Department of Communication Science, Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, the Netherlands.
Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; Prevention and care Programme, Pharos, National Centre of Expertise on Health Disparities, Utrecht, the Netherlands.
J Geriatr Oncol. 2022 Jul;13(6):862-870. doi: 10.1016/j.jgo.2022.04.009. Epub 2022 May 17.
Due to various socio-cultural and language related factors, healthcare providers experience barriers when communicating with older culturally and linguistically diverse (CALD) patients with cancer, which can lower the quality of care received by patients and negatively impact healthcare providers. Studies focusing on communication barriers of older CALD patients with cancer and a systematic comparison of those barriers between different healthcare providers have been largely missing.
In order to lay out the healthcare providers' perceived barriers to communication, the present study identified and compared communication barriers among different healthcare providers when caring for older CALD patients with cancer.
An online survey was conducted among healthcare providers in the Netherlands who identified as being involved in the care of CALD patients with cancer (N = 191), specifically; GPs (N = 54), specialists (N = 29), oncology nurses (N = 77), and pharmacists (N = 31). Providers assessed twelve pre-specified factors on (i) importance and (ii) frequency of these factors as barriers to communication. A composite score by employing the QUOTE (Quality Of care Through the patients' Eyes) methodology was used to rank, and classify factors as either potential or influential barriers.
Overall, low Dutch language proficiency of older CALD patients with cancer, family interpreters providing inadequate translations, not knowing the extent of patients' informational needs, cultural differences in views about healthcare (i.e., illnesses and treatments) and family members blocking communication were found to be influential communication barriers. Healthcare providers showed several differences in what they perceived to be a potential or an influential barrier: Cultural differences in views about healthcare and patients getting treatment in their home countries were important barriers for GPs, while not knowing the patient's contact person was for pharmacists. Nurses perceived the highest number of influential barriers, while specialists perceived the least. We conclude that specific interventions that address differences in perceived barriers among providers are needed, and we highlight potential interventions that involve digital communication tools, such as the Conversation Starter.
由于各种社会文化和语言相关因素，医疗保健提供者在与患有癌症的文化和语言多样化的老年患者（CALD）沟通时会遇到障碍，这会降低患者接受的护理质量，并对医疗保健提供者产生负面影响。专注于患有癌症的老年 CALD 患者沟通障碍的研究以及对不同医疗保健提供者之间这些障碍的系统比较在很大程度上仍然缺失。
为了阐明医疗保健提供者感知到的沟通障碍，本研究确定并比较了不同医疗保健提供者在照顾患有癌症的老年 CALD 患者时的沟通障碍。
在荷兰，参与照顾 CALD 癌症患者的医疗保健提供者（N=191）中进行了在线调查，具体包括全科医生（N=54）、专家（N=29）、肿瘤护士（N=77）和药剂师（N=31）。提供者评估了十二项预先指定的因素，这些因素涉及（i）对沟通的重要性和（ii）这些因素作为障碍的频率。采用 QUOTE（通过患者的眼睛评估护理质量）方法的综合评分用于对因素进行排名，并将因素分类为潜在障碍或有影响力的障碍。
总体而言，患有癌症的老年 CALD 患者的荷兰语水平较低、家庭口译员提供的翻译不足、不了解患者信息需求的程度、对医疗保健（即疾病和治疗）的文化差异以及家庭成员阻碍沟通被认为是有影响力的沟通障碍。医疗保健提供者在他们认为是潜在障碍还是有影响力的障碍方面表现出了一些差异：对医疗保健和患者在本国接受治疗的看法的文化差异是全科医生的重要障碍，而不了解患者的联系人则是药剂师的障碍。护士感知到的有影响力的障碍最多，而专家感知到的障碍最少。我们得出的结论是，需要针对提供者之间感知障碍的差异采取具体的干预措施，我们强调了潜在的干预措施，包括数字沟通工具，如对话启动器。
