7/24/2019 Communication Poster for CRCHD FINAL

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Language barrier, cultural difference and patient involvement are

key issues in patient-physician communication for Asian American

breast cancer survivors.

Proper patient education with linguistically and culturally

appropriate information and tools may help improve communication

with physician and decision-making process.

As a next step, we plan to design and implement a theory-based,culturally and linguistically appropriate intervention to Korean breast

cancer survivors. his will include skills to enhance patient-

physician communication.

What Is Lacking in Patient-Physician Communication:from Asian American Breast Cancer Patients and Oncologists Perspecties

Sunmin Lee,1 Grace X. Ma,2,3Carolyn Y. Fang2,3,4Lu Chen,1Youngsuk Oh,1Lynn Scully1

1 e!ar"men" o# $!i%emiology an% &ios"a"is"ics, 'ni(ersi"y o# Marylan% School o# )u*lic +eal"h, College )ark, Marylan%2e!ar"men" o# )u*lic +eal"h, College o# +eal"h )ro#essions, em!le 'ni(ersi"y, )hila%el!hia, )ennsyl(ania

3Cen"er #or -sian +eal"h, em!le 'ni(ersi"y, )hila%el!hia, )ennsyl(ania4 Cancer )re(en"ion an% Con"rol, Fo Chase Cancer Cen"er, )hila%el!hia, )ennsyl(ania

Ackno!ledgments: This research is a pilot project

supported by NIH-NCIs Community Network ProgramCenter, CCH!C "#$ CNPC %&"#$C '#&'-(&, PI) *race+a

Patient Characteristics n!" #$ %hinese & ' Koreans( Participants were between $)-*" years of age. +aority were married

#/( and had college or above education #/(. +ost of them have completed active cancer treatment #"/(. +ore than

half were diagnosed with breast cancer within a year #'*/(.

Oncologist Characteristics

Key Interview Questions

o explore patient-physician communication process in Asian

American breast cancer patients from both patients and oncologistsperspectives.

0reast cancer is the leading cancer in incidence and among top

five in mortality in %hinese & Korean women #%K1( in the 2.3.

#+iller et al., 4))(5apid and steady increase of breast cancer incidence in %K1

since 6")7s. #8orme9 et al., 4)6)(Patient-physician communication and coordination is essential in

the :uality of cancer survivorship care. #Arora et al., 4)66(Asian American patients have reported lower satisfaction with

health care compared to 1hites and 0lacks. #3aha, Arbelae9 &

%ooper, 4));(

Study Design % metropolitan area.

Participant Recruitment A convenience sample of %hinese and Korean breast cancer

survivors living in 1ashington >.%. metropolitan area. Patients were recruited from community based organi9ations,

posters on websites well known among Korean=%hineseimmigrants, and personal contacts.

?ncologists were recruited from personal contacts. hey

were not necessarily oncologists of women we interviewed.

Data Collection and Analysis %omprehensive interview guides were developed separately

for patients and oncologists based on literature review and

input from experts on breast cancer survivorship and

oncologists. @nterviews were recorded, transcribed, and translated. ranscripts were analy9ed by two independent coders and

their analysis was compared and contrasted, and finally

agreed upon in the research team.

Oncologist "# Oncologist "$ Oncologist "%

ge %in years $ #( '

Country o. birth /orea India "0

*ender 1 1 +

2anguage spoken %other

than 3nglish/orean, 0panish,

PortugueseTamil, 0panish /orean

34er communicate withpatients in language other

than 3nglish5

6es 6es 6es

6ears practicing medicine 77 77 &$

INTRODUCTION

OBJECTIVE

METHODS

RESULTS

CONCLUSION, IMPLICATIONS & NEXT STEP

Patients Perspectie Oncologists Perspectie

Language Barrier

2anguage was the biggest

barrier to understanding

in.ormation and making

treatment decisions8 +edical terms were a challenge

e4en .or those who were .luent

in 3nglish8 1or some patients, they could

only rely on guessing and body

language in e9treme situations8

I. the women cannot speak

3nglish then this ser4es as a

large barrier .or understanding

in.ormation and

communicating8 Translation by .amily members

may not be accurate8 0ome patients may neglect to

ask :uestions due to concerns

o. burdening .amily members8

Cultural &ifferences

39pected the doctor to be

authority and were

disappointed when :uestions

were not answered8 !issatis.ied with doctors

ad4ice on physical acti4ity and

diet which .rom the patients

perspecti4e was not

appropriate .or sians8

In "0 culture, ha4ing breast

cancer is a badge o. honor and

sur4i4ing is something to be

proud o.8 1or some sian

women its more o. a stigma

and they are ashamed and

hesitant to discuss it8 +any sian patients want to

know 4ery speci.ically what

they can and cannot eat, and

are surprised when told that

they should just eat a healthy

balanced diet8

&ecision-'aking on (reatment

Physicians played a leading role

in most cases8 The in.luence .rom .amily

members was more e4ident in

participants who were limited

in speaking 3nglish8 +any e9pressed the desire to

be acti4ely in4ol4ed in decisionmaking8

0ome sian patients are not

4ery asserti4e and will not

e9press their concerns8 sians

in general are not 4ery

proacti4e or asserti4e8 They do not want too much

in.ormation .rom a physician,

they e9pect the physician to bethe e9pert and make the

decisions .or them8 I. they do

not recei4e this they may e4en

switch doctors8