Unveiling the unheard narratives: Integrating narrative medicine into electronic medical records for non–English-speaking cancer patients.

Abstract

e23132 Background: In recent years, narrative medicine has gained traction in medical practice, enabling patients with cancer to affirm their self-worth and preserve their integrity. However, the impact of language barriers and its potential integration into Electronic Medical Records (EMR) remains poorly understood. We hypothesized that for non-English-speaking cancer patients, conducting interviews to include their stories in the EMR would enhance connection and empathy in the medical community. Methods: Semi-structured interviews were conducted in person at our oncology clinic with 10 Mandarin- or Cantonese-speaking patients living with chronic oncological illnesses, reflecting the community we serve. Four interviews were conducted in patients' native language, while six used virtual English interpreters. The interviews explored patients' life narratives, support systems, and the impact of cancer on daily life, such as, “ Has your illness impacted your life and if so in what ways? ”. Transcripts were analyzed for thematic coding and translated into themes following the steps outlined by Braun and Clarke in 2006. Results: Four key themes emerged. First, language barriers hindered patients' communication with healthcare providers. While interpreters facilitated communication, emotional and cultural nuances were often diluted. Patients interviewed in their native language shared richer, more detailed stories than those using interpreters. Second, cancer impacted not only physicial abilites, but also emotional and social well-being, with financial challenges and health-related distress frequently mentioned. Many patients shared concerns such as, " I’m unable to work due to my illness ," and "I just watch TV and let the day pass by ". Third, family served as a critical yet emotionally complex support system. While many relied heavily on family, some felt like a burden or experienced strained relationships, saying, “ I feel like I’ve become a burden to my family. " Finally, over 70% patients found the interview valuable and therapeutic, expressing a desire to have their stories included in the EMR to bridge communication gaps. One patient noted, “ This might help the doctor understand me better, " and another stated, "I feel that having this conversation is meaningful ". Conclusions: The study highlighted the challenges faced by non-English-speaking cancer patients, including language barriers, financial strain, emotional distress, and reliance on family support. Despite the difficulties, patients valued sharing their experience and integrating the interviews into EMR to strengthen provider connections. The findings suggest a need for future efforts to incorporate culturally and linguistically appropriate communication strategies to enable incorporation of illness narratives into the EMR toward further evaluation of its impact on care outcome.