Background:Communication barriers are a critical yet underexplored determinant of psychological well-being in oncology care,particularly among rural Chinese patients treated in urban hospitals.This study examined how ...Background:Communication barriers are a critical yet underexplored determinant of psychological well-being in oncology care,particularly among rural Chinese patients treated in urban hospitals.This study examined how Mandarin proficiency influences emotional distress and identified implications for mental health promotion.Methods:A sequential mixed-methods design was adopted.Quantitative data were collected from 180 rural cancer patients using the Putonghua Proficiency Test(PSC),the Hospital Anxiety and Depression Scale(HADS),and the Distress Thermometer(DT).Multiple linear regressions estimated covariate-adjusted associations between Mandarin proficiency and distress outcomes,controlling for demographic and clinical factors.Semi-structured interviews with 20 patients explored communication experiences and psychosocial impacts.Quantitative and qualitative findings were integrated for triangulated interpretation.Results:Lower Mandarin proficiency was significantly associated with higher anxiety(β=−0.30,p=0.001),depression(β=−0.25,p=0.01),and distress(β=−0.28,p=0.003),with an adjusted R^(2)=0.18(F=7.4,p<0.001).Each 10-point increase in PSC corresponded to a 0.5-point reduction in DT score(B=−0.05,p=0.003).Qualitative themes revealed confusion,stigma,isolation,and reliance on family interpreters,confirming that linguistic inequity functions as an independent psychosocial stressor in oncology care.Conclusion:Language barriers significantly heighten distress among rural Chinese cancer patients.Addressing these barriers through interpreter services,culturally responsive staff training,and inclusive educational materials should be recognized as a core strategy for mental health promotion and equitable cancer care.展开更多
文摘Background:Communication barriers are a critical yet underexplored determinant of psychological well-being in oncology care,particularly among rural Chinese patients treated in urban hospitals.This study examined how Mandarin proficiency influences emotional distress and identified implications for mental health promotion.Methods:A sequential mixed-methods design was adopted.Quantitative data were collected from 180 rural cancer patients using the Putonghua Proficiency Test(PSC),the Hospital Anxiety and Depression Scale(HADS),and the Distress Thermometer(DT).Multiple linear regressions estimated covariate-adjusted associations between Mandarin proficiency and distress outcomes,controlling for demographic and clinical factors.Semi-structured interviews with 20 patients explored communication experiences and psychosocial impacts.Quantitative and qualitative findings were integrated for triangulated interpretation.Results:Lower Mandarin proficiency was significantly associated with higher anxiety(β=−0.30,p=0.001),depression(β=−0.25,p=0.01),and distress(β=−0.28,p=0.003),with an adjusted R^(2)=0.18(F=7.4,p<0.001).Each 10-point increase in PSC corresponded to a 0.5-point reduction in DT score(B=−0.05,p=0.003).Qualitative themes revealed confusion,stigma,isolation,and reliance on family interpreters,confirming that linguistic inequity functions as an independent psychosocial stressor in oncology care.Conclusion:Language barriers significantly heighten distress among rural Chinese cancer patients.Addressing these barriers through interpreter services,culturally responsive staff training,and inclusive educational materials should be recognized as a core strategy for mental health promotion and equitable cancer care.
