Skip to main content
Log in

Identifying the informational and psychosocial needs of Chinese immigrant cancer patients: a focus group study

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The Chinese immigrant community faces multiple barriers to quality cancer care and cancer survivorship. Psychosocial interventions can positively impact quality of life, anxiety, and distress in cancer patients. In this study, we explored the informational and psychosocial needs of Chinese cancer patients to inform the development of culturally targeted support and survivorship interventions.

Methods

We conducted four focus groups with a total of 28 Chinese cancer patients to elucidate their cancer informational and psychosocial needs. The groups were conducted using standard methodology and guided by community-based participatory research principles. Sessions were audio recorded, transcribed, and translated into English. The research team conducted the analysis.

Results

Frequently occurring themes included (1) the need for accurate information on cancer and treatment options, (2) the role of language barriers in accessing cancer care, (3) the role of food in cancer and the need for nutritional information, and (4) the role of Chinese medicine in cancer treatment. Participants expressed significant dissatisfaction with the amount, reliability, and/or comprehensibility of available information.

Conclusions

Support groups and programs should be developed to address participants’ needs for more information on cancer and its treatment. Programs should educate and empower patients on how to find further Chinese language information and resources and effectively communicate their questions and needs to providers in an interpreted encounter. System-level approaches should be implemented to ensure provision of interpretation services. Additionally, programs should incorporate the unique cultural needs of this population related to food/nutrition and Chinese medicine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Camarota SA (2007) Immigrants in the United States, 2007: a profile of America’s foreign-born population. Center for Immigration Studies, Washington

    Google Scholar 

  2. Martin P, Midgley E (2010) Immigration in America 2010. Population Reference Bureau. http://www.prb.org/Publications/PopulationBulletins/2010/immigrationupdate1.aspx. Accessed March 2011

  3. United States Census Bureau. American Community Survey (2006) S0201. Selected population profile in the United States, Chinese alone, New York City. United States Census Bureau. http://factfinder.census.gov. Accessed May 2011

  4. McCracken M, Olsen M, Chen MS Jr, Jemal A, Thun M, Cokkinides V, Deapen D, Ward E (2007) Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities. CA Cancer J Clin 57(4):190–205

    Article  PubMed  Google Scholar 

  5. Shavers VL, Brown ML (2002) Racial and ethnic disparities in the receipt of cancer treatment. J Natl Cancer Inst 94(5):334–357

    Article  PubMed  Google Scholar 

  6. Lee-Lin F, Menon U, Pett M, Nail L, Lee S, Mooney K (2008) Measuring breast cancer and mammography screening beliefs among Chinese American immigrants. West J Nurs Res 30(7):852–868. doi:10.1177/0193945908319247

    Article  PubMed  Google Scholar 

  7. Chuang SC, Chen W, Hashibe M, Li G, Zhang ZF (2006) Survival rates of invasive breast cancer among ethnic Chinese women born in East Asia and the United States. Asian Pac j cancer prev: APJCP 7(2):221–226

    PubMed  Google Scholar 

  8. Deapen D, Liu L, Perkins C, Bernstein L, Ross RK (2002) Rapidly rising breast cancer incidence rates among Asian-American women. Int J Cancer 99(5):747–750. doi:10.1002/ijc.10415

    Article  PubMed  CAS  Google Scholar 

  9. Institute NC dictionary of cancer terms. http://cancer.gov/dictionary?CdrID=445089. Accessed May 2011

  10. Reis L, Melbert D, Krapcho M (2011) SEER cancer statistics review, 1975–2005. http://seer.cancer.gov/csr/1975_2005. Accessed April 2011

  11. Guidry JJ, Torrence W, Herbelin S (2005) Closing the divide: diverse populations and cancer survivorship. Cancer 104(11 Suppl):2577–2583. doi:10.1002/cncr.21251

    Article  PubMed  Google Scholar 

  12. Lam WW, Fielding R (2003) The evolving experience of illness for Chinese women with breast cancer: a qualitative study. Psycho-Oncology 12(2):127–140. doi:10.1002/pon.621

    Article  PubMed  Google Scholar 

  13. Ngo-Metzger Q, Massagli MP, Clarridge BR, Manocchia M, Davis RB, Iezzoni LI, Phillips RS (2003) Linguistic and cultural barriers to care. J gen intern med 18(1):44–52

    Article  PubMed  Google Scholar 

  14. Mui AC, Kang SY, Kang D, Domanski MD (2007) English language proficiency and health-related quality of life among Chinese and Korean immigrant elders. Health Soc Work 32(2):119–127

    Article  PubMed  Google Scholar 

  15. Liang W, Wang JH, Chen MY, Shibao F, Lee M, Schwartz MD, Pasick RJ, Mandelblatt JS (2008) Developing and validating a measure of Chinese cultural views of health and cancer. Health educ behav 35(3):361–375. doi:10.1177/1090198106294893

    Article  Google Scholar 

  16. Yu MY, Hong OS, Seetoo AD (2003) Uncovering factors contributing to under-utilization of breast cancer screening by Chinese and Korean women living in the United States. Ethn Dis 13(2):213–219

    PubMed  Google Scholar 

  17. MLA Language Map Data Center. Data center results: New York, New York. http://www.mla.org/map_data_results&state_id=36&place_id=51000&cty_id=. Accessed July 2011

  18. Lai DW, Chau SB (2007) Predictors of health service barriers for older Chinese immigrants in Canada. Health Soc Work 32(1):57–65

    Article  PubMed  Google Scholar 

  19. Surbone A (2008) Cultural aspects of communication in cancer care. Support care cancer 16(3):235–240. doi:10.1007/s00520-007-0366-0

    Article  PubMed  Google Scholar 

  20. Thorne SE, Hislop TG, Armstrong EA, Oglov V (2008) Cancer care communication: the power to harm and the power to heal? Patient educ couns 71(1):34–40. doi:10.1016/j.pec.2007.11.010

    Article  PubMed  Google Scholar 

  21. Lin CC (2000) Barriers to the analgesic management of cancer pain: a comparison of attitudes of Taiwanese patients and their family caregivers. Pain 88(1):7–14

    Article  PubMed  CAS  Google Scholar 

  22. Wang XS, Cleeland CS, Mendoza TR, Engstrom MC, Liu S, Xu G, Hao X, Wang Y, Ren XS (1999) The effects of pain severity on health-related quality of life: a study of Chinese cancer patients. Cancer 86(9):1848–1855. doi:10.1002/(SICI)1097-0142(19991101)86:9<1848::AID-CNCR29>3.0.CO;2-M

    Article  PubMed  CAS  Google Scholar 

  23. Lin JS, Finlay A, Tu A, Gany FM (2005) Understanding immigrant Chinese Americans’ participation in cancer screening and clinical trials. J commun health 30(6):451–466

    Article  Google Scholar 

  24. Nguyen GT, Bowman MA (2007) Culture, language, and health literacy: communicating about health with Asians and Pacific Islanders. Fam Med 39(3):208–210

    PubMed  Google Scholar 

  25. Rudd R, Kirsch I, Yamamato K (2004) Literacy and health in America

  26. Weis J (2003) Support groups for cancer patients. Support care cancer 11(12):763–768. doi:10.1007/s00520-003-0536-7

    Article  PubMed  Google Scholar 

  27. Lindemalm C, Strang P, Lekander M (2005) Support group for cancer patients. Does it improve their physical and psychological wellbeing? A pilot study. Support care cancer 13(8):652–657. doi:10.1007/s00520-005-0785-8

    Article  PubMed  CAS  Google Scholar 

  28. Kass S (1999) Breast-cancer intervention group aids physical healing, research finds. APA Monitor 30 (9)

  29. Fallowfield L (1995) Psychosocial interventions in cancer. BMJ 311(7016):1316–1317

    Article  PubMed  CAS  Google Scholar 

  30. Mok BH (2001) Cancer self-help groups in China: a study of individual change, perceived benefit, and community impact. Small Group Res 32(2):115–132

    Article  Google Scholar 

  31. Chiu L (2001) Spiritual resources of Chinese immigrants with breast cancer in the USA. Int J Nurs Stud 38(2):175–184

    Article  PubMed  CAS  Google Scholar 

  32. Shih FJ (1996) Concepts related to Chinese patients’ perceptions of health, illness and person: issues of conceptual clarity. Accid Emerg Nurs 4(4):208–215

    Article  PubMed  CAS  Google Scholar 

  33. Helgeson VS, Cohen S, Schulz R, Yasko J (1999) Education and peer discussion group interventions and adjustment to breast cancer. Arch Gen Psychiatry 56(4):340–347

    Article  PubMed  CAS  Google Scholar 

  34. Changrani J, Lieberman M, Golant M, Rios P, Damman J, Gany F (2008) Online cancer support groups: experiences with underserved immigrant Latinas. Prim Psychiatry 15(10):55–62

    Google Scholar 

  35. Krueger R, Casey MA (2008) Focus groups: a practical guide for applied research, 4th edn. Sage, Thousand Oaks

    Google Scholar 

  36. Israel BA, Schulz AJ, Parker EA, Becker AB (1998) Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health 19:173–202. doi:10.1146/annurev.publhealth.19.1.173

    Article  PubMed  CAS  Google Scholar 

  37. Kidd PS, Parshall MB (2000) Getting the focus and the group: enhancing analytical rigor in focus group research. Qual Health Res 10(3):293–308

    Article  PubMed  CAS  Google Scholar 

  38. Krueger RA (1994) Focus groups: a practicial guide for applied research. International Journal of Interpreter Education, 2nd edn. Sage, Thousand Oaks

  39. Fallowfield L, Ford S, Lewis S (1995) No news is not good news: information preferences of patients with cancer. Psycho-Oncology 4(3):197–202

    Article  PubMed  Google Scholar 

  40. Cassileth BR, Zupkis RV, Sutton-Smith K, March V (1980) Information and participation preferences among cancer patients. Ann Intern Med 92(6):832–836

    PubMed  CAS  Google Scholar 

  41. Betancourt JR (2003) Cross-cultural medical education: conceptual approaches and frameworks for evaluation. Acad Med 78:560–569

    Article  PubMed  Google Scholar 

  42. Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong OII (2003) Defining cultural competence: a practical framework for addressing racial/ethnical disparities in health and health care. Public Health Rep 188:293–302

    Google Scholar 

  43. Kagawa-Singer M (2003) A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Acad Med 78:577–587

    Article  PubMed  Google Scholar 

  44. McCune JS, Hatfield AJ, Blackburn AA, Leith PO, Livingston RB, Ellis GK (2004) Potential of chemotherapy-herb interactions in adult cancer patients. Support care cancer 12(6):454–462. doi:10.1007/s00520-004-0598-1

    Article  PubMed  Google Scholar 

  45. Lee J, Bell K (2011) The impact of cancer on family relationships among Chinese patients. J Transcult Nurs. doi:10.1177/1043659611405531

  46. Smith C, Hung LC (2012) The influence of Eastern philosophy on elder care by Chinese Americans: attitudes toward long-term care. J Transcult Nurs 23(1):100–105

    Article  PubMed  Google Scholar 

  47. Nuyen A (2004) The contemporary relevance of the Confucian idea of filial piety. J Chin Philos 31(4):433–450

    Article  Google Scholar 

  48. Huang X, Butow P, Meiser B, Goldstein D (1999) Attitudes and information needs of Chinese migrant cancer patients and their relatives. Aust N Z J Med 29(2):207–213

    Article  PubMed  CAS  Google Scholar 

  49. Liu JE, Mok E, Wong T (2005) Perceptions of supportive communication in Chinese patients with cancer: experiences and expectations. J Adv Nurs 52(3):262–270. doi:10.1111/j.1365-2648.2005.03583.x

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

This study had no specific funding. None of the authors have any conflicts of interest. The corresponding author has a full control of all primary data and agrees to allow the journal to review the data if requested.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jennifer Leng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leng, J., Lee, T., Sarpel, U. et al. Identifying the informational and psychosocial needs of Chinese immigrant cancer patients: a focus group study. Support Care Cancer 20, 3221–3229 (2012). https://doi.org/10.1007/s00520-012-1464-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-012-1464-1

Keywords

Navigation