Enhancing patient participation of older migrant cancer patients: needs, barriers, and eHealth
Open accessAbstract
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.
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Digital literacy, language, access to devices, reliable internet connectivity, and confidence using technology affected participation across several studies.
“Digital literacy, language, access to devices, reliable internet connectivity, and confidence using technology affected participation across several studies [25,37,46,48,50,58].”
From Digital health technologies in oncology services: A scoping review of clinical implementation, organisational evidence gaps, and policy implications (2026) · cites this paper as [48]
The Language barrier and low health literacy section identifies language as a barrier to participation. The Technology acceptance section reports difficulty using the Health Communicator and doubts about being able to use it, supporting the digital-skills and confidence portions. The cited paper does not establish that access to devices or reliable internet connectivity affected participation. (LLM, conf=0.87)
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- Authors
- Yılmaz, N. G., Sungur, H., van Weert, J. C. M., van den Muijsenbergh, M. E. T. C., & Schouten, B. C.
- Affiliations
- Amsterdam University Medical Centers (NL)
- University of Amsterdam (NL)
- Department of Communication Science, Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
- Corresponding author
- Yılmaz, Nida Gizem
- Venue
- Ethnicity & Health
- Publisher
- Informa UK Limited
- Published
- 2020-12-14
- Volume
- 27
- Issue
- 5
- Pages
- 1123-1146
- ISSN
- 1355-7858 (ISSN-L)
- 1465-3419
- OpenAlex
- W3113006135
- Cited by
- 34
- References
- 44
- Citations by year
- 2026: 9 · 2025: 4 · 2024: 9 · 2023: 5 · 2022: 6 · 2020: 1
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Ethnicity and Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by-nc-nd)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Dutch Cancer Foundation
- KWF Kankerbestrijding
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Keywords
- patient participation, elderly cancer patients, cancer survivors, migrant patients, Turkish-Dutch, Moroccan Dutch, e-health, multilingual health communication, patient needs, barriers to care, health literacy, language barriers, cultural taboos, trust in healthcare, physician-patient relationship, psychosocial support, technology acceptance, general practitioners, oncology nurses
- MeSH terms
- Aged, Humans, Middle Aged, Neoplasms, Patient Participation, Physician-Patient Relations, Transients and Migrants, Telemedicine, Qualitative Research
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