Dr Gertrude Phiri1, Dr Joyce Muge-Sugutti1, Dr Davina Porock1
1Edith Cowan University, Joondalup, Australia
Biography:
Dr Phiri’s nursing career started in hospital settings in Zambia as a Registered Nurse, later moving to training in an HIV/AIDS focused Non-Governmental Organisation. As part of the training team, she supported home-based care volunteers and managed a hospice that provided respite for family carers. In Australia, she worked in Aged Care as a senior nurse in clinical governance while also mentoring nurses in clinical practice. She is a Lecturer and Research Scholar at Edith Cowan University in Western. Dr Phiri’s research interests are in migration, aged care, and palliative and end-of-life care for culturally and linguistically diverse (CaLD) communities.
Abstract:
Background:
Over the past two decades, the population of migrants of African descent in Australia has grown significantly. As this community ages, the need for culturally sensitive end-of-life (EOL) planning becomes increasingly urgent. Yet, EOL planning remains a relatively unfamiliar concept among many African migrant groups, whose collectivist cultural values often prioritize family and community over individual autonomy. Despite numerous studies highlighting their limited engagement with EOL services, little progress has been made in bridging this gap. In these cultural contexts, care for a terminally ill family member is typically coordinated by the extended family, often without the direct input of the individual concerned. This communal approach stands in contrast to Australian palliative care models, which emphasize individual agency, formal documentation, and personal decision-making in EOL planning.
Aims:
This paper investigates the underlying factors contributing to African migrants’ limited engagement with palliative and end-of-life care services in Australia.
Methods:
Employing a constructivist grounded theory approach, fourteen participants were each interviewed twice, spaced two to four weeks apart. All interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently, guided by coding and constant comparative techniques.
Results:
Six categories emerged: 1) Remodelling Self, 2) Disintegrating Family Dynamics, 3) Resetting the Life Button, 4) Shuttling Back and Forth, 5) Finding Equilibrium, and 6) Pursuing the Horizon, culminating in the Dynamic Process of Toing and Froing substantive theory.
Conclusion:
It is essential for both African migrants and healthcare providers to recognize the Dynamic Process of Toing and Froing and understand how it affects migrants’ capacity to participate in end-of-life planning within the Australian context. Grasping the substantive theory can empower migrants to seek support and enable healthcare professionals to deliver culturally appropriate end-of-life care information essential for effective planning.