Skip to main content
Top
Published in: International Journal for Equity in Health 1/2019

Open Access 01-12-2019 | Migration Medicine | Research

Does migrant background predict to what extent colorectal cancer patients want to be informed about their life expectancy? – a cross-sectional analysis

Authors: Marja Leonhardt, Katja Aschenbrenner, Martin E. Kreis, Johannes C. Lauscher

Published in: International Journal for Equity in Health | Issue 1/2019

Login to get access

Abstract

Background

Although migrant health is a topic of interest across Europe and although health care services in Germany consider migrant health issues, people with a migrant background often experience difficulties regarding health care provision. The prevalence of various cancers among migrants is lower relative to non-migrants although this equalizes with increasing duration of residence. There are documented differences in health behavior and disease-coping strategies between migrants and non-migrants, but data are scarce on this subject. This analysis investigates the extent of information migrant and non-migrant colorectal cancer (CRC) patients in Germany want about their life expectancy and the level of trust they have in their treating physician.

Method

Data from 522 CRC patients were collected through a self-reported questionnaire. Migrant background was determined by the patients’ and/or their parents’ birthplace. Bivariate analyses were applied to determine the differences between migrants and non-migrants. A multivariate analysis was used to measure the effect of migration background, demographics, and cancer stage and treatment on the preferred extent of information about life expectancy and trust in their treating physician.

Results

There were no significant differences regarding demographics or cancer stage and treatment between migrant and non-migrant CRC patients. Having a migrant background had no influence on the level of trust in the treating physician, but migrants preferred to be less informed about their life expectancy than non-migrants (21.4% vs. 13.4%, p = 0.04). The multivariate analysis showed that men (aOR = 2.102, CI: 1.123–3.932) and patients with a non-migrant background (aOR = 5.03, CI: 1.02–24.73) preferred receiving information about the approximate value of their life expectancy, rather than receiving no information.

Conclusion

The study found more similarities than discrepancies between migrant and non-migrant CRC patients regarding demographic factors and stage of disease and treatment, which may be a consequence of an increasingly homogeneous cross-cultural society. However, cultural differences between the minority and host population remain and should always be taken into account in daily clinical practice and in the communication skills training of health care professionals. The study also indicates that recording migration background into health registers would facilitate migrant-sensitive research.
Literature
1.
go back to reference Federal Statistical Office (Destatis), Bevölkerung und Erwerbstätigkeit. Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2017 [Population and employment. Populations with migrant background]. Wiesbaden; 2018. Federal Statistical Office (Destatis), Bevölkerung und Erwerbstätigkeit. Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2017 [Population and employment. Populations with migrant background]. Wiesbaden; 2018.
2.
go back to reference Federal Office for Migration and Refugees. Die morbidity and mortality of migrants in Germany [Morbidity and mortality of migrants in Germany], 9. Report. Berlin; 2011. Federal Office for Migration and Refugees. Die morbidity and mortality of migrants in Germany [Morbidity and mortality of migrants in Germany], 9. Report. Berlin; 2011.
3.
go back to reference Malmusi D, Borrell C, Benach J. Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin. Soc Sci Med. 2010;71(9):1610–9.CrossRef Malmusi D, Borrell C, Benach J. Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin. Soc Sci Med. 2010;71(9):1610–9.CrossRef
4.
go back to reference Schouten BC, Meeuwesen L. Cultural differences in medical communication: a review of the literature. Patient Educ Couns. 2006;64(1–3):21–34.CrossRef Schouten BC, Meeuwesen L. Cultural differences in medical communication: a review of the literature. Patient Educ Couns. 2006;64(1–3):21–34.CrossRef
5.
go back to reference Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.CrossRef Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.CrossRef
6.
go back to reference Robert Koch-Institut und die Gesellschaft der epidemiologischen Forschung in Deutschalnd e.V.. Krebs in Deutschland für 2013/2014 [Cancer in Germany]. vol.10. Berlin; 2017. Robert Koch-Institut und die Gesellschaft der epidemiologischen Forschung in Deutschalnd e.V.. Krebs in Deutschland für 2013/2014 [Cancer in Germany]. vol.10. Berlin; 2017.
7.
go back to reference Berens EM, Mohwinkel LM, van Eckert S, Reder M, Kolip P, Spallek J. Uptake of gynecological Cancer screening and performance of breast self-examination among 50-year-old migrant and non-migrant women in Germany: results of a cross-sectional study (InEMa). J Immigr Minor Health. 2018. Berens EM, Mohwinkel LM, van Eckert S, Reder M, Kolip P, Spallek J. Uptake of gynecological Cancer screening and performance of breast self-examination among 50-year-old migrant and non-migrant women in Germany: results of a cross-sectional study (InEMa). J Immigr Minor Health. 2018.
8.
go back to reference Leinonen MK, Campbell S, Ursin G, Trope A, Nygard M. Barriers to cervical cancer screening faced by immigrants: a registry-based study of 1.4 million women in Norway. Eur J Pub Health. 2017;27(5):873–9.CrossRef Leinonen MK, Campbell S, Ursin G, Trope A, Nygard M. Barriers to cervical cancer screening faced by immigrants: a registry-based study of 1.4 million women in Norway. Eur J Pub Health. 2017;27(5):873–9.CrossRef
9.
go back to reference Leonhardt M, Aschenbrenner K, Kreis ME, Lauscher JC. Exploring the characteristics and potential disparities of non-migrant and migrant colorectal cancer patients regarding their satisfaction and subjective perception of care - a cross-sectional study. BMC Health Serv Res. 2018;18(1):423.CrossRef Leonhardt M, Aschenbrenner K, Kreis ME, Lauscher JC. Exploring the characteristics and potential disparities of non-migrant and migrant colorectal cancer patients regarding their satisfaction and subjective perception of care - a cross-sectional study. BMC Health Serv Res. 2018;18(1):423.CrossRef
10.
go back to reference Smaland Goth UG, Berg JE. Migrant participation in Norwegian health care. A qualitative study using key informants. Eur J Gen Pract. 2011;17(1):28–33.CrossRef Smaland Goth UG, Berg JE. Migrant participation in Norwegian health care. A qualitative study using key informants. Eur J Gen Pract. 2011;17(1):28–33.CrossRef
11.
go back to reference Lee S, Chen L, Ma GX, Fang CY. What Is Lacking in Patient-Physician Communication: Perspectives from Asian American Breast Cancer Patients and Oncologists. J Behav Health. 2012. 1(2).CrossRef Lee S, Chen L, Ma GX, Fang CY. What Is Lacking in Patient-Physician Communication: Perspectives from Asian American Breast Cancer Patients and Oncologists. J Behav Health. 2012. 1(2).CrossRef
12.
go back to reference Epstein AS, Prigerson HG, O'Reilly EM, Maciejewski PK. Discussions of life expectancy and changes in illness understanding in patients with advanced Cancer. J Clin Oncol. 2016;34(20):2398–403.CrossRef Epstein AS, Prigerson HG, O'Reilly EM, Maciejewski PK. Discussions of life expectancy and changes in illness understanding in patients with advanced Cancer. J Clin Oncol. 2016;34(20):2398–403.CrossRef
13.
go back to reference Bradley EH, Hallemeier AG, Fried TR, Johnson-Hurzeler R, Cherlin EJ, Kasl SV, et al. Documentation of discussions about prognosis with terminally ill patients. Am J Med. 2001;111(3):218–23.CrossRef Bradley EH, Hallemeier AG, Fried TR, Johnson-Hurzeler R, Cherlin EJ, Kasl SV, et al. Documentation of discussions about prognosis with terminally ill patients. Am J Med. 2001;111(3):218–23.CrossRef
14.
go back to reference Hillen MA, de Haes HC, Stalpers LJ, Klinkenbijl JH, Eddes EH, Butow PN, et al. How can communication by oncologists enhance patients' trust? An experimental study. Ann Oncol. 2014;25(4):896–901.CrossRef Hillen MA, de Haes HC, Stalpers LJ, Klinkenbijl JH, Eddes EH, Butow PN, et al. How can communication by oncologists enhance patients' trust? An experimental study. Ann Oncol. 2014;25(4):896–901.CrossRef
16.
go back to reference Weissman JS, Betancourt J, Campbell EG, Park ER, Kim M, Clarridge B, et al. Resident physicians’ preparedness to provide cross-cultural care. JAMA. 2005;294(9):1058–67.CrossRef Weissman JS, Betancourt J, Campbell EG, Park ER, Kim M, Clarridge B, et al. Resident physicians’ preparedness to provide cross-cultural care. JAMA. 2005;294(9):1058–67.CrossRef
18.
go back to reference Achimas-Cadariu P, Iancu M, Kubelac P, Pop F, Braicu I, Vlad C, et al. Expectations and perspectives of ovarian cancer patients about cancer management in Romania. The international NOGGO-ENGOT trial: EXPRESSION III. Eur J Cancer Care (Engl). 2017, 26(6).CrossRef Achimas-Cadariu P, Iancu M, Kubelac P, Pop F, Braicu I, Vlad C, et al. Expectations and perspectives of ovarian cancer patients about cancer management in Romania. The international NOGGO-ENGOT trial: EXPRESSION III. Eur J Cancer Care (Engl). 2017, 26(6).CrossRef
19.
go back to reference Oskay-Ozcelik G, Lehmacher W, Konsgen D, Christ H, Kaufmann M, Lichtenegger W, et al. Breast cancer patients' expectations in respect of the physician-patient relationship and treatment management results of a survey of 617 patients. Ann Oncol. 2007;18(3):479–84.CrossRef Oskay-Ozcelik G, Lehmacher W, Konsgen D, Christ H, Kaufmann M, Lichtenegger W, et al. Breast cancer patients' expectations in respect of the physician-patient relationship and treatment management results of a survey of 617 patients. Ann Oncol. 2007;18(3):479–84.CrossRef
20.
go back to reference Bureau for Statistics Berlin-Brandenburg, (2016). Statistical report a I 5 – hj 2 / 15. Potsdam. Bureau for Statistics Berlin-Brandenburg, (2016). Statistical report a I 5 – hj 2 / 15. Potsdam.
21.
go back to reference Reus-Pons M, Mulder CH, Kibele EUB, Janssen F. Differences in the health transition patterns of migrants and non-migrants aged 50 and older in southern and western Europe (2004-2015). BMC Med. 2018;16(1):57.CrossRef Reus-Pons M, Mulder CH, Kibele EUB, Janssen F. Differences in the health transition patterns of migrants and non-migrants aged 50 and older in southern and western Europe (2004-2015). BMC Med. 2018;16(1):57.CrossRef
22.
go back to reference Vang ZM, Sigouin J, Flenon A, Gagnon A. Are immigrants healthier than native-born Canadians? A systematic review of the healthy immigrant effect in Canada. Ethn Health. 2017;22(3):209–41.CrossRef Vang ZM, Sigouin J, Flenon A, Gagnon A. Are immigrants healthier than native-born Canadians? A systematic review of the healthy immigrant effect in Canada. Ethn Health. 2017;22(3):209–41.CrossRef
23.
go back to reference Boateng L, Nicolaou M, Dijkshoorn H, Stronks K, Agyemang C. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam. BMC Health Serv Res. 2012;12:75.CrossRef Boateng L, Nicolaou M, Dijkshoorn H, Stronks K, Agyemang C. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam. BMC Health Serv Res. 2012;12:75.CrossRef
24.
go back to reference von Au A, Weiler U, Stefanovic S, Wallwiener M, Heil J, Golatta M, et al. Breast cancer presentation and therapy in migrant versus native German patients: contrasting and convergent data of a retrospective monocentric study. Arch Gynecol Obstet. 2016;294(1):145–52.CrossRef von Au A, Weiler U, Stefanovic S, Wallwiener M, Heil J, Golatta M, et al. Breast cancer presentation and therapy in migrant versus native German patients: contrasting and convergent data of a retrospective monocentric study. Arch Gynecol Obstet. 2016;294(1):145–52.CrossRef
25.
go back to reference Cohen M. An integrated view of cultural perceptions of cancer among Arab people in Israel. Health Psychol Rev. 2014;8(4):490–508.CrossRef Cohen M. An integrated view of cultural perceptions of cancer among Arab people in Israel. Health Psychol Rev. 2014;8(4):490–508.CrossRef
26.
go back to reference HealthCare Chaplaincy Network. In: Handbook of patients’ spiritual and cultural values for health care professionals. New York: Updated edition 3/13; 2013. HealthCare Chaplaincy Network. In: Handbook of patients’ spiritual and cultural values for health care professionals. New York: Updated edition 3/13; 2013.
27.
go back to reference Tayeb MA, Al-Zamel E, Fareed MM, Abouellail HA. A "good death": perspectives of Muslim patients and health care providers. Ann Saudi Med. 2010;30(3):215–21.CrossRef Tayeb MA, Al-Zamel E, Fareed MM, Abouellail HA. A "good death": perspectives of Muslim patients and health care providers. Ann Saudi Med. 2010;30(3):215–21.CrossRef
28.
go back to reference Sprung CL, Maia P, Bulow HH, Ricou B, Armaganidis A, Baras M, et al. The importance of religious affiliation and culture on end-of-life decisions in European intensive care units. Intensive Care Med. 2007;33(10):1732–9.CrossRef Sprung CL, Maia P, Bulow HH, Ricou B, Armaganidis A, Baras M, et al. The importance of religious affiliation and culture on end-of-life decisions in European intensive care units. Intensive Care Med. 2007;33(10):1732–9.CrossRef
29.
go back to reference Triandis HCTD. Culture and its implications for intergroup behavior. Brown R GS, editor. Oxford: Blachwell; 2001. Triandis HCTD. Culture and its implications for intergroup behavior. Brown R GS, editor. Oxford: Blachwell; 2001.
30.
go back to reference Hofstede G, Hofstede G. J., & Minkov, M. cultures and organizations: software of the mind : intercultural cooperation and its importance for survival. New York. London: McGraw-Hill; 2010. Hofstede G, Hofstede G. J., & Minkov, M. cultures and organizations: software of the mind : intercultural cooperation and its importance for survival. New York. London: McGraw-Hill; 2010.
31.
go back to reference Biyikli GE. Difficulties in health care for female Turkish immigrants with type 2 diabetes: a qualitative study in Vienna. Wien Klin Wochenschr. 2017;129(9–10):337–44.CrossRef Biyikli GE. Difficulties in health care for female Turkish immigrants with type 2 diabetes: a qualitative study in Vienna. Wien Klin Wochenschr. 2017;129(9–10):337–44.CrossRef
32.
go back to reference Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, et al. Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Public Health. 2011;11:187.CrossRef Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, et al. Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Public Health. 2011;11:187.CrossRef
33.
go back to reference Ilkilic I. Cultural aspects of ethical decisions at the end of life and cultural competence. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008;51(8):857–64.CrossRef Ilkilic I. Cultural aspects of ethical decisions at the end of life and cultural competence. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008;51(8):857–64.CrossRef
34.
go back to reference Erdsiek F, Waury D, Brzoska P. Oral health behaviour in migrant and non-migrant adults in Germany: the utilization of regular dental check-ups. BMC Oral Health. 2017;17(1):84.CrossRef Erdsiek F, Waury D, Brzoska P. Oral health behaviour in migrant and non-migrant adults in Germany: the utilization of regular dental check-ups. BMC Oral Health. 2017;17(1):84.CrossRef
35.
go back to reference Kietzmann D, Wiehn S, Kehl D, Knuth D, Schmidt S. Migration background and overall satisfaction with pre-hospital emergency care. Appl Nurs Res. 2016;29:96–100.CrossRef Kietzmann D, Wiehn S, Kehl D, Knuth D, Schmidt S. Migration background and overall satisfaction with pre-hospital emergency care. Appl Nurs Res. 2016;29:96–100.CrossRef
36.
go back to reference Schenk L. Migrationssensible Gesundheitsforschung: Theoretische und empirische Forschungsergebnisse - [Migrant sensitive health research: Theoretical and empirical results]. Berlin: Freie Universität Berlin; 2016. Schenk L. Migrationssensible Gesundheitsforschung: Theoretische und empirische Forschungsergebnisse - [Migrant sensitive health research: Theoretical and empirical results]. Berlin: Freie Universität Berlin; 2016.
Metadata
Title
Does migrant background predict to what extent colorectal cancer patients want to be informed about their life expectancy? – a cross-sectional analysis
Authors
Marja Leonhardt
Katja Aschenbrenner
Martin E. Kreis
Johannes C. Lauscher
Publication date
01-12-2019
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2019
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-019-1105-0

Other articles of this Issue 1/2019

International Journal for Equity in Health 1/2019 Go to the issue