“Breaking breast cancer news” with ethnic minority: a UK experience

Breaking bad news is a challenge in medicine. It requires good communication skills, understanding, and empathy on the part of a clinician. Communication has both verbal and non-verbal components. The requirement for non-verbal communication varies with various diverse groups, depending upon their cultural and religious beliefs. Breaking bad news in an ethnically diverse group is complex where cultural, religious, and language barriers may exist. The National Health Service was established in 1948. Ethnic minority comprised of only 0.2% (53,000) of the total population. The health care professionals shared the same cultural backgrounds as their patients at that time. Census in 2011 indicates that the number of the ethnically diverse group has increased to 14% (2 million) in England and Wales. Eighty-six percent of the population was white British. Asians (Pakistani, Indian, Bangladeshi, and other) “groups” made up 7.5% of the population; black groups 3.4%; Chinese groups 0.7%; Arab groups 0.4%; and other groups 0.6%. This figure is expected to increase by 20%–30% in 2050. It is, therefore, important that a doctor working within the National Health Service in the UK, should be prepared to deal with patients who may have a different culture, faith, language, and set of beliefs. In this article, I have highlighted the various challenges/issues in communication with such patients, available resources, and recommendations of strategies to improve their care. Unfortunately, no one single strategy can be applied to all as each patient should be recognized individually and as such, different factors have different weightings on each consultation. It is, therefore, important that hospitals raise cultural and religious awareness so that the doctors can be more understanding toward their patients. This will not only improve the patient’s experience, medical staff would also feel professionally satisfied.