Language created a barrier to fully comprehending treatment risks
According to data presented at the Fifth American Association for Cancer Research Conference on The Science of Cancer Health Disparities, immigration status and language barriers of caregivers appear to influence the care of Hispanic children with cancer and impact the experience of the families within the medical system.
Mark Fluchel, MD, assistant professor in the department of pediatrics, division of hematology-oncology at the University of Utah Primary Children’s Medical Center in Salt Lake City, and colleagues performed a study involving the primary caregivers of pediatric patients with cancer who were being treated at the University of Utah.
Spanish surveys were completed by 46 participants, and 323 participants completed English surveys. Questions for the caregivers pertained to various aspects of the child’s care, such as how soon after recognizing a symptom they sought care, how satisfied they were with the care, and whether the child was in a clinical trial. Financial, emotional, and language barriers to the child’s care were also assessed.
Of the Spanish-speaking respondents, defined as any caregiver who reported Spanish as their primary language, more than 65% reported problems with their ability to speak English. In regard to legal status, 70% of Spanish-speaking respondents reported that at least 1 member of their household had “undocumented” legal status. More than 1 in 10 (13%) reported avoiding or delaying care due to their immigration status.
When questioned about clinical trial participation, 70% of Spanish-speaking caregivers and 40% of English-speaking caregivers reported that the child was enrolled in a clinical trial. However, upon verifying this information, researchers discovered that 32% of the Spanish-speaking and 12% of the English-speaking caregivers were incorrect about the child’s enrollment.
When compared with English-speaking caregivers, more Spanish speakers reported feeling that the potential side effects of therapy were not explained well. However, Spanish-speaking respondents were more satisfied with the overall care of their child.
Questions regarding language barriers revealed that of the Spanish-speaking participants, 37% felt they were not fully understood by the oncology staff, and 22% reported that they had falsely claimed understanding the oncology staff because they were embarrassed that they did not speak English. One-third (33%) felt that their child would have received better care if English was their first language, and 11% reported being uncomfortable asking for an interpreter.
“For families for whom there is a language and possibly a cultural barrier, extra care needs to be taken to make sure we are providing the best care possible,” Fluchel said. “The most important thing we can do is to quickly establish a trusting relationship with patients and their families and make sure they are comfortable asking for clarification. Once that kind of relationship is established, I think communication errors are less likely.”
Source: AACR.