Culture sensitive care in oncology care settings in Jordan: a qualitative study

Cultural beliefs significantly impact cancer perceptions, treatment choices, and care experiences. In Jordan, diverse patient background requires cultural competence and bias awareness among providers. This study aims to explore the cultural beliefs and practices of patients and their families in the experience of cancer care, and how these practices influence such care in Jordan.

This is a multi-center qualitative study used semi-structured face-to-face interviews with oncology healthcare providers, caregivers, and patients from three tertiary Jordanian hospitals providing cancer care. Purposive sampling was employed, and the interviews were analyzed using thematic analysis and NVivo 12 software.

We conducted 108 face-to-face interviews with 35 patients, 37 caregivers, and 36 providers. Notably, 22% of patients and caregivers were non-Jordanian. Thematic analysis identified five major themes shared across both Jordanian and non-Jordanian participants: (1) Tradition and Rituals: Preferences varied around food, visitations and modifications to usual religious practices, (2) Cancer Conceptualization: While many viewed cancer as a divine test, others attributed it to genetics, poor nutrition, stress, or environmental factors such as pollution, (3) Advance Directives and information sharing: Participants preferred timely discussions on directives with preferences ranging from proactive to gradual disclosure. Shared decision-making was emphasized. Typically involving physicians, family members, and key figures, especially the patient spouse or eldest male relative. Some caregivers and providers reported withholding details from patients and children upon family's request, (4) Psychosocial and practical concerns: Participants expressed worries about treatment side effects, disease progression, financial burden, and the future of patient' children, and (5) Healthcare Provider's Characteristics: Patients preferred respect, and clinical expertise over providers' gender, nationality, or religion. However they favored same-gender nurses for daily care and those who could communicate in Arabic.

The study demonstrates how culturally embedded beliefs, family dynamics, and faith-based interpretations uniquely shape cancer care interactions in Jordan. Addressing these context-specific cultural factors is essential for strengthening culturally responsive communication and patient-centered oncology services in the region.