Communicating with patients from minority backgrounds: Individual challenges experienced by oncology health professionals

Kaaren J Watts; Bettina Meiser; Elvira Zilliacus; Rajneesh Kaur; Mona Taouk; Afaf Girgis; Phyllis Butow; David Goldstein; Sandra Hale; Astrid Perry; Sanchia K Aranda; David W Kissane

doi:10.1016/j.ejon.2016.12.001

Communicating with patients from minority backgrounds: Individual challenges experienced by oncology health professionals

Eur J Oncol Nurs. 2017 Feb:26:83-90. doi: 10.1016/j.ejon.2016.12.001. Epub 2016 Dec 24.

Authors

Affiliations

¹ Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia.
² Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: b.meiser@unsw.edu.au.
³ Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia.
⁴ Psycho-Oncology Co-Operative Research Group, Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, NSW 2006, Australia.
⁵ Prince of Wales Hospital, Sydney, NSW 2031, Australia.
⁶ Faculty of Arts and Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia.
⁷ Multicultural Health Service, South Eastern Sydney Local Health District, Sydney, NSW 2217, Australia.
⁸ Cancer Council Australia, Sydney, NSW 2000, Australia.
⁹ Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3168, Australia.

PMID: 28069155
DOI: 10.1016/j.ejon.2016.12.001

Abstract

Purpose: Oncology health professionals (HPs) are increasingly required to care for patients from minority backgrounds. Yet many HPs have not had formal training in how to communicate effectively in culturally diverse settings. More information is needed about the challenges that oncology HPs face in communicating with minority patients to inform the content of formal training programs. This qualitative study aimed to identify oncology nurses' and oncologists' individual experiences and challenges in communicating with patients from minority backgrounds.

Method: Thirty-eight oncology HPs (21 oncology nurses, 12 medical oncologists, and 5 radiation oncologists) were interviewed individually or in focus groups about their experiences communicating with patients from minority backgrounds. The interviews were audio taped and analysed thematically.

Results: The majority of participants (82%) reported varying degrees of uncertainty and discomfort regarding working with minority patients, with many barriers to communication encountered. Participants perceived that minority patients received less emotional support than majority group patients. They experienced challenges in balancing beliefs about patient autonomy with cultural differences regarding the role of the family. Strategies employed by participants to facilitate interactions included: modifying speech, taking more time in consultations, rapport building, and using nonverbal techniques.

Conclusions: Oncology HPs encounter many linguistic and cultural barriers when communicating with minority patients. They need formal training tailored to developing culturally competent communication. Oncology nurses and oncologists could benefit from formal communication skills training focused upon cultural competence during their career development programs.

Keywords: Communication skills; Cultural competence; Health professionals; Minorities; Oncology nurses.

MeSH terms

Adult
Attitude of Health Personnel*
Communication*
Cultural Competency*
Female
Health Personnel / psychology*
Humans
Male
Middle Aged
Minority Groups / psychology*
Oncology Nursing / methods*
Qualitative Research