Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York.
Department of Psychiatry, Weill Cornell Medical College, New York, New York.
J Palliat Med. 2020 Apr;23(4):489-497. doi: 10.1089/jpm.2019.0423. Epub 2019 Oct 30.
Latino patients with advanced cancer need culturally responsive, effective psychotherapeutic interventions that can assist them in coping with their diagnosis and improve spiritual and existential well-being and psychological adjustment. This study describes the cultural and linguistic adaptation of individual meaning-centered psychotherapy for Latinos with advanced cancer. A mixed-methods, concurrent integrative approach was used for this study, using the ecological validity and cultural adaptation process models as frameworks for cultural adaptation. Quantitative and qualitative data were collected through (1) a survey of mental health professionals ( = 70) who offer services to Latino cancer patients; (2) a questionnaire for Latino patients with advanced cancer ( = 54), measuring relevant intervention concepts; and (3) in-depth interviews with 24 Latino patients. Quantitative findings showed that most of the goals and concepts were highly acceptable for patients and providers. The qualitative findings supported adaptations to include using more simple definitions; changing phrases that are challenging to translate and comprehend; using words that are common to all Latino cultures, providing more than one option if needed; simplifying the questions/reflections, as needed; changing the metaphors to be culturally congruent; and modifying content to make it responsive to Latino cultural values and norms. Findings demonstrate the need for adaptation to achieve the aims of the intervention, accounting for both linguistic and cultural considerations, emphasizing issues related to literacy, cultural and linguistic diversity, cultural values, and culturally congruent content. The mixed-methods approach is described to provide recommendations for clinicians, researchers, and program developers.
晚期癌症的拉丁裔患者需要文化响应的、有效的心理治疗干预措施，以帮助他们应对诊断，改善精神和存在幸福感以及心理调整。本研究描述了针对晚期癌症拉丁裔患者的个体意义中心心理治疗的文化和语言适应性。本研究采用混合方法、同期综合方法，将生态有效性和文化适应过程模型作为文化适应的框架。通过（1）对为拉丁裔癌症患者提供服务的心理健康专业人员（=70）的调查；（2）对晚期癌症拉丁裔患者（=54）的问卷，测量相关干预概念；以及（3）对 24 名拉丁裔患者的深入访谈，收集了定量和定性数据。定量结果表明，大多数目标和概念对患者和提供者来说都是高度可接受的。定性结果支持进行适应性调整，包括使用更简单的定义；改变难以翻译和理解的短语；使用所有拉丁裔文化共有的词汇，如果需要，提供多个选项；根据需要简化问题/反思；改变隐喻以符合文化背景；并修改内容以使其对拉丁裔文化价值观和规范做出响应。研究结果表明，需要进行适应性调整，以实现干预的目标，同时考虑到语言和文化因素，强调与读写能力、文化和语言多样性、文化价值观以及文化一致的内容相关的问题。描述混合方法方法是为了向临床医生、研究人员和项目开发人员提供建议。
