Annals of Oncology
Volume 25, Issue 8, 2014, Pages 1643-1649

Immigrants' perceptions of the quality of their cancer care: An Australian comparative study, identifying potentially modifiable factors (Article) (Open Access)

Goldstein D. , Bell M.L. , Butow P.* , Sze M. , Vaccaro L. , Dong S. , Liauw W. , Hui R. , Tattersall M. , Ng W. , Asghari R. , Steer C. , Vardy J. , Parente P. , Harris M. , Karanth N.V. , King M. , Girgis A. , Eisenbruch M. , Jefford M.
  • a Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
  • b Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
  • c Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia, Centre of Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, Australia
  • d Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
  • e Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
  • f Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
  • g Cancer Care Centre, St George Hospital, Sydney, Australia
  • h Department of Medical Oncology, Westmead Hospital and Blacktown Oncology Unit, Blacktown Hospital Sydney, Sydney, Australia
  • i Department of Cancer Medicine, University of Sydney, Sydney, Australia, Department of Medical Oncology, Royal Prince Alfred Hospital, Sydney, Australia
  • j Department of Medical Oncology, Liverpool Hospital, Sydney, Australia
  • k Bankstown Cancer Care Centre, Bankstown Lidcombe Hospital, Sydney, Australia
  • l Border Medical Oncology, Wodonga, Australia
  • m Centre of Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, Australia
  • n Department of Clinical Haematology and Medical Oncology, Box Hill Hospital, VIC, Australia
  • o Department of Medical Oncology, Monash Medical Centre, VIC, Australia
  • p Department of Medical Oncology, Royal Darwin Hospital, NT, Australia
  • q Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
  • r Translational Cancer Research Unit, Ingham Institute for Applied Medical Research, University of NSW, Sydney, Australia
  • s School of Psych, Psychiatry and Psych Medicine, Monash University, VIC, Australia
  • t Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia, Division of Medicine, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia

Abstract

Background: Recent data show a falling cancer mortality in the general population without a similar shift in immigrant outcomes, leading to a greater cancer burden and mortality for immigrants. Our aims were to compare perceived patterns of care in immigrants and native-born cancer patients. Patients and methods: This was a hospital-based sample of first-generation immigrants and Australian-born Anglo patients in the first year following diagnosis. It was restricted to Chinese, Arabic, or Greek speakers. Eligible participants, recruited via 16 oncology clinics, were over 18, with cancer (any type or stage), and having commenced treatment at least 1 month previously. Five hundred and seventy-one CALD patients (comprising 145 Arabic, 248 Chinese, and 178 Greek) and a control group of 274 Anglo-Australian patients participated. Results: Immigrants had difficulty communicating with the doctor (73% versus 29%) and understanding the health system (38% versus 10%). Differences were found in 'difficulty knowing who to see' (P = 0.0002), 'length of time to confirm diagnosis' (P = 0.04), wanting more choice about a specialist and hospital (P < 0.0001); being offered the opportunity to see a counselor (P < 0.0001); and actually seeing one (P < 0.0001). There were no significant self-reported differences regarding how cancer was detected, time to see a health professional, or type first seen; however, immigrants reported difficulty knowing who to see. Previous studies showed differences in patterns of care according to socioeconomic status (SES) and educational level. Despite adjusting for age, sex, education, marital status, SES, time since diagnosis, and type of cancer, we did not find significant differences. Instead, we found that understanding of the health system and confidence understanding English were important factors. Conclusions: This study confirmed that immigrants with cancer perceive an inferior quality of cancer care. We highlight potentially modifiable factors including assistance in navigating the health system, translated information, and cultural competency training for health professionals. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Author Keywords

Immigrant health Health services Cancer outcomes Care co-ordination

Index Keywords

doctor patient relation patient care perception Greek (people) Australian (people) educational status immigrant Chinese Greek (language) cancer patient malignant neoplastic disease Confounding Factors (Epidemiology) Australia indigenous people Neoplasms human epidemiology Self Report middle aged Ethnic Groups statistics and numerical data ethnic group controlled study priority journal comparative study cancer staging Aged Arab language psychosocial care marriage social status migrant cross-sectional study Arabic (language) psychology Humans male Emigrants and Immigrants female Aged, 80 and over primary tumor very elderly questionnaire Article cancer care Questionnaires adult major clinical study health care quality age Quality of Health Care medical specialist patient attitude Chinese (language) Australian disease severity sex health practitioner mortality
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84905163844&doi=10.1093%2fannonc%2fmdu182&partnerID=40&md5=1718dddc48006a38936fd8d1546c2659
DOI: 10.1093/annonc/mdu182
ISSN: 09237534
Cited by: 17
Original Language: English