Grappling with cultural differences; Communication between oncologists and immigrant cancer patients with and without interpreters

ObjectiveImmigrants report challenges communicating with their health team. This study compared oncology consultations of immigrants with and without interpreters vs Anglo-Australian patients.MethodsPatients with newly diagnosed incurable cancer who had immigrated from Arabic, Chinese or Greek speaking countries or were Anglo-Australian, and family members, were recruited from 10 medical oncologists in 9 hospitals. Two consultations from each patient were audio-taped, transcribed, translated into English and coded.ResultsSeventy-eight patients (47 immigrant and 31 Anglo-Australian) and 115 family members (77 immigrant and 38 Anglo Australian) participated in 141 audio-taped consultations. Doctors spoke less to immigrants with interpreters than to Anglo-Australians (1443 vs. 2246 words, p = 0.0001), spent proportionally less time on cancer related issues (p = 0.005) and summarising and informing (p ≤ 0.003) and more time on other medical issues (p = 0.0008) and directly advising (p = 0.0008). Immigrants with interpreters gave more high intensity cues (10.4 vs 7.4). Twenty percent of cues were not interpreted. Doctors tended to delay responses to or ignore more immigrant than Anglo-Australian cues (13% vs 5%, p = 0.06).ConclusionsImmigrant cancer patients with interpreters experience different interactions with their doctors than Anglo-Australians, which may compromise their well-being and decisions.Practice implicationsGuidelines and proven training programmes are needed to improve communication with immigrant patients, particularly those with interpreters.