Researchers undertook a study among oncology nurses to examine how well the needs of the limited English proficient (LEP) patient population are being met, and they identified areas where there appeared to be room for improvement. The findings were published in the Clinical Journal of Oncology Nursing.

“When a limiting factor such as a language barrier is added, nurses’ ability to provide care can be hampered,” wrote the researchers in their report.

The researchers explained that patients who could be considered LEP are those for whom English is not a primary language, and who experience a limitation in written and/or verbal communication.

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In this study, the researchers surveyed 44 oncology nurses from an inpatient oncology unit at the North Carolina Cancer Hospital in Chapel Hill. The researchers used nurses’ responses to evaluate cultural awareness and the availability of resources to address relevant needs of the Latinx patient population.

The majority of oncology nurses in this study had educational backgrounds at the level of a first bachelor of science in nursing. Spanish proficiency was considered low for 36 of the survey respondents, with 5 showing moderate proficiency and 3 showing high proficiency. Survey results overall suggested that cultural awareness was moderate to high.

However, nurses indicated a desire for more resources for fairly and safely providing care to patients from the LEP population who have cancer. Specific challenges included language barriers, difficulty in educating these patients about their care, inefficiencies in accessing interpreters, insufficient time, and difficulty in giving patients emotional support.

The researchers noted that cultural awareness was less of a limitation in the ability to provide care than communication was. Specific recommendations included having an interpreter in the unit, employing a greater proportion of bilingual staff, making materials available in more than 1 language, and offering language training at no cost.


Betancur S, Walton AL, Smith-Miller C, Wiesen C, Bryant AL. Cultural awareness: ensuring high-quality care for limited English proficient patients. Clin J Oncol Nurs. 2020;24(5):530-537. doi:10.1188/20.CJON.530-537