The care of Hispanic children with cancer may be negatively affected by language barriers and undocumented immigration status, indicates a study presented at the Fifth AACR Conference on The Science of Cancer Health Disparities.
Among the findings, Spanish-speaking caregivers of Hispanic children with cancer felt they were not well-informed regarding side effects of therapy when compared to English-speaking caregivers; however, Spanish-speaking study participants were more satisfied with overall care received.
“Ensuring good communication with patients and their families is as important as the actual therapy we give, regardless of what language is spoken,” Mark Fluchel, M.D., assistant professor in the department of pediatrics, division of hematology-oncology at the University of Utah Primary Children’s Medical Center in Salt Lake City, said in a statement. “However, for families for whom there is a language and possibly a cultural barrier, extra care needs to be taken to make sure we are providing the best care possible.”
Fluchel, who received his medical degree from Vanderbilt University School of Medicine, has made the oncology needs of underserved, immigrant and rural communities his primary concern throughout much of his career.
For the research, Fluchel and his team conducted surveys among Spanish- and English-speaking caregivers for pediatric cancer patients being treated at the University of Utah.
Caregivers of Hispanic children, study
More than 300 English surveys were distributed, compared to 46 Spanish surveys, and participants—parents or caregivers of Hispanic children with cancer—were asked questions regarding overall care of children under their watch. Questions addressed issues such as recognition of symptoms, how satisfied caregivers were with care, if the child was in a clinical trial, and the impact of finances and language on treatment.
Researchers found a significant disparity when it came to clarity regarding the informed consent process; 32 percent of Spanish-speaking caregivers incorrectly reported their child was involved in a clinical trial, compared to 12 percent of English-speaking participants.
Spanish-speaking participants also revealed language was a barrier when discussing treatment with oncology staff.
Thirty-seven percent of Spanish-speaking study participants indicated they did not feel they had been understood by treatment staff, and 22 percent indicated they had falsely claimed to understand oncology staff out of embarrassment due to poor English skills.
- Thirty-three percent felt treatment for their child would have been better had English been their primary language, and 11 percent indicated they were uncomfortable requesting an interpreter.
“As is the case with English speakers as well, we cannot assume that everything we say is understood,” Fluchel said. “The most important thing we can do is to quickly establish a trusting relationship with patients and their families and make sure they are comfortable asking for clarification. Once that kind of relationship is established, I think communication errors are less likely.”
While language posed issues for many of the Spanish-speaking caregivers of Hispanic children, immigration status also played a role.
Seventy percent of Spanish-speaking caregivers noted at least one member of their household was undocumented, and 13 percent admitted to delaying care to their children due to this immigration status.