Influence of migrant background on patient preference and expectations in breast and gynecological malignancies (NOGGO-expression V study): results of a prospective multicentre study in 606 patients in Germany

BMC Cancer. 2021 Sep 12;21(1):1018. doi: 10.1186/s12885-021-08731-6.

Abstract

Background: An effective cross-cultural doctor-patient communication is vital for health literacy and patient compliance. Building a good relationship with medical staff is also relevant for the treatment decision-making process for cancer patients. Studies about the role of a specific migrant background regarding patient preferences and expectations are lacking. We therefore conducted a multicentre prospective survey to explore the needs and preferences of patients with a migrant background (PMB) suffering from gynecological malignancies and breast cancer to evaluate the quality of doctor-patient communication and cancer management compared to non-migrants (NM).

Methods: This multicentre survey recruited patients with primary or recurrence of breast, ovarian, peritoneal, or fallopian tube cancer. The patients either filled out a paper form, participated via an online survey, or were interviewed by trained staff. A 58-item questionnaire was primarily developed in German and then translated into three different languages to reach non-German-speaking patients.

Results: A total of 606 patients were included in the study: 54.1% (328) were interviewed directly, 9.1% (55) participated via an online survey, and 36.8% (223) used the paper print version. More than one quarter, 27.4% (166) of the participants, had a migrant background. The majority of migrants and NM were highly satisfied with the communication with their doctors. First-generation migrants (FGM) and patients with breast cancer were less often informed about participation in clinical trials (p < 0.05) and 24.5% of them suggested the help of an interpreter to improve the medical consultation. Second and third-generation migrants (SGM and TGM) experienced more fatigue and nausea than expected.

Conclusions: Our results allow the hypothesis that training medical staff in intercultural competence and using disease-related patient information in different languages can improve best supportive care management and quality of life in cancer patients with migrant status.

Keywords: Doctor-patient relationship; Migrants; Patient preference; Survey; Therapy expectations.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / psychology
  • Communication
  • Culturally Competent Care / ethnology
  • Female
  • Genital Neoplasms, Female / ethnology*
  • Genital Neoplasms, Female / psychology
  • Germany
  • Health Literacy
  • Humans
  • Middle Aged
  • Motivation*
  • Needs Assessment*
  • Neoplasm Recurrence, Local / ethnology
  • Patient Compliance
  • Patient Preference / ethnology*
  • Patient Preference / statistics & numerical data
  • Patient Satisfaction / ethnology
  • Patient Satisfaction / statistics & numerical data
  • Physician-Patient Relations*
  • Prospective Studies
  • Surveys and Questionnaires
  • Transients and Migrants* / statistics & numerical data
  • Translations
  • Young Adult