Background: Cultural competency is increasingly recommended in policy and practice to improve end-of-life
(EoL) care for minority ethnic groups in multicultural societies. It is imperative to critically analyze this approach
to understand its underlying concepts.
Aim: Our aim was to appraise cultural competency approaches described in the British
literature on EoL care
and minority ethnic groups.
Design: This is a critical review. Articles on cultural competency were identified from a
systematic review of the
literature on minority ethnic groups and EoL care in the United Kingdom. Terms, definitions, and conceptual
models of cultural competency approaches were identified and situated according to purpose, components, and
origin. Content analysis of definitions and models was carried out to identify key components.
Results: One-hundred thirteen
articles on minority ethnic groups and EoL care in the United Kingdom were
identified. Over half (n = 60) contained a term, definition, or model for cultural competency. In all, 17 terms, 17
definitions, and 8 models were identified. The most frequently used term was ‘‘culturally sensitive,’’ though
‘‘cultural competence’’ was defined more often. Definitions contained one or more of the components: ‘‘cognitive,’’
‘‘implementation,’’ or ‘‘outcome.’’ Models were categorized for teaching or use in patient assessment.
Approaches were predominantly of American origin.
Conclusions: The variety of terms, definitions, and models underpinning
cultural competency approaches
demonstrates a lack of conceptual clarity, and potentially complicates implementation. Further research is
needed to compare the use of cultural competency approaches in diverse cultures and settings, and to assess the
impact of such approaches on patient outcomes.