Should culture affect practice? A comparison of prognostic discussions in consultations with immigrant versus native-born cancer patients

Butow, PN; Sze, M; Eisenbruch, M; Bell, ML; Aldridge, LJ; Abdo, S; Tanious, M; Dong, S; Iedema, R; Vardy, J; Hui, R; Boyle, F; Liauw, W; Goldstein, D

Should culture affect practice? A comparison of prognostic discussions in consultations with immigrant versus native-born cancer patients

Butow, PN Sze, M Eisenbruch, M Bell, ML Aldridge, LJ Abdo, S Tanious, M Dong, S Iedema, R

Vardy, J Hui, R Boyle, F Liauw, W Goldstein, D

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Publication Type:: Journal Article
Citation:: Patient Education and Counseling, 2013, 92 (2), pp. 246 - 252
Issue Date:: 2013-08-01

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Field	Value	Language
dc.contributor.author	Butow, PN	en_US
dc.contributor.author	Sze, M	en_US
dc.contributor.author	Eisenbruch, M	en_US
dc.contributor.author	Bell, ML	en_US
dc.contributor.author	Aldridge, LJ	en_US
dc.contributor.author	Abdo, S	en_US
dc.contributor.author	Tanious, M	en_US
dc.contributor.author	Dong, S	en_US
dc.contributor.author	Iedema, R https://orcid.org/0000-0001-6792-1048	en_US
dc.contributor.author	Vardy, J	en_US
dc.contributor.author	Hui, R	en_US
dc.contributor.author	Boyle, F	en_US
dc.contributor.author	Liauw, W	en_US
dc.contributor.author	Goldstein, D	en_US
dc.date.available	2013-03-07	en_US
dc.date.issued	2013-08-01	en_US
dc.identifier.citation	Patient Education and Counseling, 2013, 92 (2), pp. 246 - 252	en_US
dc.identifier.issn	0738-3991	en_US
dc.identifier.uri	http://hdl.handle.net/10453/27069
dc.description.abstract	Objective: Poor prognosis is difficult to impart, particularly across a cultural divide. This study compared prognostic communication with immigrants (with and without interpreters) versus native-born patients in audio-taped oncology consultations. Methods: Ten oncologists, 78 patients (31 Australian-born, 47 immigrants) and 115 family members participated. The first two consultations after diagnosis of incurable disease were audiotaped, transcribed and coded. 142 consultations were included in the analysis. Results: Fifty percent of doctor and 59% of patient prognostic speech units were not interpreted or interpreted non-equivalently when an interpreter was present. Immigrant status predicted few prognostic facts, and oncologist characteristics no prognostic facts, disclosed. Oncologists were significantly less likely to convey hope to immigrants (p = 0.0004), and more likely to use medical jargon (p = 0.009) than with Australian-born patients. Incurable disease status and a limited life span were commonly acknowledged, generally with no timeframe provided. Physical issues were discussed more commonly than emotional aspects. Conclusions: While culture did not appear to influence doctor speech, interpreters filtered or blocked much prognostic communication. Practice implications: Initiatives to empower all patients to attain needed information, optimise communication when an interpreter is present and train cancer health professionals in culturally appropriate care, are urgently required. © 2013 Elsevier Ireland Ltd.	en_US
dc.relation.ispartof	Patient Education and Counseling	en_US
dc.relation.isbasedon	10.1016/j.pec.2013.03.006	en_US
dc.subject.classification	Public Health	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Prognosis	en_US
dc.subject.mesh	Attitude of Health Personnel	en_US
dc.subject.mesh	Communication	en_US
dc.subject.mesh	Communication Barriers	en_US
dc.subject.mesh	Physician-Patient Relations	en_US
dc.subject.mesh	Culture	en_US
dc.subject.mesh	Tape Recording	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Health Services Needs and Demand	en_US
dc.subject.mesh	Referral and Consultation	en_US
dc.subject.mesh	Physician's Practice Patterns	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Emigrants and Immigrants	en_US
dc.subject.mesh	Practice Patterns, Physicians'	en_US
dc.title	Should culture affect practice? A comparison of prognostic discussions in consultations with immigrant versus native-born cancer patients	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	92	en_US
utslib.for	2001 Communication and Media Studies	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Arts and Social Sciences
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	92	en_US

Abstract:

Objective: Poor prognosis is difficult to impart, particularly across a cultural divide. This study compared prognostic communication with immigrants (with and without interpreters) versus native-born patients in audio-taped oncology consultations. Methods: Ten oncologists, 78 patients (31 Australian-born, 47 immigrants) and 115 family members participated. The first two consultations after diagnosis of incurable disease were audiotaped, transcribed and coded. 142 consultations were included in the analysis. Results: Fifty percent of doctor and 59% of patient prognostic speech units were not interpreted or interpreted non-equivalently when an interpreter was present. Immigrant status predicted few prognostic facts, and oncologist characteristics no prognostic facts, disclosed. Oncologists were significantly less likely to convey hope to immigrants (p = 0.0004), and more likely to use medical jargon (p = 0.009) than with Australian-born patients. Incurable disease status and a limited life span were commonly acknowledged, generally with no timeframe provided. Physical issues were discussed more commonly than emotional aspects. Conclusions: While culture did not appear to influence doctor speech, interpreters filtered or blocked much prognostic communication. Practice implications: Initiatives to empower all patients to attain needed information, optimise communication when an interpreter is present and train cancer health professionals in culturally appropriate care, are urgently required. © 2013 Elsevier Ireland Ltd.

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http://hdl.handle.net/10453/27069