Should culture affect practice? Prognostic discussions with immigrants (original) (raw)

Journal of Clinical Oncology, 2013

Abstract

6556 Background: Poor prognosis is difficult to impart, particularly across a cultural divide. This study is the first to compare prognostic communication with immigrants (with and without interpreters) versus native–born patients in audio-taped oncology consultations. Methods: Ten oncologists, 78 patients (31 Australian-born, 47 immigrants) and 115 family members participated. The first two consultations after diagnosis of incurable disease were audiotaped, transcribed and coded. 142 consultations were included in the analysis. Results: Fifty percent of doctor and 59% of patient prognostic speech units were notinterpreted or interpreted non-equivalently when an interpreter was present. Immigrant status predicted few, and oncologist characteristics no, prognostic facts disclosed. Oncologists were significantly less likely to convey hope to immigrants, and more likely to use medical jargon (p = 0.009) than with Australian-born patients. Incurable disease status and a limited life spa...

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