Perspectives of oncology health workers in Flanders on caring for patients of non-Western descent

Linguistic barriers in communication between oncologists and cancer patients with migration background in Germany: an explorative analysis based on the perspective of the oncologists from the mixed-methods study POM

OBJECTIVE

We aimed at investigating the predictors of linguistic barriers among office-based haemato-oncologists during consultation with migrant cancer patients in Germany.

METHODS

Physicians from haemato-oncological practices were invited to participate in a cross-sectional study. Linguistic barriers and family factors were ascertained using a newly developed online-questionnaire with the scales "Overall linguistic barriers", "Self-perceived linguistic barriers" and "Family factors - antagonistic behaviour". Predictors of linguistic barriers were identified using multivariate ANOVA via step-wise backwards selection.

RESULTS

Fifty-five physicians participated in the study. Treating patients from Sub-Saharan Africa predicted higher overall and self-perceived linguistic barriers (F [2,46] = 4.51, p = .04; and F [3,45] = 5.44, p = .02, respectively). Working in an single practice (F [3,45] = 4.19; p = .05) predicted higher self-perceived linguistic barriers. Employees who could act as translators predicted lower barriers in form of antagonistic behaviour from relatives (F [2,48] = 6.12; p = .02).

CONCLUSIONS

The results indicate that linguistic barriers are affected by the level of linguistic concordance between patients and medical personnel. A temporary solution might be the presence of linguistically competent personnel in the practice. However, the results of this study highlight the need for greater availability of linguistic competent translators for consultations in haemato-oncological practices.

Oncology healthcare provider perspectives on caring for diverse patients fifteen years after Unequal Treatment

OBJECTIVE

The purpose of this study was to provide a snapshot of U.S. oncology provider perspectives on caring for diverse patients, including self-rated awareness, comfort, skills, practices, challenges, facilitators, and barriers.

METHODS

An online survey was administered to a convenience sample of multidisciplinary oncology providers. Descriptive statistics and bivariate analyses were computed for Likert-style items to investigate differences by level of past diversity training. Qualitative content analysis was conducted on open-response questions.

RESULTS

Roughly one-third (36.7%) of the 406 survey respondents reported receiving high levels of past diversity training, with statistically significant differences by training amount for self-rated skills and select awareness and practice items (p < 0.05). Key challenges qualitatively described included language barriers (n = 143) and alternative health beliefs (n = 52). Knowledge and training (n = 62), interpretation services (n = 53), and staff attitudes (n = 46) were the most frequently mentioned factors affecting culturally sensitive care.

CONCLUSION

Fifteen years after the publication of Unequal Treatment, the National Academies' landmark report on healthcare disparities, oncology healthcare providers have ongoing challenges caring for diverse patients and opportunities to implement recommendations from the report.

PRACTICE IMPLICATIONS

Content of diversity trainings should focus on identified gaps and practical challenges. Multi-level supports are needed, including resources and training for oncology providers.