Perspectives of oncology nurses and oncologists regarding barriers to working with patients from a minority background: Systemic issues and working with interpreters

Abstract

This study aimed to ascertain the systemic barriers encountered by oncology health professionals (HPs) working with patients from ethnic minorities to guide the development of a communication skills training programme. Twelve medical and five radiation oncologists and 21 oncology nurses were invited to participate in this qualitative study. Participants were interviewed individually or in a focus group about their experiences working with people from minority backgrounds. All interviews were transcribed verbatim and analysed thematically. HPs encountered language and communication barriers in their interactions with patients and their families, which were perceived to impact negatively on the quality and amount of information and support provided. There was a shortage of, and poor processes for engaging, interpreters and some HPs were concerned about the accuracy of interpretation. HPs expressed a need for training in cultural awareness and communication skills with a preference for face-to-face delivery. A lack of funding, a culture of "learning on the job", and time constraints were systemic barriers to training. Oncologists and oncology nurses encounter complex challenges in clinical interactions with minority patients and their families, including difficulties working with interpreters. Formal training programmes targeted to the development of culturally competent communication skills are required.

Chinese‐Australian women with breast cancer call for culturally appropriate information and improved communication with health professionals

“…The problems with interpreter services identified in the current study are noteworthy. Consistent with other literature, participants expressed concerns about the quality of interpretation, specifically issues with accuracy, omission, and communication of emotional messages. Availability of interpreters and the impact of appointment scheduling were also identified, highlighting that there are logistic as well as quality barriers to engaging with such services.…”

“…Furthermore, several studies report errors of omission and inaccuracy, which seem to be more prevalent in consultations involving the presentation of prognostic information . Interpreters are also not always accessible when required or available in the range of language groups . Despite the significant communication challenges, Chinese migrants in Australia and the United States have also shared positive experiences where they felt comfortable with the interpreter and spoke favorably about their interaction with their doctor …”

Exploring the incidence of culturally responsive communication in Australian healthcare: the first rapid review on this concept

“…Availability of resources and literature in relevant languages with appropriate graphics is also a factor indicating a commitment to culturally responsive communication [32,34,37,38,40,41,43,45,46,49,50]. The employment of culturally diverse staff reflecting the represented cultures of its service users [26, 28-30, 37, 40, 45, 46], along with the availability and use of quality interpreter services contribute to the ability to achieve culturally responsive communication [12,26,28,29,32,34,41,45,46,49,50]. The literature revealed that healthcare practitioners often cited interpreters as the cause of miscommunications, affecting their inability to achieve culturally responsive care and communication [12,26,28,32,34,46].…”

“…The characteristics that a healthcare practitioner must display to achieve culturally responsive communication include: self-reflection and reflexivity [12, 27, 28, 36-41, 44, 45, 50], flexibility [28,37,41,44,45], self-and otherawareness [28,36,37,40], being respectful [12,34,35, 38,40,42,44,48], being trustworthy [12,27,34,44], being honest and transparent [34,37,38,42,44], being non-judgmental [27,35,37,38] and have a willingness to learn [12,32,40,41,44,46].…”

Clinical trials, culture and language: More than meets the eye?

“…Translators are often difficult to organize, and even if they are present, patients may have difficulty remembering the information they were given. 10 Health professionals report that they are uncertain if they will be able to obtain confirmed consent, and therefore may spend precious time explaining a trial to another patient.…”