Gedik Asiye, van Meerten Esther, Husson Olga, van der Graaf Winette T A
Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam 3015 GD, the Netherlands.
Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam 3015 GD, the Netherlands.
Patient Educ Couns. 2025 May;134:108679. doi: 10.1016/j.pec.2025.108679. Epub 2025 Jan 27.
With rising cancer incidence rates and a growing migrant population in Europe, understanding oncologists' challenges in communication and providing cancer care to patients with a non-Western migration (NWM) background is crucial. This study aimed to explore the perspectives and experiences of oncologists, including those in training, as they interact with such patients about their cancer diagnosis, stage, treatment, and prognosis.
Between June and September 2023, an online survey was conducted among medical oncologists and trainees (MO) and pulmonologists and trainees (PO) from university medical centers or regional hospitals in the Netherlands. The survey, hosted on LimeSurvey, included descriptive statistics, Chi-Square tests to compare the responses of MO and PO, and thematic qualitative analysis of responses to open questions.
The survey included 112 oncologists, including trainees. The majority directly disclosed a cancer diagnosis to patients, often using family members as interpreters because of language barriers. When families opposed direct disclosure, most oncologists explored the patients' preferences. More than half of MO and PO were satisfied with their communication, with PO reporting higher levels of helplessness and discontent. Challenges included managing family expectations and addressing cultural differences. Qualitative analysis of open responses revealed six themes in decreasing frequency: person-centered care, cultural competence and ethics, education and research, third parties, communication, and palliative care. Nearly 80 percent of oncologists want more research to develop practical tools to optimize communication.
Oncologists (in training) adhere to Western care practices when communicating with patients with an NWM background, which can lead to challenges because of different expectations and cultural beliefs. Oncologists express a need for tools to optimize communication with patients with an NWM background.
The implementation of education and training programs can support oncologists in their daily work and promote culturally sensitive healthcare delivery in oncology.
随着欧洲癌症发病率的上升和移民人口的增加，了解肿瘤学家在沟通方面面临的挑战以及为具有非西方移民（NWM）背景的患者提供癌症护理至关重要。本研究旨在探讨肿瘤学家（包括正在接受培训的人员）在与这类患者讨论癌症诊断、分期、治疗和预后时的观点和经验。
2023年6月至9月期间，对荷兰大学医学中心或地区医院的医学肿瘤学家及学员（MO）和肺科医生及学员（PO）进行了在线调查。该调查通过LimeSurvey进行，包括描述性统计、用于比较MO和PO回答的卡方检验，以及对开放性问题回答的主题定性分析。
该调查包括112名肿瘤学家，包括学员。大多数人会直接向患者透露癌症诊断结果，由于语言障碍，他们经常让家庭成员担任翻译。当家属反对直接透露时，大多数肿瘤学家会探究患者的偏好。超过一半的MO和PO对他们的沟通感到满意，PO报告的无助感和不满程度更高。挑战包括管理家属的期望和应对文化差异。对开放性回答的定性分析揭示了六个主题，按出现频率递减依次为：以患者为中心的护理、文化能力与伦理、教育与研究、第三方、沟通和姑息治疗。近80%的肿瘤学家希望进行更多研究以开发实用工具来优化沟通。
肿瘤学家（正在接受培训的人员）在与具有NWM背景的患者沟通时遵循西方护理实践，由于期望和文化信仰不同，这可能会带来挑战。肿瘤学家表示需要工具来优化与具有NWM背景的患者的沟通。
实施教育和培训项目可以在日常工作中支持肿瘤学家，并促进肿瘤学中具有文化敏感性的医疗服务提供。
