ABSTRACT

Objectives

To gain insight into (1) the unfulfilled instrumental and affective needs of Turkish-Dutch and Moroccan-Dutch older cancer patients/survivors, (2) the barriers perceived by healthcare professionals in fulfilling these needs, and (3) how the Health Communicator, a multilingual eHealth tool, can support the fulfillment of patients’/survivors’ needs, and decrease professionals’ barriers.

Design

We conducted a pre-implementation study of the Health Communicator using semi-structured interviews with Turkish-Dutch (n = 10; mean age = 69.10) and Moroccan-Dutch (n = 9; mean age = 69.33) older cancer patients/survivors, and held two focus groups with general practitioners (GPs; n = 7; mean age 45.14) and oncology nurses (ONs; n = 5; mean age = 49.60). Topic list consisted of questions related to needs and perceived barriers. Analysis was based on grounded theory. The acceptance of the Health Communicator was inquired by questions based on the concepts of the Technology Acceptance Model, and analyzed deductively.

Results

Patients/survivors reported unfulfilled needs concerning: (1) information about cancer (treatment), (2) information about the healthcare system, (3) possibilities regarding psychosocial support, and (4) doctor-patient relationship. Among professionals, the main perceived barriers were: (1) patients’/survivors’ low health literacy and language barrier, (2) cultural taboo, (3) lack of insight into patients’ instrumental needs, and (4) patients’/survivors’ lack of trust in Dutch healthcare. Both patients/survivors and professionals thought that implementing the Health Communicator could be effective in fulfilling most of the needs and decreasing the barriers. However, a majority of the patients/survivors were hesitant regarding the use of it, because they found it too difficult to use. Professionals showed a positive intention towards using the Health Communicator.

Conclusions

To enhance patient participation among older migrant cancer patients/survivors, the Health Communicator is, under certain conditions, a promising tool for fulfilling patients’/survivors’ unfulfilled instrumental and affective needs and for bridging barriers perceived by professionals.

中文翻译：

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加强老年移民癌症患者的患者参与：需求、障碍和电子健康

摘要

目标

为了深入了解 (1) 土耳其-荷兰和摩洛哥-荷兰老年癌症患者/幸存者未满足的工具性和情感需求，(2) 医疗保健专业人员在满足这些需求方面遇到的障碍，以及 (3)健康传播者如何，一种多语言的电子健康工具，可以支持满足患者/幸存者的需求，并减少专业人员的障碍。

设计

我们通过对土耳其-荷兰（ n  = 10；平均年龄 = 69.10）和摩洛哥-荷兰（n  = 9；平均年龄 = 69.33）老年癌症患者/幸存者的半结构化访谈，对Health Communicator进行了实施前研究，并与全科医生（全科医生； n  = 7；平均年龄 45.14）和肿瘤科护士（ONs；n  = 5；平均年龄 = 49.60）举行了两个焦点小组。主题列表包括与需求和感知障碍相关的问题。分析基于扎根理论。基于技术接受模型的概念，对健康传播者的接受程度进行提问，并进行演绎分析。

结果

患者/幸存者报告了以下未满足的需求：（1）有关癌症（治疗）的信息，（2）有关医疗保健系统的信息，（3）有关社会心理支持的可能性，以及（4）医患关系。在专业人员中，主要感知障碍是：（1）患者/幸存者的健康素养和语言障碍，（2）文化禁忌，（3）缺乏对患者工具需求的洞察力，以及（4）患者/幸存者' 对荷兰医疗保健缺乏信任。患者/幸存者和专业人员都认为实施Health Communicator可以有效地满足大部分需求并减少障碍。然而，大多数患者/幸存者对使用它犹豫不决，因为他们发现它太难使用了。专业人员对使用Health Communicator表现出积极的态度。

结论

为了提高老年移民癌症患者/幸存者的患者参与度，在某些情况下，健康传播器是满足患者/幸存者未满足的工具和情感需求以及弥合专业人员感知障碍的有前途的工具。