Assessment of language needs and resource use among Canadian immigrant patients with cancer.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 77-77
Author(s):  
Sophia Liu ◽  
Elliot Charles Smith ◽  
Alexandra McCartney ◽  
Amedra Basgaran ◽  
Karmugi Balaratnam ◽  
...  

77 Background: Canada's foreign-born population is estimated to reach up to 30% by 2036. Immigrants diagnosed with cancer can face poorer cancer outcomes compared to non-immigrants due to language barriers affecting physician-patient communication and non-equivalent interpretation by untrained translators. Reducing this disparity is a growing challenge due to continued high immigration rates. As Canadian data is lacking, we explored the language needs and resource utilization of Canadian cancer patients. Methods: Adult cancer survivors from Princess Margaret Cancer Centre were surveyed in English on their socio-demographics, perceived communication difficulties, and interpreter use. Results: Of 470 patients, 45% were foreign-born; 37% self-identified as immigrants; 78% spoke mostly English at home. Among self-identified immigrants, median age at diagnosis was 60 years, 46% were female, and 59% completed post-secondary education. Top three countries of origin were China (23%), India (10%), and Italy (9%). Although 73% of immigrants reported English as their most comfortable language in which to receive healthcare information, 18% reported difficulties communicating with the doctor in English at a few visits or more, 14% indicated some discomfort communicating with their oncologist in English, and 4% of immigrants felt their cancer care was affected by a language barrier. Twenty-six percent of immigrants required interpretation, with 91% employing family, 7% utilizing professional interpreters, and only 19% have ever used the institutional language services. Conclusions: Although most immigrants identify English as their most comfortable language for healthcare delivery, some still experience communication difficulties with their oncologist during at least a few visits. However, most patients felt comfortable communicating with their oncologists and do not feel their cancer care is affected. Most relied on family members to interpret, while local hospital language resources were largely underutilized. Strategies for promoting professional translation service use may help improve immigrants’ experience, caregivers’ burden, and enhance physicians’ ability to counsel patients directly.

2021 ◽  
Author(s):  
Kea Turner ◽  
Margarita Bobonis Babilonia ◽  
Cristina Naso ◽  
Oliver Nguyen ◽  
Brian D. Gonzalez ◽  
...  

BACKGROUND Rapid implementation of telemedicine for cancer care during COVID-19 required innovative and adaptive solutions among healthcare workers. OBJECTIVE The objective of this qualitative study was to explore healthcare workers’ experiences with telemedicine implementation during COVID-19. METHODS We conducted semi-structured interviews with 40 oncology healthcare workers who implemented telemedicine during COVID-19. The interviews were recorded, transcribed verbatim, and analyzed for themes using Dedoose software (Version 4.12). RESULTS Approximately half of participants were physicians (55%) and one quarter of participants were APPs (25%). Other participants included social workers (n=3), psychologists (n=2), dieticians (n=2), and a pharmacist. Five key themes were identified: 1) establishing and maintaining patient-provider relationships, 2) coordinating care with other providers and informal caregivers, 3) adapting in-person assessments for telemedicine, 4) developing workflows and allocating resources, and 5) future recommendations. Participants described innovative strategies for implementing telemedicine, such as coordinating inter-disciplinary visits with multiple providers. Healthcare workers discussed key challenges, such as workflow integration, lack of physical exam and biometric data, and overcoming the digital divide. Participants recommended policy advocacy to support telemedicine (e.g., medical licensure policies) and monitoring how telemedicine affects patient outcomes and healthcare delivery. CONCLUSIONS To support the growth of telemedicine, implementation strategies are needed to ensure providers and patients have the tools necessary to effectively engage in telemedicine. At the same time, cancer care organizations will need to engage in advocacy to ensure policies are supportive of oncology telemedicine and develop systems to monitor the impact of telemedicine on patient outcomes, healthcare quality, costs, and equity. CLINICALTRIAL N/A


2018 ◽  
Vol 33 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Tina J Wang ◽  
Jeffrey A Russell

BACKGROUND: Dance is a rigorous art form and athletic activity accompanied by a high injury rate. The purpose of this study was to gather injury and healthcare availability information from university dancers to better understand dancers’ access to professional medical attention and their satisfaction with the medical advice they receive. METHODS: An author-designed online questionnaire about dance-related injury (DRI), access to healthcare, and satisfaction with healthcare was distributed to dancers at 102 American post-secondary institutions in 2 states that offer programs in dance; 211 dancers completed the survey. RESULTS: 75% of dancers reported seeking healthcare advice from dance teachers. A majority (55%) who visited healthcare professionals for a DRI disclosed negative experiences; the top reasons stemmed from the professionals’ not understanding dancers (70%), providing unhelpful advice (43%), or not spending enough time in the healthcare consultation (33%). Of dancers who reported positive experiences, they most commonly discovered the provider by word-of-mouth (89%) or through the provider’s affiliation with their institution (41%). CONCLUSION: Dancers tend to access healthcare when it is available to them but find the lack of relevant and applicable advice from healthcare practitioners the biggest contributors to their negative experience with the healthcare system. When confronted with DRIs, dancers tend to seek advice from their dance instructors. To ensure proper evaluation, instructors should refer dancers to licensed healthcare providers, and dance medicine practitioners should make themselves known to dancers through both formal and informal networks.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Pernilla Pergert ◽  
Solvig Ekblad ◽  
Olle Björk ◽  
Karin Enskär ◽  
Tom Andrews

Sweden's population is gradually changing to become more multiethnic and diverse and that applies also for recipients of health care, including childhood cancer care. A holistic view on the sick child in the context of its family has always been a cornerstone in childhood cancer care in Sweden. The purpose of this study was to gain knowledge about the experiences and main concern of foreign-born parents in the context of paediatric cancer care. Interviews were performed with eleven foreign-born parents and data were analysed using a classic grounded theory approach. Foreign-born parents often feel in a position of powerless dependence, but family interests are protected in their approaches to interaction with healthcare staff, through cooperation, contesting, and reluctant resigning. Healthcare staff need to listen to foreign-born parents and deal with their concerns seriously to prevent powerless-dependence and work for trustful cooperation in the common fight against childhood cancer.


Cancer ◽  
2010 ◽  
Vol 116 (23) ◽  
pp. 5497-5506 ◽  
Author(s):  
Signe Smith Nielsen ◽  
Yulei He ◽  
John Z. Ayanian ◽  
Scarlett Lin Gomez ◽  
Katherine L. Kahn ◽  
...  

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1537-1537
Author(s):  
Carolina Bernabe Ramirez ◽  
Ana I. Velazquez Manana ◽  
Coral Olazagasti ◽  
Cristiane Decat Bergerot ◽  
Enrique Soto Perez De Celis ◽  
...  

1537 Background: The severe acute respiratory syndrome 2 (SARS-cov-2) virus causing COVID-19 has brought great challenges to global health services affecting cancer care delivery, outcomes, and increasing the burden in oncology providers (OP). Our study aimed to describe the challenges that OP faced while delivering cancer care in Latin America. Methods: We conducted an international cross-sectional study using an anonymous online survey in Spanish, Portuguese, and English. The questionnaire included 43 multiple choice questions. The sample was stratified by OP who have treated patients with COVID-19 versus those who have not treated patients with COVID-19. Data was analyzed with descriptive statistics and Chi-square tests. Results: A total of 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Oncologists represented 46% of respondents, followed by 25% surgical-oncologists. Of the respondents, 56% treated patients with COVID-19. A significant proportion of OP reported newly adopting telemedicine during COVID-19 (14% vs 72%, p=0.001). More than half (58%) of OP reported making changes to the treatments they offered to patients with cancer. As shown in the table, caring for patients with COVID-19 significantly influenced practice patterns of OP. Access to specialty services and procedures was significantly reduced: 40% noted significantly decreased or no access to imaging, 20% significantly decreased or no access to biopsies, 65% reported delays in surgical oncology referrals, and 49% in radiation oncology referrals. A vast majority (82%) reported oncologic surgeries were delayed or cancelled, which was heightened among those treating patients with COVID-19 (87% vs 77%, p=0.001). Conclusions: The COVID-19 pandemic has significantly affected the way cancer care is delivered in globally. Although changes to healthcare delivery are necessary as a response to this global crisis, our study highlights the significant disruption and possible undertreatment of patients with cancer in Latin America that results from COVID-19.[Table: see text]


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18656-e18656
Author(s):  
Nina Morena ◽  
Nicholas Zelt ◽  
Diana Nguyen ◽  
Carrie A. Rentschler ◽  
Devon Greyson ◽  
...  

e18656 Background: Medical oncology (MEDONC) requires a combination of skills in collaboration, communication, and professionalism, ultimately delivering technical and clinical knowledge in practice. Standard assessment tools (e.g. written examination, OSCE) are not effective in evaluating competencies beyond technical skills and fail to define the cancer care experience holistically. This explorative, descriptive study aims to identify the potential of unstructured, unsolicited, open access online patient reviews (OPRs) as a tool to assess physician competency. Methods: University-affiliated MEDONCs in Ontario (Canada) were selected. All OPRs were identified on RateMD using every name permutation; physician names and institutional affiliations were removed from comments. A descriptive analysis of the cohort was completed. The CanMEDS Framework, defining physician standards, was used with its hierarchy of roles, concepts, and competencies. Two reviewers, a communication studies researcher and a healthcare professional, independently assessed comments and identified common themes. Competency-level assessments were evaluated using kappa with linear weights. Results: 473 OPRs were identified for 49 MEDONCs (71% male, 29% female). Of these, 23% were written by care providers. Competencies defining roles of Medical Expert, Communicator, and Professional were most prevalent (64%, 38%, and 27% respectively). Agreement levels were high in all roles (wK = 0.71 - 1.00). Themes identified were similar in positive and negative evaluations. Most commonly discussed positive themes were knowledge translation and compassionate interpersonal skills. Most common negative themes centered on lack of humility, compassion, and communication skills. 38% of comments were marked helpful, indicating engagement with other OPRs as a key characteristic of rating tools. In addition to the physician in question, 21% of OPRs reported on healthcare delivery by staff. Conclusions: OPRs emphasize experiential competencies related to interpersonal skills and suggest an alternative format to evaluating such aspects of MEDONC competencies.[Table: see text]


2020 ◽  
Vol 30 (6) ◽  
pp. 1152-1157
Author(s):  
Venla Lehti ◽  
Jaana Suvisaari ◽  
Mika Gissler ◽  
Niina Markkula

Abstract Background Migrant populations may have different mental health service needs when compared with native populations. One indicator of service use is the use of psychotropic medication. The aim of this study was to compare the purchases of psychotropic drugs among different migrant populations with the native population in Finland. Methods Foreign-born participants (n = 184 805) and their Finnish-born controls (n = 185 183) were identified from the Finnish Central Population Register. Information on their purchases of psychotropic drugs in 2011–15 was collected from the National Prescription Register. A washout period of 2009–10 was used to define incident purchases. Cox regression analysis was the statistical method used. Results At least one incident purchase of a psychotropic drug was identified for 11.1% of migrant women, 11.4% of Finnish-born women, 8.7% of migrant men and 9.8% of Finnish-born men. When controlled for age, sex, marital status, socioeconomic status and social assistance, migrants were less likely to purchase psychotropic drugs (adjusted hazard ratio 0.96, 95% confidence interval 0.93–0.98), but there was variation between different drug categories. Recent migrants and migrants from Asia and Sub-Saharan Africa were least likely to purchase drugs. Migrants from Nordic countries and other Western countries most closely resembled the Finnish-born controls. Conclusions Recent migrants in Finland appear to use fewer psychotropic drugs than native Finns. It is important to analyze the reasons for this pattern, as they may indicate delays in access to care or benefits. The heterogeneity of migrant populations must also be considered when developing services to better address their needs.


2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 34-34
Author(s):  
Karma L. Kreizenbeck ◽  
Teah Hoopes ◽  
Lotte Steuten ◽  
Veena Shankaran ◽  
Bernardo Goulart ◽  
...  

34 Background: In the context of many initiatives aimed at measuring quality and value in cancer care, the Hutchinson Institute for Cancer Outcomes Research (HICOR), partnered with community members to launch a regional, stakeholder-driven initiative to define and report value metrics for cancer care for Washington State. Region-wide Summits were held in 2014 and 2015. Participants included local healthcare delivery organizations, patient advocacy groups, payers, and policymakers. The 2014 Summit identified priority metrics; these metrics were reported at the 2015 Summit. Methods: For the 2015 Summit, HICOR staff developed algorithms to measure adherence to the community-prioritized metrics using a claims-registry linked database. Metrics spanned diagnosis, treatment, continuing, and end-of-life (EOL) phases of care. After reviewing adherence at the clinic-level and for the region, attendees were invited to attend break-out sessions for metrics where there was the largest variation: hospital and ED use during treatment, hospital and ED use at EOL, and breast cancer surveillance. Within the breakout sessions, participants were asked to identify barriers to adherence and possible interventions to improve care. After discussion, participants individually ranked the top 3 interventions and estimated expected improvement to be gained by successful implementation of the intervention Results: Table. Working groups were formed to develop detailed protocols for implementable interventions. Conclusions: Using an iterative, transparent, multi-stakeholder process, it is feasible build regional consensus to identify and prioritize value metrics in cancer care, and to develop consensus regarding approaches to improve adherence to those metrics. [Table: see text]


2008 ◽  
Vol 2 (3) ◽  
pp. 179-189 ◽  
Author(s):  
Ellen Burke Beckjord ◽  
Neeraj K. Arora ◽  
Wendy McLaughlin ◽  
Ingrid Oakley-Girvan ◽  
Ann S. Hamilton ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document