Use of traditional therapies in palliative care for Australian First Nations peoples: An integrative review

AIMS AND OBJECTIVES

To conduct an integrative review of the literature to understand how the incorporation of traditional therapies affect First Nations people's utilisation of palliative care services.

BACKGROUND

First Nations peoples face many barriers related to accessing and utilising specialised health services such as palliative care. Whilst culturally appropriate care has been shown to improve these outcomes, there is little evidence regarding how this may be achieved.

DESIGN

Integrative review.

METHODS

A systematic search was conducted using electronic databases CINAHL, Joanna Briggs, Medline, Scopus, ScienceDirect InformitHealth and ProQuest between the years of 2005 - 2021 databases were searched for papers with full text available and published in English. Papers were included if they were primary-based research and focused on the topics of the use of traditional therapies in a palliative care context by First Nations persons. The Critical Appraisal Skills Programme principles were used to assess the methodological quality of the selected articles.

RESULTS

Seven studies met the inclusion criteria and were included in the review. The review included six qualitative studies and one quantitative study. From these studies, five themes were identified in the literature: supporting a holistic approach, developing culturally appropriate care, conflict within a Western medical model, regulatory issues, and geographical barriers.

CONCLUSION

There is a dearth of current literature available discussing the utilization of traditional therapies in palliative care. From the literature analysed, the benefits of including traditional therapies are overall positive, however, there are barriers including conflict with the Western model of medicine and regulation. More research is required in the provision of traditional therapies in palliative care.

RELEVANCE TO CLINICAL PRACTICE

The incorporation of traditional medicines within a palliative care setting could help nurses provide holistic and culturally appropriate care, especially in rural and remote areas where they make up the majority of the healthcare force.

Herbal medicines: challenges in the modern world. Part 1. Australia and New Zealand

As in many developed countries, herbal medicines (HMs) are widely used in Australia and New Zealand (NZ). The popularity of HM continues to rise. Western, Asian and indigenous HMs are used, reflecting the cultural diversity of people in this region. HMs in Australia are regulated on a risk-based system with many HMs identified as being low risk. The legislation was reviewed in 2015 and proposals for change are under consideration. In NZ, it is recognised that current regulations for HMs and other natural health products (NHPs) do not adequately protect public health. NZ is entering a phase of regulatory change for this sector, and proposals for a 'light-touch' regulatory framework for NHPs are planned to be introduced into legislation during 2016.

A brief review of the application and pharmacology of ethnomedicines of Indigenous Australians

OBJECTIVE

Indigenous Australians suffer higher mortality and have statistically worse outcomes for many chronic disease states than the non-Indigenous population. Although many of these people are prescribed pharmaceutical drugs for their illnesses, some still use medicines that were traditional to their culture. This report reviews some of the traditional medicines used for ailments seen in Indigenous Australian communities.

DESIGN

A literature search was conducted, with the period between the publication of an 'Aboriginal Pharmacopoeia' in 1988 and 'current' our target interval for searching. The ethics of publishing knowledge belonging to Aboriginal people is briefly discussed in this context.

RESULTS

Ailments were grouped into communicable diseases, pain and inflammation, skin disorders and gastrointestinal disorders. Although cancer is regarded as a disease of the 'white man', it is briefly discussed in the context that several traditional medicines and foods may have provided some protective effects. Where known, the ethnopharmacology of these medicines is discussed, as well as a brief description of their preparation and application.

CONCLUSION

Some Indigenous Australians continue to use traditional medicines. We have tabulated these according to ailment, and have listed pharmacological actions where known. What is not known, however, is their potential to interact with pharmaceutical drugs. Further study in this area is needed to optimise health outcomes for Indigenous Australians, especially those in remote communities.