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澳大利亚移民癌症患者及其家庭的治疗决策经历。

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

作者信息

Shaw Joanne, Zou Xian, Butow Phyllis

机构信息

Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW 2006, Australia.

School of Psychology, University of Sydney, Sydney, NSW 2006, Australia.

出版信息

Patient Educ Couns. 2015 Jun;98(6):742-7. doi: 10.1016/j.pec.2015.01.012. Epub 2015 Jan 24.

Abstract

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

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.

PRACTICE IMPLICATIONS

To reduce health disparities doctors need to address language difficulties and be aware of cultural differences.

摘要

目的

探讨来自阿拉伯、中国或希腊背景的澳大利亚癌症移民患者及其亲属的治疗决策经历。

方法

来自癌症支持小组和肿瘤诊所的73名患者和18名护理人员以参与者自己的语言参加了焦点小组(n = 14)或半结构化访谈(n = 21)。作为患者整体治疗经历的一部分,讨论了参与者的治疗决策偏好,并进行了主题分析。

结果

数据中出现了四个主要主题:(1)患者在决策中的感知角色;(2)信息获取及语言的影响;(3)文化影响;(4)家庭参与。大多数参与者在治疗咨询期间经历了被动参与,但表示希望更多地参与。语言而非文化是积极参与的更大障碍。用英语有效沟通困难是参与治疗决策的最主要障碍。为克服语言挑战,参与者积极从其他来源寻求信息。

结论

本研究为澳大利亚癌症护理系统中语言和文化对癌症移民患者及其家庭治疗决策经历的影响提供了新见解。

实践意义

为减少健康差距,医生需要解决语言困难并意识到文化差异。

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