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Burke C, Doody O, Lloyd B. Healthcare practitioners' perspectives of providing palliative care to patients from culturally diverse backgrounds: a qualitative systematic review. BMC Palliat Care 2023; 22:182. [PMID: 37978500 PMCID: PMC10655398 DOI: 10.1186/s12904-023-01285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Palliative care practitioners are increasingly caring for patients and families from diverse cultural backgrounds. There is growing awareness of the influence of culture on many aspects of care in the palliative phase of an illness. However, disparities have been noted in the provision of palliative care to patients from culturally diverse backgrounds and challenges have been reported in meeting their needs and those of their families. METHOD A qualitative systematic review of research papers identified through searching four databases. Papers were screened against inclusion criteria within the timeframe of January 2012 to March 2022. Data was extraction from all included studies and methodological quality assessed utilising the Critical Appraisal Skills Programme Tool. Thematic analysis followed Braun and Clarke's framework and the review is reported in line with PRISMA guidelines. FINDINGS The search yielded 1954 results of which 26 were included for appraisal and review. Four themes were identified: communication and connection, the role of the family in death and dying, the role of education in addressing uncertainty, and institutional and societal factors. The findings highlighted challenges of communication and a fear of acting in a culturally insensitive way, the pivotal role of the family, the need for an individualised approach to care, the universality of needs when approaching end of life and the need for education of practitioners. CONCLUSION These findings suggest that healthcare practitioners draw on their existing skills to adapt their practice to meet the needs of patients from culturally diverse backgrounds. However, results also indicate a need for further education and identification of educational approaches best suited to supporting healthcare professionals in practice.
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Affiliation(s)
- Colette Burke
- Milford Care Centre, Castletroy, Limerick, V94 H795, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Barbara Lloyd
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, V94 T9PX, Ireland.
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2
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Marino F, Alby F, Zucchermaglio C, Scalisi TG, Lauriola M. Navigating Intercultural Medical Encounters: An Examination of Patient-Centered Communication Practices with Italian and Foreign Cancer Patients Living in Italy. Cancers (Basel) 2023; 15:cancers15113008. [PMID: 37296970 DOI: 10.3390/cancers15113008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Effective communication is crucial in cancer care due to the sensitive nature of the information and the psychosocial impact on patients and their families. Patient-centered communication (PCC) is the gold standard for providing quality cancer care, as it improves patient satisfaction, treatment adherence, clinical outcomes, and overall quality of life. However, doctor-patient communication can be complicated by ethnic, linguistic, and cultural differences. This study employed the ONCode coding system to investigate PCC practices in oncological visits (doctor's communicative behavior, patient's initiatives, misalignments, interruptions, accountability, and expressions of trust in participants' talk, Markers of uncertainty in doctor's talk, markers of emotions in doctor's talk). Forty-two video-recorded patient-oncologist encounters (with 22 Italian and 20 foreign patients), including both first and follow-up visits, were analyzed. Three discriminant analyses were conducted to assess differences in PCC between patient groups (Italian or foreign patients) according to the type of encounter (first visit or follow-up) and the presence or absence of companions during the encounters. Multiple regression analyses were performed to evaluate the PCC differences by oncologist age, patient age, and patient sex, controlling for the type of encounter, the presence of a companion during the visit, and patient group on ONCode dimensions. No differences were found in PCC by patient group in discriminant analyses and regressions. Doctor communication behavior, interruptions, accountability, and expressions of trust were higher in first visits than in follow-ups. The disparities in PCC were primarily linked to the type of visit and the age of the oncologist. However, a qualitative analysis showed notable differences in the types of interruptions during visits with foreign patients compared to Italian patients. It is essential to minimize interruptions during intercultural encounters to foster a more respectful and conducive environment for patients. Furthermore, even when foreign patients demonstrate sufficient linguistic competence, healthcare providers should not solely rely on this factor to ensure effective communication and quality care.
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Affiliation(s)
- Filomena Marino
- Department of Social and Developmental Psychology, Sapienza Università di Roma, 00185 Roma, Italy
| | - Francesca Alby
- Department of Social and Developmental Psychology, Sapienza Università di Roma, 00185 Roma, Italy
| | - Cristina Zucchermaglio
- Department of Social and Developmental Psychology, Sapienza Università di Roma, 00185 Roma, Italy
| | - Teresa Gloria Scalisi
- Department of Social and Developmental Psychology, Sapienza Università di Roma, 00185 Roma, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza Università di Roma, 00185 Roma, Italy
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3
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Murong M, Giannopoulos E, Pirrie L, Giuliani ME, Fazelzad R, Bender J, Jones J, Papadakos J. The Experience of Informal Newcomer Cancer Caregivers with Limited Language Proficiency: A Scoping Review. J Immigr Minor Health 2023; 25:436-448. [PMID: 36538206 DOI: 10.1007/s10903-022-01442-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
This scoping review explored what is known about the experiences of informal cancer caregivers (CGs) who are newcomers with limited language proficiency. A literature search was performed in seven databases and the search yielded 11,289 articles. After duplicate removal and title and abstract screening, 216 articles underwent full text review and 57 articles and were synthesized. Most studies (n = 41, 72%) were qualitative and were published in North America (n = 35, 61%). Most CG participants were female (69%) and only 19 studies explicitly identified the CG country of origin. Of those that did, 26% originated from Asia, with most migrating from East Asia. Significant challenges were experienced by newcomer CGs and chief among these were related to communication challenges with HCPs that were exacerbated by a lack of availability of medical interpreters and the complexity of oncology health information. Efforts are needed to better integrate newcomer CGs into cancer care.
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Affiliation(s)
- Mijia Murong
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Eleni Giannopoulos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
| | - Lorraine Pirrie
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Meredith Elana Giuliani
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada.,The Institute for Education Research, University Health Network, Toronto, Canada.,Department of Radiation of Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Rouhi Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jacqueline Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Janet Papadakos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada. .,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. .,The Institute for Education Research, University Health Network, Toronto, Canada.
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4
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Nic Giolla Easpaig B, Tran Y, Winata T, Lamprell K, Fajardo Pulido D, Arnolda G, Delaney GP, Liauw W, Smith K, Avery S, Rigg K, Westbrook J, Olver I, Currow D, Girgis A, Karnon J, Ward RL, Braithwaite J. Providing outpatient cancer care for CALD patients: a qualitative study. BMC Res Notes 2021; 14:304. [PMID: 34372907 PMCID: PMC8350263 DOI: 10.1186/s13104-021-05724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE There have been few descriptions of how outpatient cancer care is provided to patients from culturally and linguistically diverse (CALD) communities. As populations who experience disparities in cancer care access and outcomes, deeper understanding is needed to help identify those factors which can shape the receipt of multidisciplinary care in ambulatory settings. This paper reports on data collected and analysed as part of a multicentre characterisation of care in Australian public hospital cancer outpatient clinics (OPCs). RESULTS Analysis of data from our ethnographic study of four OPCs identified three themes: "Identifying CALD patient language-related needs"; "Capacity and resources to meet CALD patient needs", and "Making it work for CALD communities." The care team comprises not only clinicians but also families and non-clinical staff; OPCs serve as "touchpoints" facilitating access to a range of therapeutic services. The findings highlight the potential challenges oncology professionals negotiate in providing care to CALD communities and the ways in which clinicians adapt their practices, formulate strategies and use available resources to support care delivery.
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Affiliation(s)
- Bróna Nic Giolla Easpaig
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Teresa Winata
- Infant, Child and Adolescent Mental Health Services, Liverpool Hospital, Liverpool, NSW Australia
| | - Klay Lamprell
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Diana Fajardo Pulido
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Gaston Arnolda
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Geoff P. Delaney
- South-Western Sydney Local Health District, Liverpool, NSW Australia
- South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Winston Liauw
- St. George Cancer Care Centre, St. George Hospital, Kogarah, NSW Australia
- St. George Hospital Clinical School, University of New South Wales, Sydney, NSW Australia
| | - Kylie Smith
- South-Western Sydney Local Health District, Liverpool, NSW Australia
| | - Sandra Avery
- South-Western Sydney Local Health District, Liverpool, NSW Australia
| | - Kim Rigg
- St. George Cancer Care Centre, St. George Hospital, Kogarah, NSW Australia
| | - Johanna Westbrook
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Ian Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA Australia
| | - David Currow
- College of Medicine and Public Health, Flinders University, Adelaide, SA Australia
- Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Afaf Girgis
- South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Adelaide, SA Australia
| | - Robyn L. Ward
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
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5
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Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review. Global Health 2021; 17:87. [PMID: 34321015 PMCID: PMC8318324 DOI: 10.1186/s12992-021-00737-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
International evidence suggests migrants experience inequitable access, outcomes and treatment quality across the cancer care continuum. There is currently limited research assessing equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia. A detailed protocol and search strategy were developed and used to identify all relevant literature, utilising the Joanna Briggs Institute Reviewer’s Manual. Systematic searching was conducted via multiple databases and identified studies were screened against pre-identified inclusion and exclusion criteria. 71 studies met the inclusion criteria for analysis. Most studies examined cancer detection via screening. Very few studies examined cancer prevention, diagnosis, treatment or palliative care. Most studies focused on patient-sided barriers to care and there was a paucity of information regarding institutional barriers to health. Cancer-related outcomes were seldom examined, and most studies were qualitative or behavioral analysis. Results highlighted significant communication issues spanning the cancer care continuum and a context of inadequate support for both patients and clinicians. There is a demonstrable need to examine equity in access and outcomes for culturally and linguistically diverse cancer populations. This requires the identification of cancer-related disparities and an examination of institutional barriers to care. Through addressing this dearth of information, future research and health policy can support the operationalisation of health equity.
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Affiliation(s)
- Brighid Scanlon
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia. .,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.
| | - Mark Brough
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
| | - David Wyld
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia.,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.,University of Queensland, 20 Weightman Street, QLD, 4006, Herston, Australia
| | - Jo Durham
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
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6
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Suarez NRE, Urtecho M, Jubran S, Yeow ME, Wilson ME, Boehmer KR, Barwise AK. The Roles of medical interpreters in intensive care unit communication: A qualitative study. PATIENT EDUCATION AND COUNSELING 2021; 104:1100-1108. [PMID: 33168459 PMCID: PMC8068732 DOI: 10.1016/j.pec.2020.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To understand healthcare team perceptions of the role of professional interpreters and interpretation modalities during end of life and critical illness discussions with patients and families who have limited English proficiency in the intensive care unit (ICU). METHODS We did a secondary analysis of data from a qualitative study with semi-structured interviews of 16 physicians, 12 nurses, and 12 professional interpreters from 3 ICUs at Mayo Clinic, Rochester. RESULTS We identified 3 main role descriptions for professional interpreters: 1) Verbatim interpretation; interpreters use literal interpretation; 2) Health Literacy Guardian; interpreters integrate advocacy into their role; 3) Cultural Brokers; interpreters transmit information incorporating cultural nuances. Clinicians expressed advantages and disadvantages of different interpretation modalities on the professional interpreter's role in the ICU. CONCLUSION Our study illuminates different professional interpreters' roles. Furthermore, we describe the perceived relationship between interpretation modalities and the interpreter's roles and influence on communication dynamics in the ICU for patients with LEP. PRACTICE IMPLICATIONS Patients benefit from having an interpreter, who can function as a cultural broker or literacy guardian during communication in the ICU setting where care is especially complex, good communication is vital, and decision making is challenging.
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Affiliation(s)
| | - Meritxell Urtecho
- Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, Minnesota, USA.
| | - Samira Jubran
- Language Services, Mayo Clinic, Rochester, Minnesota, USA.
| | - Mei-Ean Yeow
- Center For Palliative Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Michael E Wilson
- Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Kasey R Boehmer
- Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, Minnesota, USA.
| | - Amelia K Barwise
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, USA.
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7
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Gerchow L, Burka LR, Miner S, Squires A. Language barriers between nurses and patients: A scoping review. PATIENT EDUCATION AND COUNSELING 2021; 104:534-553. [PMID: 32994104 PMCID: PMC8011998 DOI: 10.1016/j.pec.2020.09.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/05/2020] [Accepted: 09/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers. METHODS A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists. RESULTS 48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions. CONCLUSION Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload. PRACTICE IMPLICATIONS This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.
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Affiliation(s)
- Lauren Gerchow
- New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY, USA.
| | - Larissa R Burka
- New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY, USA
| | - Sarah Miner
- St. John Fisher College Wegmans School of Nursing, 3690 East Ave, Rochester, NY, USA
| | - Allison Squires
- New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY, USA
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8
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Finazzi T, Papachristofilou A, Zimmermann F. "Connection Failed": A Word of Caution on Telemedicine in Radiation Oncology. Int J Radiat Oncol Biol Phys 2020; 108:435-437. [PMID: 32890527 PMCID: PMC7462966 DOI: 10.1016/j.ijrobp.2020.06.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/21/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Tobias Finazzi
- Clinic of Radiotherapy and Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Frank Zimmermann
- Clinic of Radiotherapy and Radiation Oncology, University Hospital Basel, Basel, Switzerland
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9
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Quantifying the Language Barrier-A Total Survey of Parents' Spoken Languages and Local Language Skills as Perceived by Different Professions in Pediatric Palliative Care. CHILDREN-BASEL 2020; 7:children7090118. [PMID: 32882877 PMCID: PMC7552692 DOI: 10.3390/children7090118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/16/2020] [Accepted: 08/28/2020] [Indexed: 12/20/2022]
Abstract
To date, there are no specific figures on the language-related characteristics of families receiving pediatric palliative care. This study aims to gain insights into the languages spoken by parents, their local language skills and the consistency of professional assessments on these aspects. Using an adapted version of the “Common European Framework of Reference for Languages”, the languages and local language skills of parents whose children were admitted to an inpatient pediatric palliative care facility (N = 114) were assessed by (a) medical staff and (b) psychosocial staff. Nearly half of the families did not speak the local language as their mother tongue. The most frequently spoken language was Turkish. Overall, the medical staff attributed better language skills to parents than the psychosocial staff did. According to them, only 27.0% of mothers and 38.5% of fathers spoke the local language at a high level while 37.8% of mothers and 34.6% of fathers had no or rudimentary language skills. The results provide important information on which languages pediatric palliative care practitioners must be prepared for. They sensitize to the fact that even within an institution there can be discrepancies between the language assessments of different professions.
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10
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Skaczkowski G, Pejoski N, Kaur J, White V, Livingston PM, Wilson C. Distress and problem assessment among people living with cancer from Culturally and Linguistically Diverse backgrounds. Psychooncology 2020; 29:1662-1669. [PMID: 32748467 DOI: 10.1002/pon.5503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/07/2020] [Accepted: 07/22/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine whether routine assessment of distress, recommended as part of comprehensive cancer care, is utilised equally with culturally and linguistically diverse (CALD) vs non-CALD people living with cancer. METHODS A medical records review of all patients attending cancer-specific treatment units at a single tertiary hospital in Melbourne, Australia between 2015-2018. Recording of administration of the Distress Thermometer and Problem Checklist (DT and PC) was extracted for all patients. Details regarding how the DT and PC (used together) was administered were extracted for a random sub-sample of 294 CALD patients and 294 matched non-CALD patients. RESULTS A total of 6977 patients were identified (12.0% CALD). Just over half of the CALD (54.7%) and non-CALD (58.2%) patients had a recorded DT and PC (P > 0.05). For the sub-sample analysis, CALD patients were less likely to complete the form themselves (14.8% vs 75.9% non-CALD) and were more likely to have a family member complete the form (55.1% vs 15.1% non-CALD). CALD patients reported a similar level of distress to non-CALD patients. Distress scores for CALD and non-CALD patients were higher when family members completed the form. Provision of discussion, written information, referral offers and rates of referral acceptance were similar between CALD and non-CALD patients. CONCLUSIONS Assessment of distress and associated problems, and the process following assessment, were similar for CALD and non-CALD patients. However, differences in how the form was completed highlight the need for further improvements to ensure that CALD patients are actively involved in their care.
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Affiliation(s)
- Gemma Skaczkowski
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia.,Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia.,Department of Rural Health, Allied Health and Human Performance, University of South Australia, Melbourne, Australia
| | - Natalie Pejoski
- Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia
| | - Jasmeen Kaur
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Victoria White
- School of Psychology, Deakin University, Melbourne, Australia
| | - Patricia M Livingston
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Melbourne, Australia
| | - Carlene Wilson
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia.,Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia
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11
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Levesque JV, Gerges M, Wu VS, Girgis A. Chinese-Australian women with breast cancer call for culturally appropriate information and improved communication with health professionals. Cancer Rep (Hoboken) 2020; 3:e1218. [PMID: 32671993 DOI: 10.1002/cnr2.1218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/13/2019] [Accepted: 08/20/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND For culturally and linguistically diverse patients, breast cancer presents complex physical, psychosocial, and health care challenges, often exacerbated by a lack of culturally appropriate information and communication barriers with the treating team (even with the help of interpreters). AIM This qualitative study aims to broadly explore the experience of breast cancer and coping strategies utilized by Chinese-Australian women. METHODS AND RESULTS Twenty-four Chinese-Australian women with breast cancer participated in either a semi-structured interview or a focus group conducted in participants' preferred language, audio-recorded, transcribed, and subjected to thematic analysis. Two prominent themes emerged, related to information seeking, and communication with health care professionals. The theme of information needs and seeking highlighted unmet information needs and the multiple sources that are consulted for information. The second theme, communication with health care professionals, language barriers, and preferences, identified varying degrees of involvement in treatment decision-making, preference for information and interactions in Cantonese or Mandarin, and problems with interpreter services. CONCLUSION Chinese women with breast cancer face significant challenges in obtaining adequate information and can feel excluded from treatment decision-making. Women in this study expressed their eagerness for obtaining accurate information and engaging in open communication with their doctors. There is a need for culturally sensitive information resources and decision aids to enhance communication between Chinese migrant patients with cancer and health care professionals. Clinician participation in cultural awareness training is also recommended.
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Affiliation(s)
- Janelle V Levesque
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Martha Gerges
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Verena S Wu
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
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12
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Minnican C, O’Toole G. Exploring the incidence of culturally responsive communication in Australian healthcare: the first rapid review on this concept. BMC Health Serv Res 2020; 20:20. [PMID: 31910837 PMCID: PMC6947994 DOI: 10.1186/s12913-019-4859-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/22/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Increasing diversity in Australia requires healthcare practitioners to consider the cultural, linguistic, religious, sexual and racial/ethnic characteristics of service users as integral components of healthcare delivery. This highlights the need for culturally appropriate communication and care. Indeed the Australian Government in various policies mandates culturally responsive communication. Therefore this paper aims to provide a brief overview of Australian healthcare literature exploring the components; prevalence and effects of this style of communication in healthcare. METHODS A rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on the components, prevalence and outcomes of culturally responsive communication in Australian healthcare, published in English between 2008 and 2018. Articles were reviewed using reliable critical appraisal procedures. RESULTS Twenty- six articles were included in the final review (23 qualitative studies; 2 systematic reviews; 1 mixed methods study). The literature indicates knowledge of the positive effects of culturally responsive communication in healthcare. It also highlights the disparity between the perceptions of healthcare practitioners and services users over the existence and components of culturally responsive communication in healthcare. The review identified a limited use of this style of communication, but rather a focus on barriers to culturally appropriate care, lacking an awareness of the importance of culturally responsive communication in this care. CONCLUSION While literature suggests the importance and positive effects of culturally responsive communication, evidence suggests inconsistent implementation of this style of communication within Australian healthcare settings. This has implications for the outcomes of healthcare for the diverse population in Australia.
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Affiliation(s)
| | - Gjyn O’Toole
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
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Coetzee D, Pereira AG, Scheurer JM, Olson APJ. Medical Student Workshop Improves Student Confidence in Working With Trained Medical Interpreters. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520918862. [PMID: 32440571 PMCID: PMC7227139 DOI: 10.1177/2382120520918862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Many physicians care for patients whose primary spoken language is not English, and these interactions present challenges in physician-patient communication. These challenges contribute to the significant health disparities experienced by populations with limited English proficiency (LEP). Using trained medical interpreters is an important step in addressing this problem, as it improves communication outcomes. Despite this, many medical education programs have little formal instruction on how to work effectively with interpreters. METHODS To address this gap, we created an interactive workshop led by professional trained interpreters and faculty facilitators for medical students in their clinical years. Students were asked to evaluate the session based on relevance to their clinical experiences and helpfulness in preparing them for interactions with patients with LEP. RESULTS Immediately after the session, students reported that the clinical scenarios presented were similar those seen on their clinical clerkships. They also reported increased confidence in their ability to work with interpreters. On later follow-up, students reported that the instruction helped prepare them for subsequent patient interactions that involved interpreters. CONCLUSION A workshop is an effective method for improving medical student comfort and confidence when working with interpreters for populations with LEP.
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Affiliation(s)
- Donna Coetzee
- Department of Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Anne G. Pereira
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Johannah M Scheurer
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Andrew PJ Olson
- Department of Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
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Villalobos AVK, Phillips S, Zhang Y, Crawbuck GSN, Pratt-Chapman ML. Oncology healthcare provider perspectives on caring for diverse patients fifteen years after Unequal Treatment. PATIENT EDUCATION AND COUNSELING 2019; 102:1859-1867. [PMID: 31056266 DOI: 10.1016/j.pec.2019.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Aubrey V K Villalobos
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Serena Phillips
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Yuqing Zhang
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Graham S N Crawbuck
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Mandi L Pratt-Chapman
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA.
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Evaluation of an online communication skills training programme for oncology nurses working with patients from minority backgrounds. Support Care Cancer 2018; 27:1951-1960. [DOI: 10.1007/s00520-018-4507-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/09/2018] [Indexed: 12/28/2022]
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