Prognostic communication preferences of migrant patients and their relatives
Mitchinson, D and Butow, P and Sze, M and Aldridge, L and Hui, R and Vardy, J and Eisenbruch, M and Iedema, R and Goldstein, D, Prognostic communication preferences of migrant patients and their relatives, Psycho-Oncology, 21, (5) pp. 496-504. ISSN 1099-1611 (2012) [Refereed Article]
Objectives: Migrant patients comprise a significant proportion of Western oncologistsí
clientele. Although previous research has found that barriers exist in the communication
between ethnically diverse patients and health professionals, little is known about their personal
preferences for communication and information, or the concordance of views held between
patients and family members.
Methods: Seventy-three patients (31 Anglo-Australians, and 20 Chinese, 11 Arabic and 11
Greek migrants) and 65 relatives (25 Anglo-Australians, and 23 Chinese, 11 Arabic and 7
Greek migrants) were recruited through nine Sydney oncology clinics. Following prognostic
consultations, participants were interviewed in their preferred language about their experiences
and ideals regarding information and communication with oncologists. Interviews were audiotaped,
translated and transcribed, and then thematically analysed using N-Vivo software.
Results: Consistency was found in patient preferences, regardless of ethnicity, in that almost
all patients preferred prognostic information to be delivered in a caring and personalised
manner from an authoritative oncologist. Contrary to previous research, migrant patients often
expressed a desire for prognostic disclosure. Discordance was found between migrant patients
and their families. These families displayed traditional non-Western preferences of nondisclosure
of prognosis and wanted to actively influence consultations by meeting with
oncologists separately beforehand and directing the oncologists on what and how information
should be conveyed to patients.
Conclusions: Many of the communication issues facing patients in the metastatic cancer
setting are shared amongst Anglo-Australian and migrant patients alike. Understanding the
dynamics within migrant families is also an important component in providing culturally
sensitive communication. Future directions for research are provided.