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Comparative Study
. 2003 Aug 18;89(4):641-7.
doi: 10.1038/sj.bjc.6601159.

Quality of life and understanding of disease status among cancer patients of different ethnic origin

N Tchen  1 , P Bedard, Q-L Yi, M Klein, D Cella, S Eremenco, I F Tannock
Affiliations
Comparative Study

Quality of life and understanding of disease status among cancer patients of different ethnic origin

N Tchen et al. Br J Cancer. .

Abstract

Patients managed in European or North American cancer centres have a variety of ethnic backgrounds and primary languages. To gain insight into the impact of ethnic origin, we have investigated understanding of disease status and quality of life (QoL) for 202 patients. Patients completed questionnaires in their first language (52 English, 50 Chinese, 50 Italian, 50 Spanish or Portuguese), including the Functional Assessment of Cancer Therapy - General (FACT-G) QoL instrument, questions about disease status, expectations of cure and the language and/or type of interpretation used at initial consultation. Physicians also evaluated their status of disease and expectation of cure, and performance status was estimated by a trained health professional. The initial consultation was usually provided in English (except for 32% of Chinese-speaking patients); interpretation was provided by a family member for 34% of patients with limited English proficiency (LEP) and by a bilingual member of staff for 21%. Patients underestimated their extent of disease and overestimated their probability of cure (P=0.001 and <0.0001, respectively). Estimates of probability of cure by the English speakers were closer to those of their physicians than the other groups (P=0.02). English-speaking patients reported better and Italian-speaking patients poorer overall QoL (P<0.001 for Italian vs other groups). Performance status was correlated with QoL and most closely related with the extent of disease. Understanding of cultural differences is important for optimal management of patients with cancer.

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Figures

Figure 1
Figure 1
Language and type of interpretation at first consultation. (15 patients – 10 Chinese, three Italian and two Spanish/Portuguese-speaking – indicated a mixed consultation using their own language and English with interpretation and are represented in both categories in the figure.)
Figure 2
Figure 2
Satisfaction with the information received. (A) A Percentage of patients who are quite well or very well satisfied. (B) Percentage of patients who would like to have received more information.
Figure 3
Figure 3
Estimates of likelihood of cure of their disease by patients in the four language groups in comparison to physician estimates.
Figure 4
Figure 4
Effect of language group on (A) Overall Quality of Life Score, and (B) Different domains of Quality of Life.
See this image and copyright information in PMC

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