Badanta, 2023). In palliative care patients, skin becomes weaker due to ageing, poor blood circulation, malnutrition, and a weak immune system. These conditions predispose patients to pressure ulcers, moisture-associated skin damage, delayed wound healing and skin tears. Tissue integrity must be closely monitored as positioning changes and special considerations regarding wound care and fluid intake and output.

Ethnic Sensitivity in Skin and Tissue Management

Each culture has different skin and tissue treatment practices. Natural remedies, like the application of ointments from some herbs and massage therapy, enhance medical care for the skin in some cultures (Dahlberg et al., 2021). Patients who have a family are usually cared for in matters related to their personal hygiene and skin integrity measurement. Furthermore, this is because they need to be regularly massaged and repositioned to avoid sore formation (Dahlberg et al., 2021). On the other hand, Western palliative care settings have embraced clinical wound management, such as use of pressure-relieving devices, advanced dressing and proper repositioning timetable. Despite the need to maintain cultural sensitivity, the following areas of tissue viability should not be compromised when nurses offer palliative care (Liyew, Tilahun and Kassew, 2021). When families opt for natural remedies, the nurses can incorporate these methods while following the applicable scientific approaches, such as wound care and pressure ulcer preventive measures. The openness of cross-cultural care communication plays a vital role in compliance with cultural practices and medical protocols among patients in terminally ill care.

Transcultural Nursing Models in Palliative Care

• Transcultural Nursing Theory by Leininger: Leininger’s Transcultural nursing theory focuses on cultural assimilation, whereby the client’s cultural beliefs, values and practices are included in the care given to the patient (Lasmaida and Dedi, 2024). It is applicable in palliative care in that it allows different cultures to be considered when determining pain management policies regarding treatment for terminally ill patients, the involvement of families, and even funeral processes (Lasmaida and Dedi, 2024). Knowledge of the patient cultural beliefs will enable the nurses to attend to the patient’s psychological and spiritual needs in a way that does not counter their cultural belief system.
• Papadopoulos, Tilki & Taylor’s (PTT) Model: The Papadopoulos, Tilki, and Taylor (PTT) model of cultural competence focuses on four key stages: cultural knowledge, sensitivity, and understanding (Baiocco et al., 2021). It is the definition of culture cognizance, culture sensitization, and culture capability, in other words. Cultural competence factors include cultural attitude and cognition; the former entails identifying and understanding cultural preferences. Cultural receptiveness ensures that the patient is treated with dignity (Baiocco et al., 2021). Cultural proficiency is the application of this knowledge in practice. In palliative care, this model enables the nurses to look at themselves and ask questions concerning their perceived culture as they try to enhance their care skills centred on patients’ cultures.
• Campinha-Bacote’s Cultural Competence Model: Campinha-Bacote also emphasizes cultural competence as a learning process (Gradellini et al., 2021). This framework comprises cultural awareness, knowledge, skills, encounters, and desire. It requires the participation of nurses with multicultural patient audiences, which is essential in building communication skills and maintaining a willingness to learn more about cultural attitudes towards the end of life (Gradellini et al., 2021). Cultural humility is a crucial concept that should be included in the practice. This model forces or promotes the healthcare fraternity to adopt this aspect in practice to enhance healthcare delivery.
• Use of Transcultural Models in Palliative Care: Consequently, in applying the models of transcultural nursing practice in offering palliative care, there is a need to promote patients’ needs. Culture must be considered when using pain assessment instruments because some patients may not be able to report pain verbally (Collins et al., 2020). It should be acceptable to honour end-of-life procedures, and, where possible, the family should be particular about the decisions that must be made. Cultural competence is essential when responding to clients as it means acknowledging various perceptions regarding life-sustaining measures and hospice care, which may assist nurses in remaining clinically relevant (Collins et al., 2020).

Cultural Interpretations of Illness and Palliative Care Needs

• Views of Sickness and Dying: Death is considered an inevitable occurrence, and many cultures have diverse approaches to bearing illnesses as well as pain and dying. For other cultures, sickness is a form of passage, and dying is a process rather than a finality. There are instances of religious and traditional forms of treatment incorporated into medical practice where physical and spiritual support to the patient are considered essential. While healthcare organisations have a similar structure in Western countries, how illness is understood and treated in those societies is very different.
• Role of Family in Palliative Care: This paper sought to establish family roles in providing palliative care from one culture to another. In some cultures, the family participates in patient care; hence, everyone decides on the treatment and pain-controlling plans (Simon et al., 2020). They change diapers, feed the baby, and help bathe him or her all the extended family, especially the grandparents, is involved in emotional support and religious practices. On the other hand, the Western concept of palliative care focuses on patients’ self-determination, where patients' families provide necessary support and bear no responsibility for making decisions regarding the patient’s health (Velić et al., 2023).
• Pain and Spiritual Concerns: Culture affects perceptions of pain control in palliative care (Okolo et al., 2024). In some cultures, when one experiences pain, he or she assumes it is customary to endure it or accepts it as a sign of spiritual prowess, hence opting not to take strong pain management chemicals like opioids. They followed their notion of care where other cultures value comfort and symptom control and encourage optimum pain control measures.
• Organizational Barriers to Culturally Sensitive End-of-Life Care: Challenges to delivering culturally competent palliative care to patients may include language barriers, differences in expectations of care, and the healthcare institution's policies on care that patients from other cultures may not understand (C. Shawn Burke, Doody and Lloyd, 2023). Patients and families can use different languages, so they can have communication difficulties with healthcare professionals, thus needing professional interpreters and culturally appropriate patient information.

Anti-Discriminatory Practice in Palliative Care

Anti-discriminatory practice in palliative care makes it possible for the patients to be treated fairly, with dignity, and with the right quality of care irrespective of their colour, origin, beliefs, economic status, sexual orientation or ability (Westwood, 2022). They range from unconscious prejudice of health care providers, inadequate or unfair provision of pain relief for patients of colour, language barrier effects, and culturally insensitive decisions about whether to withdraw or withhold treatment. Culture and diversity are the first strategic clinical care principles that allow all cultures and backgrounds to have balanced and adequate access to palliative care (Westwood, 2022). This does not mean that equity is equal treatment of all patients and does not acknowledge that some patients may have special needs or have peculiar challenges understanding or getting through to a provider. This is another essential principle because all palliative care patients must be respected from different cultural backgrounds. Specific patient populations may have religious or spiritual convictions regarding issues to do with end-of-life treatment options and choices with how and when to die, choices concerning the use of pain-controlling drugs, as well as choices regarding funeral rights (Bradford, 2023).

Challenges in Delivering Culturally Competent Palliative Care

• Differences in Cultural Attitudes Toward Death and Dying: The magnitude of cross-cultural variations concerning end-of-life care is a severe issue, mainly because of the differing perceptions of death and dying (Glyn-Blanco, Lucchetti and Badanta, 2023). In Nigerian society, the topic of death cannot be easily and commonly discussed because such discussions are considered unearthing agony or causing death. On the contrary, the English culture accepts prolific communication concerning end-of-life decisions (Cain et al., 2018). This study supposes that patients have to engage in the process of ACP in which they state their preferences concerning pain management, life-sustaining treatments, and end-of-life location.
• Available Pain Relief and Choice of Medication: Pain is another cardinal feature of palliative care, and the availability and use of pain-relieving medications also differ between Nigeria and the UK (Pastrana et al., 2025). Several diverse opioids, such as morphine and fentanyl, are commonly used in the UK and are viewed as routine practices in palliative care. However, due to the orthodox conduct of opioid policies in Nigeria and the fear of addiction, it becomes challenging to meet adequate relief of pain (Phillips, Ford and Bonnie, 2017).
• Organizational Pressures and No Cultural Awareness Education: Most healthcare facilities align themselves with Eurocentric medical systems incompatible with other cultural views on end-of-life care (Zaks, 2023). Lack of culturally competent spiritual support, culturally responsive food options, or gender-sensitive palliative care can be hurdles for patients at the end of life.

Conclusion

A comparative analysis of palliative care between Nigeria and Britain reveals vast differences in health care infrastructure, attitudes toward death within the cultures, decision-making, pain management, and accessibility. Though both countries understand the role of compassion, dignity, and symptom relief at the end of life, each approaches it uniquely, depending on their culture, social, and economic characteristics. In Nigeria, palliative care is still not developed and highly dependent on family caregivers, traditional healing, and religious support. The limited availability of specialist palliative care services, strict regulations on opioids, and cultural issues with discussing death and dying contribute to the high challenges faced by patients and health care providers. The lack of government funding worsens the problem, making it. Flexible generic and specific patient-centred care delivery models that will respect the cultures of different patient populations will be important in enhancing palliative care outcomes. Discrimination, professionalism, and cultural sensitivity can assist the nurses in delivering quality care that is acceptable to the patients and their families’ values.

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