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基于沟通的儿科癌症诊断障碍的定性研究:主要讲西班牙语的照顾者的看法。

A qualitative inquiry of communication based barriers to the diagnosis of pediatric cancer: Perceptions of primarily Spanish-speaking caregivers.

机构信息

Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA.

Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA; Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.

出版信息

Patient Educ Couns. 2022 Jun;105(6):1503-1509. doi: 10.1016/j.pec.2021.09.028. Epub 2021 Sep 22.

Abstract

BACKGROUND

Primarily Spanish-speaking cancer patients and caregivers often experience non-congruence with healthcare providers about beliefs, values, and knowledge of cancer. Our goal was to describe how communication related to the diagnosis of cancer was influenced by culture and language among primarily Spanish-speaking caregivers of pediatric cancer patients.

METHODS

Caregivers participated in three focus groups about their experiences with their child's diagnosis, communication issues, and understanding of their child's diagnosis and treatment plan. Focus groups were audio recorded, transcribed, and qualitatively analyzed using interpretive description.

RESULTS

Three themes emerged: 1) Negative experiences and barriers during the cancer diagnosis and treatment, 2) Miscommunication and system complexity, and 3) Language barriers throughout the diagnostic process. Due to barriers and negative experiences, some caregivers reported that their child's diagnosis was delayed, that providers sometimes used dehumanizing language, and that they were confused about diagnostic testing and treatment.

CONCLUSION

Cultural and linguistic disparities in pediatric oncology must be systematically addressed at the provider, clinic, and system level.

PRACTICE IMPLICATIONS

High-quality cancer care delivered by oncologists and cancer care teams should include cultural humility when discussing the cancer diagnosis and prognosis.

摘要

背景

主要讲西班牙语的癌症患者及其护理人员经常在信仰、价值观和癌症知识方面与医疗服务提供者不一致。我们的目标是描述主要讲西班牙语的儿科癌症患者护理人员在与癌症诊断相关的沟通中,文化和语言是如何产生影响的。

方法

护理人员参加了三个关于他们孩子诊断、沟通问题以及对孩子诊断和治疗计划的理解的焦点小组。焦点小组进行了录音、转录,并使用解释性描述进行了定性分析。

结果

出现了三个主题:1)癌症诊断和治疗过程中的负面经历和障碍,2)沟通不畅和系统复杂性,3)诊断过程中的语言障碍。由于存在障碍和负面经历,一些护理人员报告说他们的孩子的诊断被延误,提供者有时使用非人性化的语言,他们对诊断测试和治疗感到困惑。

结论

儿科肿瘤学中的文化和语言差异必须在提供者、诊所和系统层面上得到系统解决。

实践意义

由肿瘤学家和肿瘤护理团队提供的高质量癌症护理,在讨论癌症诊断和预后时,应该包括文化谦逊。

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