The (Co)Production of Difference in the Care of Patients With Cancer From Migrant Backgrounds

Abstract

An extensive body of scholarship focuses on cultural diversity in health care, and this has resulted in a plethora of strategies to “manage” cultural difference. This work has often been patient-oriented (i.e., focused on the differences of the person being cared for), rather than relational in character. In this study, we aimed to explore how the difference was relational and coproduced in the accounts of cancer care professionals and patients with cancer who were from migrant backgrounds. Drawing on eight focus groups with 57 cancer care professionals and one-on-one interviews with 43 cancer patients from migrant backgrounds, we explore social relations, including intrusion and feelings of discomfort, moral logics of rights and obligation, and the practice of defaulting to difference. We argue, on the basis of these accounts, for the importance of approaching difference as relational and that this could lead to a more reflexive means for overcoming “differences” in therapeutic settings.

Social Representations of Immigrant Patients: Physicians’ Discourse

“…The above results demonstrate the dispersion of prejudiced ideologies within the health system that inhibit the access to health for immigrants and legalize a diminished quality of health provision toward immigrants. This is in line with findings of previous studies that examined health provision with regard to immigration in other countries (Ahlberg et al, 2019; Hamed et al, 2020; Shrestha-Ranjit et al, 2020) and supported that health provision is influenced by social and political determinants (Broom et al, 2020). This is especially important as the dispersion of prejudice in health systems creates and nurtures inequalities leading into further marginalization of immigrant groups.…”

Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review

“…In addition, clinicians report a context of inadequate support, resources and significant time constraints that restrict their ability to provide equitable care. These factors create a situation where CALD migrant populations are less informed about their health and treatment options, have difficulty communicating their concerns, find health services challenging to navigate and receive poorer quality care across many areas of the cancer care continuum [ 86 , 87 , 89 , 93 ]. This demonstrates a culturally dominant model of care is not adequate in promoting equitable care for all populations and that targeted, culturally and linguistically responsive services, which support both patients and clinicians, are critical to equity [ 4 ].…”

Personhood, belonging, affect and affliction

“…It's very internal, where I just want to navigate this, and take on the experience The gratitude-responsibility dialectic was a key mediating logic across many of these stories. The moralities of care -in this case from migrant cancer patients -interplay with the normative dimensions of cancer more broadly (Broom & Kenny, 2021;Broom et al, 2020), including ideas about the intersections of the privilege of getting (good) care and the vitality of a positive attitude. In pointing out the moral layers of participants' narratives, we seek, not to challenge their importance/effects, nor valorise the migrant experience, but rather, untangle how they can be subtly involved in the formation of personhood at its intersection with care.…”