Does social support reduce distress and worry among Aboriginal and Torres Strait Islander people with cancer?

Utilising the CREATE quality appraisal tool to analyse Aboriginal and Torres Strait Islander peoples' involvement and reporting of cancer research in Australia

OBJECTIVE

We aimed to evaluate Aboriginal and Torres Strait Islander involvement in research focusing on cancer experiences using an Aboriginal and Torres Strait Islander quality appraisal tool (the QAT).

METHODS

We conducted a systematic review of the peer-reviewed literature on Aboriginal and Torres Strait Islander peoples' experiences associated with cancer, recently published elsewhere. We then appraised articles for the inclusion of Aboriginal and Torres Strait Islander-led research, community consultation, and involvement.

RESULTS

91 articles were appraised. A lack of Aboriginal and Torres Strait Islander-led research and consultation was reported in the majority of articles, only 10 (11%) demonstrated success across seven (50%) or more questions of the QAT.

CONCLUSIONS

This review underscores the need for anti-racist research and publication practices that actively engage Aboriginal and Torres Strait Islander peoples and researchers. This approach is vital to enhance cancer outcomes within these communities.

IMPLICATIONS FOR PUBLIC HEALTH

To advance and prioritise appropriate involvement of Aboriginal and Torres Strait Islander peoples in cancer research, the onus must be on 'systems owners,' including academic journals and institutions, to require and report genuine engagement as standard practice. Researchers will produce higher-calibre research with a strengths-based focus, advancing the cause of equitable research.

Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer

BACKGROUND

Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia.

METHODS

A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations.

RESULTS

Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings.

CONCLUSION

Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.

Perspectives of Aboriginal People Affected by Cancer on the Need for an Aboriginal Navigator in Cancer Treatment and Support: A Qualitative Study

Aboriginal and Torres Strait Islander Australians suffer higher rates of cancer and poorer outcomes than the wider population. These disparities are exacerbated by rurality and remoteness due to reduced access and limited engagement with health services. This study explored the cancer journeys of Aboriginal patients and carers, and their views on the establishment of an Aboriginal Patient Navigator role within the Western Australian healthcare system to support cancer patients and their families. Sixteen Aboriginal participants were interviewed either face to face, by telephone, or via video conferencing platforms. The interviews were then recorded, transcribed, and thematically analyzed using standard qualitative techniques. Close consultation within the research team enhanced the rigour and robustness of the study findings. Patients and carers identified many gaps in cancer service delivery that made their experiences stressful and unnecessarily complex. Challenges included a lack of stable accommodation, financial burdens, constant travel, being "off-Country", and miscommunication with health professionals. Key sources of support and strength were the centrality of family and ongoing cultural connectedness. All participants were supportive of an Aboriginal Patient Navigator role that could address shortfalls in cancer service delivery, especially for patients from rural and remote communities. A culturally safe model of support has the potential to increase access, reduce anxiety and improve health outcomes.