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Cancer and Communication in the Health Care Setting: Experiences of Older Vietnamese Immigrants, A Qualitative Study
Authors:Giang T Nguyen MD  MPH  MSCE  Frances K Barg PhD  MEd  Katrina Armstrong MD  MSCE  John H Holmes PhD  Robert C Hornik PhD
Institution:(1) Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA;(2) Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA;(3) Center of Excellence in Cancer Communication Research, University of Pennsylvania, Philadelphia, PA, USA;(4) Graduate Program in Public Health Studies, Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA;(5) Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA;(6) Department of Anthropology, University of Pennsylvania, Philadelphia, PA, USA;(7) Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA;(8) Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
Abstract:Background As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants. Objective To learn about the cancer-related communication experiences of older Vietnamese immigrants from the insider perspective. Design Qualitative study (grounded theory, constant comparative method) using individual interviews with older Vietnamese immigrants with the purpose of discussing how they learn about cancer. Interviews were conducted in Vietnamese. Participants Vietnamese immigrants aged 50–70 years, recruited through community-based organizations. Most had low education and limited English proficiency. The sample size of 20 was sufficient to achieve theoretical saturation. Results We identified 3 categories of themes concerning informants’ experiences with cancer communication in the health care setting: (1) attitudes about addressing screening with providers, (2) issues/problems communicating with physicians about cancer, and (3) language/translation difficulties. There was substantial overlap between informants who mentioned each theme category, and 40% of the participants mentioned all 3 categories. Conclusion Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening.
Keywords:communication  cancer  immigrant  Asian  doctor–  patient relationship
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