School of Psychology, University of Sydney, Sydney, NSW, Australia.
Psychooncology. 2012 May;21(5):496-504. doi: 10.1002/pon.1923. Epub 2011 Feb 23.
Migrant patients comprise a significant proportion of Western oncologists' clientele. Although previous research has found that barriers exist in the communication between ethnically diverse patients and health professionals, little is known about their personal preferences for communication and information, or the concordance of views held between patients and family members.
Seventy-three patients (31 Anglo-Australians, and 20 Chinese, 11 Arabic and 11 Greek migrants) and 65 relatives (25 Anglo-Australians, and 23 Chinese, 11 Arabic and 7 Greek migrants) were recruited through nine Sydney oncology clinics. Following prognostic consultations, participants were interviewed in their preferred language about their experiences and ideals regarding information and communication with oncologists. Interviews were audio-taped, translated and transcribed, and then thematically analysed using N-Vivo software.
Consistency was found in patient preferences, regardless of ethnicity, in that almost all patients preferred prognostic information to be delivered in a caring and personalised manner from an authoritative oncologist. Contrary to previous research, migrant patients often expressed a desire for prognostic disclosure. Discordance was found between migrant patients and their families. These families displayed traditional non-Western preferences of non-disclosure of prognosis and wanted to actively influence consultations by meeting with oncologists separately beforehand and directing the oncologists on what and how information should be conveyed to patients.
Many of the communication issues facing patients in the metastatic cancer setting are shared amongst Anglo-Australian and migrant patients alike. Understanding the dynamics within migrant families is also an important component in providing culturally sensitive communication. Future directions for research are provided.
移民患者在西方肿瘤学家的患者群体中占有很大比例。尽管先前的研究发现，不同种族的患者与医疗保健专业人员之间存在沟通障碍，但对于他们对沟通和信息的个人偏好，以及患者和家属之间的观点是否一致，知之甚少。
通过九家悉尼肿瘤学诊所，共招募了 73 名患者（31 名盎格鲁-澳大利亚人，20 名中国人，11 名阿拉伯人和 11 名希腊移民）和 65 名亲属（25 名盎格鲁-澳大利亚人，23 名中国人，11 名阿拉伯人和 7 名希腊移民）。在进行预后咨询后，以参与者首选的语言对他们关于与肿瘤学家进行信息和沟通的经验和理想进行访谈。访谈进行了录音、翻译和转录，然后使用 N-Vivo 软件进行主题分析。
无论种族如何，患者的偏好都非常一致，几乎所有患者都希望从权威肿瘤学家那里以关怀和个性化的方式提供预后信息。与先前的研究相反，移民患者经常表示希望透露预后情况。在移民患者和他们的家属之间发现了不一致。这些家庭表现出传统的非西方偏好，即不透露预后情况，并希望通过事先与肿瘤学家分别会面并指导肿瘤学家向患者传达信息的内容和方式，积极影响咨询。
在转移性癌症环境中，患者面临的许多沟通问题在盎格鲁-澳大利亚患者和移民患者中都存在。了解移民家庭内部的动态也是提供文化敏感沟通的重要组成部分。为未来的研究提供了方向。
