title: From inside the bubble: migrants' perceptions of communication with the cancer team.
abstract: OBJECTIVE
  Migrants with cancer struggle to communicate with their health care team. This study aimed to identify health-care related unmet needs and communication issues for migrants who develop cancer and factors associated with these challenges. In this paper, the findings related to communication issues are presented.
  
  
  METHODS
  Seventy-three cancer patients diagnosed within the previous 3 years and 18 carers, who had migrated to Australia and spoke the designated languages, participated in focus groups or structured interviews. Participants were recruited from ethnic community support organisations, support groups and Oncology clinics within three metropolitan hospitals in two states of Australia. Focus groups and semi-structured interviews were conducted in participants' own language or English as preferred, audio-taped, transcribed and translated into English and analysed using qualitative methods.
  
  
  RESULTS
  Four themes emerged: (1) cultural isolation, alienation and identification; (2) language and communication difficulties; (3) interpreter issues; and (4) advice for health professionals. Participants, especially those less acculturated, described feeling alone and misunderstood, failing to comprehend medical instructions, being unable to communicate questions and concerns and a lack of consistency in interpreters and interpretation.
  
  
  CONCLUSIONS
  Migrants with cancer experience additional challenges to those of native-born patients. Participants provided cogent advice regarding optimal communication with people from their culture. There is clearly a need to develop strategies to increase the cultural competence of care to people from different countries.
authors.affiliation: Psycho-Oncology Co-operative Research Group, University of Sydney, Sydney, NSW, Australia. phyllisb@psych.usyd.edu.au
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Ming
authors.initials: M
authors.lastname: Sze
authors.forename: Priya
authors.initials: P
authors.lastname: Dugal-Beri
authors.forename: Michelle
authors.initials: M
authors.lastname: Mikhail
authors.forename: Maurice
authors.initials: M
authors.lastname: Eisenbruch
authors.forename: Michael
authors.initials: M
authors.lastname: Jefford
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.forename: Madeleine
authors.initials: M
authors.lastname: King
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D003144:Communication Barriers; D054521:Cultural Competency; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology*; D009517:New South Wales; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012918:Social Alienation / Q000523:psychology; D013315:Stress, Psychological; D014739:Victoria