title: Cancer and communication in the health care setting: experiences of older Vietnamese immigrants, a qualitative study.
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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA. nguyeng@uphs.upenn.edu
authors.forename: Giang T
authors.initials: GT
authors.lastname: Nguyen
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
authors.forename: John H
authors.initials: JH
authors.lastname: Holmes
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hornik
mesh_terms: D000368:Aged; D001213:Asian; D015331:Cohort Studies; D003144:Communication Barriers; D054242:Emigrants and Immigrants; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D015143:Philadelphia; D010817:Physician-Patient Relations; D014744:Vietnam / Q000208:ethnology