Cultural factors that influence the treatment of osteosarcoma in Zulu patients: Healthcare professionals' perspectives and strategies.

PURPOSE: International and national research regarding the discussion of cancer treatment across cultural boundaries is sparse. This study was conducted in the province of KwaZulu-Natal, South Africa, where healthcare encounters are largely culturally discordant; and this study focused on adult Zulu patients diagnosed with osteosarcoma. The purpose of this research study was to identify the cultural factors associated with discussing the different treatment options - and to explore healthcare professionals' responses to these cultural factors - from the healthcare professionals' perspective. METHODS: A qualitative, exploratory, descriptive and contextual research design was used. We conducted focus group interviews with professional nurses, allied health professionals and orthopaedic physicians. These three focus groups comprised a total of 23 participants, and interviews were conducted with each of these groups. We thematically analysed the interview transcripts, using Guba's model of trustworthiness to ensure rigour. RESULTS: We found that the factors, influencing treatment discussions in this cross-cultural clinical setting, included the meaning and the disclosure of cultural health beliefs.We identified strategies for responding to the cultural factors associated with amputation, namely timing treatment discussions, using support services, patient models and DVDs or videos. Strategies for responding to cultural and health beliefs that affect the treatment included initiating the cultural discussion, demonstrating an understanding of patients' cultural beliefs and liaising with family and cultural decision-makers wherever possible. CONCLUSION: Our findings emphasised healthcare professionals' reports of how patients can experience the discussion of culturally discordant treatment options as bad news. We recommend that the treatment discussion form an integral part of the guidelines for culturally competent communication with such cancer patients.

Strategies and challenges for communicating the diagnosis of cancer in cross-cultural clinical settings-Perspectives from South African healthcare professionals.

Communicating the diagnosis of cancer in cross-cultural clinical settings is a complex task. This qualitative research article describes the content and process of informing Zulu patients in South Africa of the diagnosis of cancer, using osteosarcoma as the index diagnosis. We used a descriptive research design with census sampling and focus group interviews. We used an iterative thematic data analysis process and Guba's model of trustworthiness to ensure scientific rigor. Our results reinforced the use of well-accepted strategies for communicating the diagnosis of cancer. In addition, new strategies emerged which may be useful in other cross-cultural settings. These strategies included using the stages of cancer to explain the disease and its progression and instilling hope using a multidisciplinary team care model. We identified several patients, professionals, and organizational factors that complicate cross-cultural communication. We conclude by recommending the development of protocols for communication in these cross-cultural clinical settings.

Culturally competent patient-provider communication in the management of cancer: An integrative literature review.

BACKGROUND: Managing cancer in a multicultural environment poses several challenges, which include the communication between the patient and the healthcare provider. Culture is an important consideration in clinical care as it contributes to shaping patients' health-related values, beliefs, and behaviours. This integrative literature review gathered evidence on how culturally competent patient-provider communication should be delivered to patients diagnosed with cancer. DESIGN: Whittemore and Knafl's approach to conducting an integrative literature review was used. A number of databases were systematically searched and a manual search was also conducted. Specific inclusion and exclusion criteria were set and documents were critically appraised independently by two reviewers. Thirty-five documents were included following these processes. Data extraction and synthesis followed and were also independently verified. RESULTS: Various strategies and personal characteristics and attitudes for culturally competent communication were identified. The importance of culturally competent healthcare systems and models for culturally competent communication were also emphasised. The findings related to all themes should be treated with caution as the results are based mostly on low-level evidence (Level VII). CONCLUSIONS: More rigorous research yielding higher levels of evidence is needed in the field of culturally competent patient-provider communication in the management of cancer. Most of the available literature was classified as non-research evidence. The themes that emerged do, however, provide some insight into how culturally competent patient-provider communication may be delivered in order to improve treatment outcomes in patients diagnosed with cancer.

Religion, spirituality and therapy: implications for training.

Religion and spirituality are recognized coping resources but are neglected in psychological training and practice. However, religion and spirituality can be successfully used to cope with psychological disorders, prevent unhealthy behaviors and promote resilience. This study explored and described two questions regarding the concepts of the terminology religion and spirituality, and the perceptions of the use of religion and spirituality in therapy. Purposive sampling was utilized in a qualitative study of 15 registered psychologists, and data were analyzed using Tesch's model of qualitative content analysis. The concepts religion and spirituality appear difficult to define but the importance of their use as coping mechanisms in their own and their clients' lives was recognized. These findings have implications for professional training.

The use of religion and spirituality in psychotherapy: enablers and barriers.

The use of religion and spirituality in psychotherapy has been a contentious issue for decades. This paper explores and describes whether psychologists would use religion and spirituality in psychotherapy as well as enablers and barriers in this regard. A qualitative exploratory descriptive method was followed using purposive sampling to obtain a sample of clinical and counselling psychologists. The focus group strategy was used to collect the data, and Tesch's model of content analysis was used to analyse the qualitative findings. Most participants expressed a willingness to discuss religion and spirituality with their clients. Participants also highlighted specific enablers and barriers to incorporating religion and spirituality in psychotherapy. This article has the potential to influence professional training in psychology and psychotherapy.

Emotional Intelligence and Locus of Control of Adult Patients with Breast Cancer Receiving Treatment

Background: This article investigates emotional intelligence and locus of control in an adult breast cancer population receiving treatment. Gaining insight into these constructs will contribute to improving breast cancer patients' psychological well-being and to reducing physical vulnerability to disease before and during treatment.Method: The researcher used an exploratory; descriptive and correlational approach. Nonprobability purposive sampling was employed. Sixty-seven breast cancer patients receiving treatment participated in the research. A biographical questionnaire; the Schutte Emotional Intelligence Scale; and the Rotter Internal-External Locus of Control Scale were used to measure the constructs explored in this article. Descriptive and inferential statistics were used to analyse the data.Results: The sample yielded above-average levels of emotional intelligence and an internal locus of control. The results indicate a statistically and practically significant negative correlation between emotional intelligence and locus of control. The significant association found between higher and lower emotional intelligence groups and internal and external locus of control groups also confirmed these results.Conclusion: Having an understanding of the psychosocial variables that impact on individuals diagnosed with a chronic illness; in this case breast cancer; can assist interventionists working in the field of positive psychology. While the stressors and challenges that breast cancer patients face are well documented; this article highlights the strength factors emotional intelligence and locus of control as important mediators in the treatment and management of breast cancer