Communication in a South African Cancer Setting: Cross-Cultural Implications

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The purpose of this article is to address cross-cultural provider–patient communication difficulties and their subsequent interference with the quality of treatment. The work currently under way between the Western-trained medical profession and three underserved communities of Black South Africans accustomed to traditional medicine systems serves as the illustrative case. Specifically, in this international project, American psychologists are assisting highly educated, urban Afrikaner medical and health care professionals enhance the cancer treatment provided to rural, low-income Zulu, Tswana, and Pedi patients. This paper consists of several sections. The first section discusses the two cultures involved in the project, with an emphasis on facts about the underserved populations. The second section summarizes findings from the administration of translations of a quality of life instrument (FACT-G). The following section outlines key findings in the area of doctor–patient communication in the Western medical context and specific provider–patient research in South Africa. Communication patterns in medical contexts as influenced by culture as well as doctor–patient relationship expectations are the focus of discussion in the fourth section, and the next section presents related general cross-cultural factors as developed by Geert Hofstede and various multicultural psychology authors. The subsequent section provides additional information from Witte and Morrison on culturally influenced perspectives of health. The final section presents several overall conclusions and recommendations to further improve quality of treatment in cross-cultural contexts.

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