title: Challenges in Cancer Self-management of Patients with Limited English Proficiency.
abstract: OBJECTIVE
  This paper summarizes the barriers and challenges in cancer care reported from a validation project of a self-management intervention handbook from Chinese-American cancer patients with limited English proficiency (LEP).
  
  
  METHODS
  Seven health-care providers (HCPs) and 16 Chinese-American cancer survivors with LEP were invited to validate a self-management intervention handbook through networking sampling method. Bilingual versions were developed and validated using the repeated translation process. Online and paper-based survey and interview were conducted to collect information on the perception of barriers and experiences on cancer care. Data were analyzed by the content analysis method.
  
  
  RESULTS
  The HCPs reported a bilingual self-management handbook which is useful and feasible for patient self-management. The challenges in giving cancer care to LEP patients included: patients do not engage in discussion, different cultural health beliefs, unable to speak to patients in their primary language, and patients are less likely to discuss emotional and social challenges during treatments. The common barriers and experiences during cancer care included: limited understanding about treatment/medication and side effects, language barriers such as unable to communicate to make the decision, unable to understand information related to resources and do not know what questions to ask, and do not know what to expect during their cancer treatment.
  
  
  CONCLUSIONS
  The current findings highlight the need of cancer self-management support for culturally diverse LEP cancer patients. Further research can include applying the supportive intervention to all LEP cancer patients.
authors.affiliation: School of Nursing, San Francisco State University, San Francisco, CA, USA.
authors.forename: Fang-Yu
authors.initials: FY
authors.lastname: Chou
authors.affiliation: Department of Nursing, Chinese Hospital, San Francisco, CA, USA.
authors.forename: Lily Y
authors.initials: LY
authors.lastname: Kuang
authors.affiliation: Physical Therapy, San Francisco State University, San Francisco, CA, USA.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lee
authors.affiliation: Asian American Studies, San Francisco State University, San Francisco, CA, USA.
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Yoo
authors.affiliation: Health Education, Chinatown Public Health Center, San Francisco, CA, USA.
authors.forename: Lei-Chun
authors.initials: LC
authors.lastname: Fung
keywords: Cancer; Chinese-American; limited English proficiency; self-management