Author and Year | Province | Aim | Population | Design | Key Findings |
---|---|---|---|---|---|
Chu et al. 2021 [13] | Ontario | To compare end-of-life care between recent immigrants and long-term residents | Cancer decedents including: 13,085 immigrants and 229,471 long-term residents ≥ 18 years at the time of death. Number of Blacks: 1052 | Retrospective, population-based cohort study between 2004 and 2015 | • Black immigrants have 1.2 times greater risk for aggressive care at end of life than long term residents (OR: 1.20, 95% CI 0.94 to 1.53). • Black immigrants are one of 3 ethnic groups that are least likely to access supportive care (ORs: 0.82, 95% CI 0.72 to 0.93;) |
Nayfeh et al. 2021 [27] | Ontario | To measure satisfaction with the quality of inpatient end-of-life care | 1,543 next-of-kin of recently deceased patients from various racial backgrounds Number of Blacks: 25 | Observational survey | • High level of satisfaction among family members of patients who died in the intensive care unit. Overall Satisfaction score was 8.30(2.09) of 10 • Satisfaction scores among black participants ranged from 8.00–9.00 of 10pionts |
Quach et al. 2021 [28] | Ontario | To compare places of care among recent immigrants and long-standing residents in the last 90 days of life. | 376 617 deceased individuals, ≥ 18 Number of Africans: 1299 | Retrospective cohort study between January 2013, and December 2016. | • Immigrants from Africa used more acute care in the last 90days of life: • Health care service use by immigrants from Africa were as follows: Subacute (6.70%), Acute (58.89%), Community (29.64%), Long-term care (4.77%). • Immigrants from Africa more likely than other participants to receive palliative physician visit in the last 90 days of life [1.35 (1.18–1.53) (P <.0001)] |
Yarnell et al. 2017 [29] | Ontario | To examine end-of-life care provided to immigrants in the last 6 months of their life. | 967 013 decedents who immigrated to Canada between 1985 and 2015. Number from the African region: 2,606 | Population-based cohort study from April 1, 2004, to March 31, 2015 | • High relative risk of dying in ICU among decedents born in Africa: (95% CI, 1.70-2.00). • Up to 482 (18%) participants of African origin died in the ICU. • High experience of aggressive care at the end of life among recent immigrants from Africa. |
Wanda et al. 2014 [32] | Nova Scotia | To examine the role of spirituality at the end of life. | 14 participants between 35 to 72 years who were either Caribbean, Canadian Black or African family caregivers or spiritual leaders. | Qualitative In-depth interviews and focus groups | • Role of pastors at end of life is seen as supportive. • More support provided to church members at the end of life, compared to non-church members. • Having faith in God was associated with more peaceful end-of-life experiences than those without faith. • Need for improved healthcare provider awareness of the spiritual needs of African families. • Need for holistic palliative care services: with end of life care plans that include spirituality and involves religious leaders. |
Maddalena et al. 2013 [30] | Nova Scotia | To assess knowledge regarding options for palliative and end of life care. | 6 African Canadian caregivers of a patient with a late-stage condition who has died within the last 5 years and no sooner than 6 months. Caregivers aged 50-70years | Qualitative: naturalistic inquiry and Participatory Action Research | • Limited knowledge of options for palliative care services. • End of life considered a “family affair.” • Preference for home care and expectation of close family members and community to provide care • Lack of respite and bereavement care. • Financial strain associated with the care of their ill family member • Limited access to information about palliative care services • Need to explore different ways of educating community members about palliative and end of life care services. • Education on available palliative care provided to participants by palliative care team seen as very helpful and hope it continues. • Concern about “strangers” getting in their homes to provide care. • Positive experience with formal healthcare system |
Maddalena et al. 2010 [31] | Nova Scotia | Examine the meanings that African Nova Scotians ascribe to their experiences of cancer, family caregiving, and use of complementary alternative medicine (CAM) at end of life. | 7 African Canadian caregivers of someone who has died from cancer within the last 3 years and no sooner than 6 months. Three case studies examined: Two African Nova Scotian families and one immigrant family from the Caribbean. Three primary caregivers, and four secondary caregivers. | Qualitative: Case study with in-depth interviews | • Expectation that family members (primarily women) will assume the primary caregiving role in the home for their ill family members with chronic illness or at the end of life. • Reluctance among participants to use conventional institution-based palliative and supportive care. • Considerable hardships experienced while caregiving including financial burden. • Primary caregivers of ill family members often assumed other caregiving roles within the family. • Participants expressed limited knowledge of the supports available within the health system as well as how to access financial supports. • Limited access to bereavement support services. • Importance of spirituality to ill family members at the end of life. • Resignation to fate and “God’s will”. • Home remedies used such as cannabis for pain management, massage and prayer identified as Complimentary and Alternative Medicine. • Use of complementary and alternative medicine due to fear of the health system or denial. |