Physician Perception of Trust and Communication with Asian Patients with Serious
Illness and Their Families in the United States: An Exploratory Qualitative
Study
#MMPMID41340643
Huan C
; Yeh IM
; Troiani FL
; Tjia J
Palliat Med Rep
2025[]; 6
(1
): 542-553
PMID41340643
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BACKGROUND: Asians in the United States receive less palliative care and enter
hospice less than Whites, disproportionately receive more invasive mechanical
ventilation, and report less involvement in decision-making with physicians than
they would like. Despite the growing literature addressing serious illness in
diverse patient populations, communication with Asians is understudied. This
study aimed to explore U.S. physician perceptions of clinical interactions with
Asian patients with serious illness and barriers and facilitators to
physician-patient communication. METHODS: This is an exploratory qualitative
descriptive study using semistructured interviews with U.S. physicians who cared
for Asian patients with serious illness. We used an inductive content analysis
approach to identify themes related to facilitators and barriers to communication
between Asian patients, their families, and physicians. RESULTS: We conducted 10
physician interviews between February and April 2024. Of participants, 50% were
White and 50% were Asian, the majority were male, and 50% specialized in
palliative care. Three major themes arose: (1) trust cannot be assumed; (2)
understanding and honoring the role of family are key; and (3) honoring the
patient's preferences for communication can build trust. CONCLUSION: This study
is a step in illustrating how a cross-cultural approach to communication needs to
align physicians, patients, and families on the process of communication and
shared decision-making and not only on the goals for care. Moving toward a
cultural adaptive approach can empower clinicians to engage in a trust-building
process of inquiry, observation, and understanding of how sociocultural factors
impact patient preferences for health care.
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