title: Communicating with patients from minority backgrounds: Individual challenges experienced by oncology health professionals.
abstract: OBJECTIVE
  Oncology health professionals (HPs) are increasingly required to care for patients from minority backgrounds. Yet many HPs have not had formal training in how to communicate effectively in culturally diverse settings. More information is needed about the challenges that oncology HPs face in communicating with minority patients to inform the content of formal training programs. This qualitative study aimed to identify oncology nurses' and oncologists' individual experiences and challenges in communicating with patients from minority backgrounds.
  
  
  METHODS
  Thirty-eight oncology HPs (21 oncology nurses, 12 medical oncologists, and 5 radiation oncologists) were interviewed individually or in focus groups about their experiences communicating with patients from minority backgrounds. The interviews were audio taped and analysed thematically.
  
  
  RESULTS
  The majority of participants (82%) reported varying degrees of uncertainty and discomfort regarding working with minority patients, with many barriers to communication encountered. Participants perceived that minority patients received less emotional support than majority group patients. They experienced challenges in balancing beliefs about patient autonomy with cultural differences regarding the role of the family. Strategies employed by participants to facilitate interactions included: modifying speech, taking more time in consultations, rapport building, and using nonverbal techniques.
  
  
  CONCLUSIONS
  Oncology HPs encounter many linguistic and cultural barriers when communicating with minority patients. They need formal training tailored to developing culturally competent communication. Oncology nurses and oncologists could benefit from formal communication skills training focused upon cultural competence during their career development programs.
authors.affiliation: Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Kaaren J
authors.initials: KJ
authors.lastname: Watts
authors.affiliation: Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: b.meiser@unsw.edu.au.
authors.forename: Bettina
authors.initials: B
authors.lastname: Meiser
authors.affiliation: Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Elvira
authors.initials: E
authors.lastname: Zilliacus
authors.affiliation: Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Rajneesh
authors.initials: R
authors.lastname: Kaur
authors.affiliation: Prince of Wales Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Mona
authors.initials: M
authors.lastname: Taouk
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia.
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.affiliation: Psycho-Oncology Co-Operative Research Group, Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, NSW 2006, Australia.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.affiliation: Prince of Wales Hospital, Sydney, NSW 2031, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Faculty of Arts and Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Hale
authors.affiliation: Multicultural Health Service, South Eastern Sydney Local Health District, Sydney, NSW 2217, Australia.
authors.forename: Astrid
authors.initials: A
authors.lastname: Perry
authors.affiliation: Cancer Council Australia, Sydney, NSW 2000, Australia.
authors.forename: Sanchia K
authors.initials: SK
authors.lastname: Aranda
authors.affiliation: Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3168, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Kissane
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D054521:Cultural Competency; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D009859:Oncology Nursing / Q000379:methods*; D036301:Qualitative Research
keywords: Communication skills; Cultural competence; Health professionals; Minorities; Oncology nurses