"Lost in translation": The experience in trans-cultural work in an Italian department of pediatric hematology and oncology

In recent decades, western Europe has experienced an increase in immigration, especially from eastern European and Southern Mediterranean countries, not only for financial reasons, but also in the quest for better and free health care. Living in a foreign country mainly difficulties affect children, women and individuals with disabilities, resulting in reduced psychological and social well-being related also to the cultural and linguistic barriers. Effective communication plays a pivotal role in clinician - patient relationship, the knowledge of patient's needs and concerns is at the base of therapeutic alliance and it allows a shared plane care involving medical and psychosocial aspects. In some case it could be difficult for sanitary staff working with patients with different culture and language, to build a good relationship base on trust and comprehension. We investigated how different professional figures face this problem. The results show that a different cultural background is essential to help them to understand other life styles. The presence of trans-cultural mediators can help both to overcome the language barriers and to understand different cultural attitudes; the medical staff is more stressed by the transcultural work than other staff members. Lack of communication represents a stressor both for the health professionals and for the patients. Training programs on improving communication skills and on overcoming language barriers are needed in order to improve the approach to foreign patients and families.