As a Chaplain Frank Munoz was an integral part of the health care team at Children’s Hospital in Orange County, California assisting children with cancer and their families manage their diagnosis. Through his work he noticed an invisible boundary between patient and families, and the health care team. Something was missing. Despite the best efforts of the group to provide the most compassionate care to the patients and their families, they were unable to reach some people and help ease their suffering. The boundary that Frank experienced fueled his desire to seek knowledge and develop skills to better serve the children and their families facing a life altering diagnosis. This inspiration led Frank to Saybrook University where he is pursuing a Ph.D. in Mind Body Medicine.
Frank then actively pursued funding for his education through the National Institutes of Health (NIH), pursuing a grant that would complement his interests. Doctoral coursework combined with the demands of learning how to be a healthcare researcher is time consuming. The combination is a beautiful synergy that is assisting Frank in learning how to best care for people that he works with, and at the same time is allowing him to make a significant contribution to health care professionals working in similar situations.
After searching the NIH grant database for opportunities that were aligned with his goals — and just as he was about to give up — Frank found the perfect fit for his interest in palliative care. After preparing a comprehensive and lengthy application for the NIH, Frank received a supplemental grant. The grant finances his education and expenses, and he is paired with a mentor. His mentor, Holly Gwen Prigerson, PhD, is a world-renowned researcher working at the Dana-Farber Cancer Institute in Boston, Massachusetts. Dr. Prigerson is mentoring Frank to achieve his goal of becoming a health care researcher in palliative care.
The team has recently prepared a paper titled, Acculturation and the End-Of-Life Care Of Cancer Patients: The United States Acculturation Scale. The paper will be presented at the American Society of Clinical Oncology in June, 2012. This paper gives insight into how one’s culture shapes how people understand illness and death. The acculturation assessment gauges how far patients are integrated into the mainstream American culture, and how that relates to end of life outcomes. The acculturation assessment is called the United States Acculturation Scale (USAS) and it was developed to assess the degree of “Americanization” in first generation or non-US born respondents. The paper confirmed the USAS as a reliable and valid measure of “Americanization” that predicts EOL preferences, planning, and care.
Frank’s role in this multi-site project is to recruit and assess patients. After conducting interviews and assessments of potential participants the information is entered into the database at the Dana Farber Cancer Institute in Boston. The overall goal of the project is to analyze various factors that influence the communication processes between patients and oncology providers. The three ethnic groups that are being studied are White, Black, and Latino. The interviews include questions regarding the patients’ physical, mental, and spiritual health. The interviews also include questions regarding the quality of healthcare they receive.
It is easy for Frank to understand when a patient declines to participate in the study. In order to participate in the study, the patient’s prognosis is usually poor. Anxiety and fear runs high for those patients. Frank is in awe of those patients who agree to be interviewed. They are courageous and understand that their information will help those diagnosed with cancer in the future. This is the first of hopefully many studies that will shed light on how health care providers can improve culturally appropriate communication between health care teams and patients.