title: Culturally competent patient-provider communication in the management of cancer: An integrative literature review.
abstract: BACKGROUND
  Managing cancer in a multicultural environment poses several challenges, which include the communication between the patient and the healthcare provider. Culture is an important consideration in clinical care as it contributes to shaping patients' health-related values, beliefs, and behaviours. This integrative literature review gathered evidence on how culturally competent patient-provider communication should be delivered to patients diagnosed with cancer.
  
  
  METHODS
  Whittemore and Knafl's approach to conducting an integrative literature review was used. A number of databases were systematically searched and a manual search was also conducted. Specific inclusion and exclusion criteria were set and documents were critically appraised independently by two reviewers. Thirty-five documents were included following these processes. Data extraction and synthesis followed and were also independently verified.
  
  
  RESULTS
  Various strategies and personal characteristics and attitudes for culturally competent communication were identified. The importance of culturally competent healthcare systems and models for culturally competent communication were also emphasised. The findings related to all themes should be treated with caution as the results are based mostly on low-level evidence (Level VII).
  
  
  CONCLUSIONS
  More rigorous research yielding higher levels of evidence is needed in the field of culturally competent patient-provider communication in the management of cancer. Most of the available literature was classified as non-research evidence. The themes that emerged do, however, provide some insight into how culturally competent patient-provider communication may be delivered in order to improve treatment outcomes in patients diagnosed with cancer.
authors.affiliation: School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; ottiliabrown1978@gmail.com.
authors.forename: Ottilia
authors.initials: O
authors.lastname: Brown
authors.affiliation: Department of Nursing Science, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa.
authors.forename: Wilma
authors.initials: W
authors.lastname: Ten Ham-Baloyi
authors.affiliation: Faculty of Health Sciences, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa.
authors.forename: Dalena Rm
authors.initials: DR
authors.lastname: van Rooyen
authors.affiliation: School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Colleen
authors.initials: C
authors.lastname: Aldous
authors.affiliation: School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Leonard Charles
authors.initials: LC
authors.lastname: Marais
keywords: cancer; cultural competence; culture; oncology; patient–provider communication