Self-Management Handbook Useful for Patients with Limited English Proficiency

The feasibility for a self-management intervention handbook confirmed in Chinese American patients with cancer with LEP.
The feasibility for a self-management intervention handbook confirmed in Chinese American patients with cancer with LEP.

ORLANDO, FL—A pilot project has confirmed the feasibility and need for a self-management intervention handbook for Chinese American patients with cancer who have limited English proficiency (LEP), a study presented at the ONS 40th Annual Congress has shown.

Among patients with cancer, LEP is associated with symptom distress, reduced cancer screening, delays in seeking health care, and lack of appropriate health-seeking behaviors, said Fang-yu Chou, PhD, RN, of the School of Nursing at San Francisco State University in San Francisco, California.

In addition, health care providers report “feeling that they are unable to communicate as effectively with LEP clients and admit to providing less patient-centered care due to language barriers,” she added.

“Language barriers and cultural differences in the illness perception may be also at play when discussing diagnoses with patients with LEP.”

Based on conceptual and research literature by a team of interdisciplinary content experts, a prototype of a self-management intervention handbook was developed that included self-care strategies on symptom management, physical activity, and communication with health care providers.

“The English version was reviewed by seven interdisciplinary health care providers for content review and validation,” Chou said. For additional feedback, an online survey was distributed to the expert panel.

Using the forward-and-backward-translation process, a Chinese version of the handbook was developed and 16 female monolingual/bilingual Chinese American survivors of cancer were invited to provide feedback.

The health care provider expert panel found the bilingual self-management handbook to be a useful and feasible tool for patient self-management. They reported that challenges and experiences in providing care to LEP patients included “patients do not engage in discussion,” “different cultural health beliefs,” “unable to speak to patients in their primary language,” and “patients are less likely to discuss emotional and social challenges during treatments.”

The panel of cancer survivors also considered the Chinese version handbook to be useful and feasible. Commonly reported barriers and experiences during their treatment included: “limited understanding about treatment/medication and side effects,” “unable to communicate in order to make decision,” “language barriers,” and “unable to understand information related to resources and do not know what to ask.”

“The findings provide preliminary data of the feasibility and need of cancer self-management for culturally diverse LEP cancer patients. Further research includes testing and applying the intervention,” Chou concluded.

Underwriting or funding source was the Office of Research and Sponsored Programs and Academic Affairs, San Francisco State University, 2013-2015 (PI: F.Chou)

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