2023-06-13 21:38:32
“Each patient comes to us with their own culture, which inevitably influences their view of health and their preferences for or once morest different treatment options.It was with these words that Elena Martinez of the University of California San Diego School of Medicine began speaking regarding language and cultural barriers at the annual conference of l’American Society of Cancer Oncology (ASCO). And this, as part of an educational session dedicated to the alliance with patients, the main theme of the 2023 edition of the meeting.
E. Martinez also participated in the drafting of a educational book published as part of ASCO in May 2023 and dedicated to creating a partnership with patients and caregivers as part of the cancer care journey.
Create a link
Language is undoubtedly one of the biggest barriers to accessing quality care and one of the keys to reducing what has been called “logout” between what emerges from clinical trials and what reaches the patient in his care pathway.
The HOLA study, quoted by E. Martinez in his presentation, confirms the importance of a concordance of language between the patient and the doctor. In this study, Spanish-speaking patients were followed by bilingual doctors or by English-speaking doctors assisted by an interpreter. Patients in the group followed by bilingual doctors were generally more satisfied and, above all, asked more questions. “This last point is a crucial aspect for obtaining quality care.“, explained E. Martinez.
Besides language, many other factors can influence the quality of care. Level of education also matters, although people with a high level of education are not always the easiest patients to monitor and involve. ” In my experience, doctors are often the most difficult patients: in some cases, they defer to their colleagues who treat them, but in others, they want to intervene in the treatment decision, which sometimes creates complex situations to manage“, comments Massimo Di Maio, full professor of medical oncology at the University of Turin and director of the medical oncology service at the Azienda Ospedaliera Ordine Mauriziano in Turin.
The heart of clinical trials
Clinical trials and historical differences in the inclusion of people from ethnic and cultural minorities at different stages of research were also discussed. ” Subjects of Caucasian origin have always been the most represented in clinical trials“, recalled E. Martinez, explaining that many obstacles limit the inclusion of minorities.
Patients complain above all regarding the problems of linguistic and cultural concordance and the difficulty of establishing a relationship of trust with the doctor, especially if they do not speak the same language. For their part, doctors mention the difficulty of understanding the language, but also of intercepting the needs and fears of patients. What to do ? Previous experiences involving the Hispanic community have shown, for example, that a bilingual doctor can improve the admission of Hispanic patients, but the work that remains to be done is certainly complex and a global involvement is necessary: of the doctor, the caregivers and of the whole community.
“The key words to create this fundamental link between the doctor and the patient are the time of communication, the listening (to the needs and the point of view of the individual) and the respect“, said M. Di Maio. “At least in Italy, this attention and the creation of a real partnership are still very often left to the initiative of the individual.“, added the expert who is also the main author of the ESMO recommendations on Patient-Reported Outcome Measures (PROMs), a useful tool for patient engagement and empowerment.
1686693936
#ASCO #doctorpatient #alliance #language #cultural #barriers
