From inside the bubble: migrants’ perceptions of communication with the cancer team
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Migrants with cancer struggle to communicate with their health care team. This study aimed to identify health-care related unmet needs and communication issues for migrants who develop cancer and factors associated with these challenges. In this paper, the findings related to communication issues are presented.
Patients and methods
Seventy-three cancer patients diagnosed within the previous 3 years and 18 carers, who had migrated to Australia and spoke the designated languages, participated in focus groups or structured interviews. Participants were recruited from ethnic community support organisations, support groups and Oncology clinics within three metropolitan hospitals in two states of Australia. Focus groups and semi-structured interviews were conducted in participants’ own language or English as preferred, audio-taped, transcribed and translated into English and analysed using qualitative methods.
Four themes emerged: (1) cultural isolation, alienation and identification; (2) language and communication difficulties; (3) interpreter issues; and (4) advice for health professionals. Participants, especially those less acculturated, described feeling alone and misunderstood, failing to comprehend medical instructions, being unable to communicate questions and concerns and a lack of consistency in interpreters and interpretation.
Migrants with cancer experience additional challenges to those of native-born patients. Participants provided cogent advice regarding optimal communication with people from their culture. There is clearly a need to develop strategies to increase the cultural competence of care to people from different countries.
KeywordsUnmet needs Communication Migrants Cancer Multi-culturalism Cultural competence
This study was funded by a grant from the Australian National Health and Medical Research Council (no. 457432). Some additional financial support was provided by Cancer Australia.
We are grateful to the organisations which assisted with access to and recruitment of community informants and research participants: CanRevive; Healthpac Medical Centre; Multicultural Cancer Information Service, Cancer Council NSW; St. George Hospital; Prince of Wales Hospital; Chinese Cancer Support VIC; Cancer Information Support Service, Cancer Council VIC, Peter MacCallum Cancer Centre. We would also like to thank Dr. Winston Liauw, Dr. Craig Lewis, Seije Gutierrez, Dr. Ven Tan, Eleanor Yip, Norma Leung, Gunjan Tripathi, Dorothy Yui, Anna Epifanio, Doreen Akkerman, Elizabeth Ballinger and Alison Hocking for assistance with identification of potential participants. We are most grateful to our members of community advisory boards who have provided invaluable advice on community engagement, interpretation of qualitative data and study procedures. Respectively they are (1) Greek Advisory Board: Nicole Komninou, Fr. Sophronios Konidaris, Maria Petrohilos, Bill Gonopoulos, Dr. Peter Calligeros, Elfa Moraitakis; (2) Chinese Advisory Board: Wendy Wang, Theresa Chow, Daniel Chan, Viola Yeung, Dr. Agnes Li, Hudson Chen, Dr. Ven Tan, Nancy Tam, Soo See Yeo, Prof. Richard Chye; (3) Arabic Advisory Board: Fr. Antonios Kaldas, Mona Saleh, Seham Gerges, Katya Nicholl.
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