Prognostic communication preferences of migrant patients and their relatives

Mitchison, Deborah; Butow, Phyllis; Sze, Ming; Aldridge, Lynley; Hui, Rina; Vardy, Janette; Eisenbruch, Maurice; Iedema, Rick; Goldstein, David

doi:10.1002/pon.1923

Cited by 58 publications

(82 citation statements)

References 36 publications

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“…If even two Western cultures differ, more divergent cultures may have greater differences. People from Eastern and some European cultures have been reported to prefer non-disclosure of prognostic information [40,41], although we found in a recent qualitative study of Chinese, Arabic and Greek immigrants in Australia with incurable cancer, that the majority of patients preferred open disclosure [42]. Direct comparisons of different cultures using identical interview schedules, as done here, would usefully add to the cross-cultural literature on these topics.…”

Section: Discussionmentioning

confidence: 69%

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

Walczak

Butow

Davidson

et al. 2013

Patient Education and Counseling

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Objective: to explore patients' perspectives across two cultures (Australia and USA) regarding communication about prognosis and end-of-life care issues and to consider the ways in which these discussions can be optimised.Methods: Fifteen Australian and 11 US patients completed individual semi-structured qualitative interviews. A further 8 US patients participated in a focus group. Interviews and focus group recordings were transcribed verbatim and interpreted using thematic text analysis with an inductive, data-driven approach.Results: Global themes identified included readiness for and outcomes of discussions of prognosis and end-of-life issues. Contributing to readiness were sub themes including patients' adjustment to and acceptance of their condition (together with seven factors promoting this), doctor and patient communication skills, mutual understandings and therapeutic relationship elements. Outcomes included sub themes of achievement of control and ability to move on. A model of the relationships between these factors, emergent cross cultural differences, and how factors may help to optimise these discussions are presented. Conclusion: Identified optimising factors illustrate Australian and US patients' perspectivesregarding how prognosis and end-of-life issues can be discussed with minimised negative impact.Practice Implications: Recognition of factors promoting adjustment, acceptance and readiness and use of the communication skills and therapeutic relationship elements identified may assist in optimising discussions and help patients plan care, achieve more control of their situation and enjoy an optimal quality-of-life.

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Section: Discussionmentioning

confidence: 69%

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

Walczak

Butow

Davidson

et al. 2013

Patient Education and Counseling

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“…Participants were eligible to participate if they were a first generation migrant from a Chinese (Cantonese or Mandarin), Greek or Arabic speaking country, had one of these languages as their first language, was aged 18 years or over and had been diagnosed with cancer within the previous three years or cared for a patient diagnosed within the preceding three years. These cultural groups were chosen as they represent the largest immigrant groups to Australia [12].…”

Section: Participantsmentioning

confidence: 99%

“…Other studies suggest migrants' information preferences are dependent upon their level of acculturation [11,12]. However little is known about the preferences of migrants with cancer to participate in treatment decision-making discussions.…”

Section: Introductionmentioning

confidence: 99%

Treatment decision making experiences of migrant cancer patients and their families in Australia

Shaw¹,

Zou²,

Butow³

2015

Patient Education and Counseling

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Objective: To explore treatment decision-making experiences of Australian migrants with cancer from Arabic, Chinese, or Greek backgrounds and their relatives.Methods: 73 patients and 18 caregivers from cancer support groups and oncology clinics participated in either a focus group (n=14) or semi-structured interview (n=21) conducted in the participant's own language. Participant treatment decision-making preferences were discussed as part of patients' overall treatment experience and a thematic analysis conducted.Results: Four main themes emerged from the data:(1) perceived role of the patient in decision-making;(2) access to information and the impact of language; (3)cultural influences (4)family involvement. The majority of participants experienced passive involvement during treatment consultations, but expressed a desire for greater involvement. Language rather than culture was a greater obstacle to active participation. Difficulty communicating effectively in English was the most significant barrier to participation in treatment decisions. To overcome language challenges, participants actively sought information from alternative sources. Conclusion and practice implications:This study provides new insights into the influence of language and culture on the treatment decision-making experiences of migrants with cancer and their families within the Australian cancer care system. To reduce health disparities doctors need to address language difficulties and be aware of cultural differences.

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“…32 In cultures where knowledge of diagnosis and prognosis is thought to be detrimental to the patient's wellbeing, family members may prefer the physician not to speak frankly with the patient. [42][43][44] Oncologists practicing in non-Western countries may be more likely to comply with such family requests.…”

Section: Patient Factorsmentioning

confidence: 99%

Deciding what information is necessary: do patients with advanced cancer want to know all the details?

Ward¹,

Russell²

2011

CMAR

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Abstract:Communicating effectively with patients who have advanced cancer is one of the greatest challenges facing physicians today. Whilst guiding the patient through complex diagnostic and staging techniques, treatment regimens and trials, the physician must translate often imprecise or conflicting data into meaningful personalized information that empowers the patient to make decisions about their life and body. This requires understanding, compassion, patience, and skill. This narrative literature review explores current communication practices, information preferences of oncology patients and their families, and communication strategies that may assist in these delicate interactions. Overwhelmingly, the literature suggests that whilst the majority of patients with advanced cancer do want to know their diagnosis and receive detailed prognostic information, this varies not only between individuals but also for a given individual over time. Barriers to the delivery and understanding of information exist on both sides of the physician-patient relationship, and family dynamics are also influential. Despite identifiable trends, the information preferences of a particular patient cannot be reliably predicted by demographic, cultural, or cancer-specific factors. Therefore, our primary recommendation is that the physician regularly asks the patient what information they would like to know, who else should be given the information and be involved in decision making, and how that information should be presented.

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Prognostic communication preferences of migrant patients and their relatives

Cited by 58 publications

References 36 publications

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

Treatment decision making experiences of migrant cancer patients and their families in Australia

Deciding what information is necessary: do patients with advanced cancer want to know all the details?

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