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


CONCLUSIONS
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.
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, USA.
Sunmin
S
Lee
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, USA.
Lu
L
Chen
Department of Public Health, College of Health Professions, Temple University, Philadelphia, USA ; Center for Asian Health, Temple University, Philadelphia, USA.
Grace X
GX
Ma
Department of Public Health, College of Health Professions, Temple University, Philadelphia, USA ; Center for Asian Health, Temple University, Philadelphia, USA ; Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, USA.
Carolyn Y
CY
Fang
Asian American; breast cancer; cultural difference; language barrier; patient-physician communication; treatment decision making