Communication problems

hamper them in overcoming other factors as well. Other factors include the perceived taboo on speaking about terminal illnesses in the Turkish and Moroccan families (76% and 46%) or special habits which impede home care nurses from working with them in an easy way (65% and 55%). Habits that may be different from Dutch patients concern, for instance, feeding and personal hygiene standards, Inhibitors,research,lifescience,medical but also the division of tasks between men and women within the family, the less openly expressed personal preferences and greater adherence to traditions within the communities. More GPs are convinced that financial problems are at stake (44%) than nurses (22%). But both GPs and nurses (59% and 65%) agree with the statement that Moroccan and Turkish families have difficulty in understanding why and to what extent they have to pay Inhibitors,research,lifescience,medical for home care services, especially because they have no payment obligations for hospital care. Few nurses (20%) or GPs (22%) think that fear of gossip in the Turkish or Moroccan community will prevent families from using home care. Professionals

did not mention factors on the level of the community. Suggestions for improvement Fludarabine chemical structure Nearly all nurses and GPs put forward suggestions for improvement. The proposals included using more professional interpreters, learning Inhibitors,research,lifescience,medical more about culturally colored beliefs on illness and death, providing information to Turkish and Moroccan families by health educators, improving Public Relations within home care organizations and making the formal needs assessment procedures less bureaucratic. Inhibitors,research,lifescience,medical It is believed that the specific needs of the Turkish and Moroccan families are neglected in the current system of needs assessment by independent agencies, Inhibitors,research,lifescience,medical because specific needs do not fit very well into the formal needs assessment procedures. On the basis of the respondents’ information presented in this section and the above sections we refined model 1 and added the perspective of professionals to the upper

part of the adapted model [see Additional file 2]. Discussion In this study we focused on the ideas and experiences of GPs and home care nurses with regard to home care for terminally ill Turkish and Moroccan patients. Comparing our findings with the results of our previous study concerning the experiences of family members [16] shows many below similarities, but also some differences. We found that both professionals and family members distinguish factors related to the individual patient, the family situation, and the organizational level. However, professionals don’t mention factors related to the community level and report some factors within the other levels that family members did not mention. Another difference concerns the fact that professionals experience communication problems as a central barrier, aggravating all other problems.