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Challenges in Cross-Cultural Communication in Breast Cancer Surgery: Is there a Gender Gap?
Hu, Shu Yang; Reel, Emma; Nisenbaum, Rosane; Scheer, Adena S.
Afiliação
  • Hu SY; Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland. shuyanghu@rcsi.ie.
  • Reel E; Department of Surgery, Michael's Hospital, University of Toronto, Toronto, Canada.
  • Nisenbaum R; Applied Health Research Centre, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
  • Scheer AS; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
J Cancer Educ ; 37(4): 1201-1208, 2022 08.
Article em En | MEDLINE | ID: mdl-33506410
ABSTRACT
The aim of this study is to identify [1] facilitators and barriers to cross-cultural communication with Canadian immigrants during the breast cancer (BC) surgical consultation and [2] the impact of cultural sensitivity training on the perception of cross-cultural communication barriers. A 29-item questionnaire mailed to 450 surgeons was developed based on the Ottawa Decision Support Framework, informed by interviews with BC practitioners and a literature review. The inclusion criteria are English-speaking general surgeons practicing in Vancouver, Montréal, and Toronto, home to > 60% of Canada's immigrant population. The association between surgeon characteristics and barriers to communication was assessed using the chi-square or Fisher's exact test. Univariate and multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between frequent perception of each barrier to communication and gender, career stage, and percentage of foreign-born patients. Between June and September 2017, 130 surveys were returned for a 29% response rate. The majority of practitioners reported experiencing language barriers in consultation with immigrant patients (71.4%). In the patient-provider relationship, the most commonly reported barrier was the patient's lack of medical understanding (81.4%). At the system level, the absence of a relative for translation was the most frequently encountered challenge (77.1%). On multivariable analysis adjusting for career stage and percentage of foreign-born patients, female gender of a surgeon was associated with more frequent perception of barriers related to language (OR 4.91, [95% CI 1.43, 16.82; p = 0.0114]), the patient's desired role in decision-making (OR 3.000 [95% CI 1.116-8.059; p = 0.0294]), and poor access to interpreters (OR 3.63 [95% CI 1.24, 10.64; p = 0.0189]). Furthermore, on multivariable analysis adjusting for gender and career stage, surgeons identified as having < 25% foreign-born patients in their practice were less likely to identify communication barriers due to the patients' perception and understanding of their healthcare (OR 0.32 [95% CI 0.11, 0.95; p = 0.041]). Cultural sensitivity training did not appear to be an influential factor though this may be due to the low number of surgeons who received training (5.7%). There are multiple cross-cultural communication challenges. Gender, years in practice, and the cultural diversity of a practice might play significant roles in the identification and perception of these barriers.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama Tipo de estudo: Prognostic_studies Limite: Female / Humans País/Região como assunto: America do norte Idioma: En Revista: J Cancer Educ Assunto da revista: EDUCACAO / NEOPLASIAS Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Irlanda

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama Tipo de estudo: Prognostic_studies Limite: Female / Humans País/Região como assunto: America do norte Idioma: En Revista: J Cancer Educ Assunto da revista: EDUCACAO / NEOPLASIAS Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Irlanda