ISSN 2146-8346
 

Original Research 


What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists

Sunmin Lee, Lu Chen, Grace X Ma, Carolyn Y Fang.

Cited by (9)

Abstract
Abstract

Objectives: Interactions between breast cancer patients and their oncologists are important as effective patient-physician communication can facilitate the delivery of quality cancer care. However, little is known about patient-physician communication processes among Asian American breast cancer patients, who may have unique communication needs and challenges. Thus, we interviewed Asian American patients and several oncologists to explore patient-physician communication processes in breast cancer care.
Methods: We conducted in-depth interviews with nine Chinese- or Korean American breast cancer patients and three Asian American oncologists who routinely provided care for Asian American patients in the Washington DC metropolitan area in 2010. We conducted patient interviews in Chinese or Korean and then translated into English. We conducted physicians’ interviews in English. We performed qualitative analyses to identify themes.
Results: For women with limited English proficiency, language was the greatest barrier to understanding information and making treatment-related decisions. Both patients and oncologists believed that interpretation provided by patients’ family members may not be accurate, and patients may neglect to ask questions because of their worry of burdening others. We observed cultural differences regarding expectations of the doctor’s role and views of cancer recovery. As expressed by the patients and observed by oncologists, Asian American women are less likely to be assertive and are mostly reliant on physicians to make treatment decisions. However, many patients expressed a desire to be actively involved in the decision-making process.
Conclusion: Findings provide preliminary insight into patient-physician communication and identify several aspects of patient-physician communication that need to be improved for Asian American breast cancer patients. Proper patient education with linguistically and culturally appropriate information and tools may help improve communication and decision-making processes for Asian American women with breast cancer.

Key words: breast cancer, patient-physician communication, language barrier, cultural difference, treatment decision making, Asian American


 
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REFERENCES
1. Adler NE, Page A, National Institue of Medicine (U.S.). Committee on Psychosocial Services to Cancer Patients / Families in a Community Setting. Cancer care for the whole patient : meeting psychosocial health needs. Washington, D.C.: National Academies Press; 2008.
2. Hewitt ME, Herdman R, Holland JC, et al. Meeting psychosocial needs of women with breast cancer. Washington, D.C.: National Academies Press; 2004.
3. Martinez LS, Schwartz JS, Freres D, et al. Patient-clinician information engagement increases treatment decision satisfaction among cancer patients through feeling of being informed. Patient Educ Couns. Dec 2009; 77(3): 384-390. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
4. Ong LM, Visser MR, Lammes FB, et al. Doctor-patient communication and cancer patients' quality of life and satisfaction. Patient Educ Couns. Sep 2000; 41(2): 145-156. [DOI via Crossref]   
5. Vogel BA, Leonhart R, Helmes AW. Communication matters: the impact of communication and participation in decision making on breast cancer patients' depression and quality of life. Patient Educ Couns. Dec 2009; 77(3): 391-397. [DOI via Crossref]    [Pubmed]   
6. Roberts CS, Cox CE, Reintgen DS, et al. Influence of physician communication on newly diagnosed breast patients' psychologic adjustment and decision-making. Cancer. Jul 1 1994; 74(1 Suppl): 336-341. [DOI via Crossref]    [Pubmed]   
7. Fallowfield LJ, Hall A, Maguire GP, et al. Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. Bmj. Sep 22 1990; 301(6752): 575-580. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
8. Street RL, Jr., Voigt B. Patient participation in deciding breast cancer treatment and subsequent quality of life. Med Decis Making. Jul-Sep 1997; 17(3): 298-306. [DOI via Crossref]    [Pubmed]   
9. Clayton MF, Dudley WN. Patient-centered communication during oncology follow-up visits for breast cancer survivors: content and temporal structure. Oncol Nurs Forum. Mar 2009; 36(2): E68-79. [DOI via Crossref]    [Pubmed]   
10. McWilliam CL, Brown JB, Stewart M. Breast cancer patients' experiences of patient-doctor communication: a working relationship. Patient Educ Couns. Feb 2000; 39(2-3): 191-204. [DOI via Crossref]   
11. Wright EB, Holcombe C, Salmon P. Doctors' communication of trust, care, and respect in breast cancer: qualitative study. Bmj. Apr 10 2004; 328(7444): 864. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
12. Siminoff LA, Graham GC, Gordon NH. Cancer communication patterns and the influence of patient characteristics: disparities in information-giving and affective behaviors. Patient Educ Couns. Sep 2006; 62(3): 355-360. [DOI via Crossref]    [Pubmed]   
13. Davey MP, Kissil K, Nino A, et al. "They paid no mind to my state of mind": African American breast cancer patients' experiences of cancer care delivery. J Psychosoc Oncol. Nov 2010; 28(6): 683-698. [DOI via Crossref]    [Pubmed]   
14. Royak-Schaler R, Passmore SR, Gadalla S, et al. Exploring patient-physician communication in breast cancer care for African American women following primary treatment. Oncol Nurs Forum. Sep 2008; 35(5): 836-843. [DOI via Crossref]    [Pubmed]   
15. Tam Ashing K, Padilla G, Tejero J, et al. Understanding the breast cancer experience of Asian American women. Psychooncology. Jan-Feb 2003; 12(1): 38-58. [DOI via Crossref]    [Pubmed]   
16. Ashing-Giwa KT, Padilla G, Tejero J, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology. Jun 2004; 13(6): 408-428. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
17. Gomez SL, Quach T, Horn-Ross PL, et al. Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. Am J Public Health. Apr 1 2010; 100 Suppl 1: S125-131. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
18. Clayman ML, Boberg EW, Makoul G. The use of patient and provider perspectives to develop a patient-oriented website for women diagnosed with breast cancer. Patient Educ Couns. Sep 2008; 72(3): 429-435. [DOI via Crossref]    [Pubmed]   
19. Karliner LS, Hwang ES, Nickleach D, et al. Language barriers and patient-centered breast cancer care. Patient Educ Couns. Aug 2011; 84(2): 223-228. [DOI via Crossref]    [Pubmed]   
20. Bakker DA, Fitch MI, Gray R, et al. Patient-health care provider communication during chemotherapy treatment: the perspectives of women with breast cancer. Patient Educ Couns. Apr 2001; 43(1): 61-71. [DOI via Crossref]   
21. Epstein RM, Street RLJ. Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda, MD: National Cancer Institute; 2007.
22. Simpson PB. Family beliefs about diet and traditional Chinese medicine for Hong Kong women with breast cancer. Oncol Nurs Forum.Sep-Oct 2003; 30(5): 834-840. [DOI via Crossref]    [Pubmed]   
23. Hawley ST, Janz NK, Hamilton A, et al. Latina patient perspectives about informed treatment decision making for breast cancer. Patient Educ Couns. Nov 2008; 73(2): 363-370. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
24. Polacek GN, Ramos MC, Ferrer RL. Breast cancer disparities and decision-making among U.S. women. Patient Educ Couns. Feb 2007; 65(2): 158-165. [DOI via Crossref]    [Pubmed]   

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How to Cite this Article
Pubmed Style

Lee S, Chen L, Ma GX, Fang CY. What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. J Behav Health. 2012; 1(2): 102-109. doi:10.5455/jbh.20120403024919


Web Style

Lee S, Chen L, Ma GX, Fang CY. What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. http://www.jbehavioralhealth.com/?mno=14821 [Access: June 18, 2018]. doi:10.5455/jbh.20120403024919


AMA (American Medical Association) Style

Lee S, Chen L, Ma GX, Fang CY. What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. J Behav Health. 2012; 1(2): 102-109. doi:10.5455/jbh.20120403024919



Vancouver/ICMJE Style

Lee S, Chen L, Ma GX, Fang CY. What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. J Behav Health. (2012), [cited June 18, 2018]; 1(2): 102-109. doi:10.5455/jbh.20120403024919



Harvard Style

Lee, S., Chen, L., Ma, G. X. & Fang, C. Y. (2012) What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. J Behav Health, 1 (2), 102-109. doi:10.5455/jbh.20120403024919



Turabian Style

Lee, Sunmin, Lu Chen, Grace X Ma, and Carolyn Y Fang. 2012. What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. Journal of Behavioral Health, 1 (2), 102-109. doi:10.5455/jbh.20120403024919



Chicago Style

Lee, Sunmin, Lu Chen, Grace X Ma, and Carolyn Y Fang. "What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists." Journal of Behavioral Health 1 (2012), 102-109. doi:10.5455/jbh.20120403024919



MLA (The Modern Language Association) Style

Lee, Sunmin, Lu Chen, Grace X Ma, and Carolyn Y Fang. "What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists." Journal of Behavioral Health 1.2 (2012), 102-109. Print. doi:10.5455/jbh.20120403024919



APA (American Psychological Association) Style

Lee, S., Chen, L., Ma, G. X. & Fang, C. Y. (2012) What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. Journal of Behavioral Health, 1 (2), 102-109. doi:10.5455/jbh.20120403024919





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