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Wilson L, Rice C, Thompson S. Social Participation and Loneliness in Older Adults in a Rural Australian Context: Individual and Organizational Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:886. [PMID: 39063463 PMCID: PMC11276585 DOI: 10.3390/ijerph21070886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/03/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
A rise in aging populations globally calls attention to factors that influence the well-being and health of older adults, including social participation. In Australia, rural older adults face cultural, social, and physical challenges that place them at risk for isolation. Thus, research surrounding social participation and healthy aging is increasingly relevant, especially in rural areas. This qualitative study in a remote town in Western Australia explores barriers and facilitators to older adults' social participation. To investigate multiple perspectives, 23 adults aged 50+ and 19 organizations from a rural town were interviewed. A stakeholder reference group was engaged to refine the research design and validate the findings. Feedback from early interviews was used to refine the data collection process, thus enhancing the validity of the findings. Thematic analysis showed that health and mobility issues, inadequate infrastructure, poor sustainability, and cultural tensions commonly impacted social participation. Themes of rural town culture, cultural power dynamics, and rural stoicism were identified as cultural aspects that inhibited participation. Based on results of this study and the supporting literature, recommendations for inclusive activities include supporting community-designed programs, utilizing culturally sensitive language and personnel, expanding services using existing community resources, and diversifying older adults' roles in existing groups.
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Affiliation(s)
- Leah Wilson
- Department of Global Health, Georgetown University, Washington, DC 20057, USA
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6009, Australia;
| | - Carrigan Rice
- Department of Global Health, Georgetown University, Washington, DC 20057, USA
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6009, Australia;
| | - Sandra Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6009, Australia;
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Pham LA, Clark PJ, Macdonald GA, Thomas JA, Dalais C, Fonda A, Kendall BJ, Thrift AP. Colorectal cancer screening participation in First Nations populations worldwide: a systematic review and data synthesis. EClinicalMedicine 2024; 73:102666. [PMID: 38828132 PMCID: PMC11139771 DOI: 10.1016/j.eclinm.2024.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024] Open
Abstract
Background First Nations populations have poorer colorectal cancer (CRC) survival compared to non-First Nations populations. Whilst First Nations populations across the world are distinct, shared experiences of discrimination and oppression contribute to persistent health inequities. CRC screening improves survival, however screening rates in First Nations populations are poorly described. This study seeks to define participation rates in CRC screening in First Nations populations worldwide. Methods A systematic literature search was conducted of PubMed, Embase, Cochrane Library, CINAHL, MEDLINE, grey literature, national registries and ClinicalTrials.gov. All sources were searched from their inception date to 18 February 2024. Studies were included if they reported CRC screening rates in adult (≥18 years) First Nations populations. We aimed to undertake a meta-analysis if there were sufficient data. Quality of papers were assessed using the Joanna Briggs Institute (JBI) appraisal tool. The study was registered with PROSPERO, CRD42020210181. Findings The literature search identified 1723 potentially eligible published studies. After review, 57 studies were included, 50 from the United States (US), with the remaining studies from Australia, Aotearoa New Zealand (NZ), Canada, Dominica and Guatemala. Additionally, eleven non-indexed reports from national programs in Australia and NZ were included. There were insufficient data to undertake meta-analysis, therefore a systematic review and narrative synthesis were conducted. CRC screening definitions varied, and included stool-based screening, sigmoidoscopy and colonoscopy. US First Nations screening rates ranged between 4.0 and 79.2%, Australia reported 10.6-35.2%, NZ 18.4-49%, Canada 22.4-53.4%, Guatemala 2.2% and Dominica 4.2%. Fifty-five studies were assessed as moderate or high quality and two as low quality. Interpretation Our findings suggested that there is wide variation in CRC screening participation rates across First Nations populations. Screening data are lacking in direct comparator groups and longitudinal outcomes. Disaggregation of screening data are required to better understand and address First Nations CRC outcome inequities. Funding None.
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Affiliation(s)
- Lily A. Pham
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Paul J. Clark
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Graeme A. Macdonald
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - James A. Thomas
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Christine Dalais
- University of Queensland Library, The University of Queensland, Brisbane, Australia
| | - Annie Fonda
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Brisbane, Australia
| | - Bradley J. Kendall
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Aaron P. Thrift
- Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, United States
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, United States
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de Groot A, Brown B, Lindsay D, Gall A, Hewlett N, Hickman A, Garvey G. 'How Your Spirit Is Travelling'-Understanding First Nations Peoples' Experiences of Living Well with and after Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:798. [PMID: 38929044 PMCID: PMC11203506 DOI: 10.3390/ijerph21060798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
As the number of people living with cancer increases, it is important to understand how people can live well with and after cancer. First Nations people diagnosed with cancer in Australia experience survival disparities relating to health service accessibility and a lack of understanding of cultural needs and lived experiences. This study aimed to amplify the voices of First Nations individuals impacted by cancer and advance the development of a culturally informed care pathway. Indigenist research methodology guided the relational and transformative approach of this study. Participants included varied cancer experts, including First Nations people living well with and after cancer, health professionals, researchers, and policy makers. Data were collected through online Yarning circles and analysed according to an inductive thematic approach. The experience of First Nations people living well with and after cancer is inextricably connected with family. The overall themes encompass hope, family, and culture and the four priority areas included the following: strength-based understanding of cancer, cancer information, access to healthcare and support, and holistic cancer services. Respect for culture is interwoven throughout. Models of survivorship care need to integrate family-centred cancer care to holistically support First Nations people throughout and beyond their cancer journey.
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Affiliation(s)
- Anneliese de Groot
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- Australian Institute of Health Innovation, Macquarie University, Sydney 2113, Australia
| | - Bena Brown
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Brisbane 4077, Australia
| | - Daniel Lindsay
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Alana Gall
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore 2480, Australia
| | - Nicole Hewlett
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
| | - Amy Hickman
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
| | - Gail Garvey
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
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Paterson C, Roberts C, Blackburn J, Jojo N, Northam HL, Wallis E, Hind A, Caulfield R, Barratt M, Toohey K, Kavanagh PS, Bacon R, Wilson RL. Understanding the needs and preferences for cancer care among First Nations people: An integrative review. J Adv Nurs 2024; 80:1776-1812. [PMID: 38018290 DOI: 10.1111/jan.15968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
AIM This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people. DESIGN Integrative review. DATA SOURCES An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted. RESULTS Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs. CONCLUSION Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs. PATIENT OR PUBLIC CONTRIBUTION Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work. IMPLICATIONS FOR NURSING PRACTICE Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Blackburn
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - A Hind
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R Caulfield
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - M Barratt
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Justice and Society, University of South Australia, Magill, South Australia, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R L Wilson
- School of Nursing and Midwifery, University of Newcastle, Gosford, New South Wales, Australia
- School of Nursing, Massey University, Palmerston North, New Zealand
- Descendent of the Wiradjuri Nation (First Nations Person), New South Wales, Australia
- Department of Nursing, RMIT University, Melbourne, Victoria, Australia
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Henningham M, Gilroy J, McGlone J, Meehan D, Nila F, McAtamney A, Buchanan T. Utilising the CREATE quality appraisal tool to analyse Aboriginal and Torres Strait Islander peoples' involvement and reporting of cancer research in Australia. Aust N Z J Public Health 2024; 48:100142. [PMID: 38574430 DOI: 10.1016/j.anzjph.2024.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
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.
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Affiliation(s)
- Mandy Henningham
- Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - John Gilroy
- Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Farhana Nila
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
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Gilroy J, Henningham M, Meehan D, Nila F, McGlone J, McAtamney A, Whittaker K, Brown B, Varlow M, Buchanan T. Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer. BMC Public Health 2024; 24:523. [PMID: 38378574 PMCID: PMC10877816 DOI: 10.1186/s12889-024-18070-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
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.
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Affiliation(s)
- John Gilroy
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Mandy Henningham
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia.
| | - Farhana Nila
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | | | | | - Bena Brown
- Inala Indigenous Health Service, Metro South Health, Inala, QLD, 4077, Australia
| | - Megan Varlow
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Tanya Buchanan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
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Albenayyan HA, AlSubaie R, Alarfaj MO, Alshekhmobarak L, Alkhalifah MF, Alsaleem H, Almulhim D, AlJughaiman AA, Albahrani FA, Aleidan AA, Alzahrani RM, Alobaid L, Alhinidi T. Cancer Stigma Among 800 Saudi Citizens: A Cross-Sectional Study and Literature Review. Cureus 2023; 15:e49088. [PMID: 38125214 PMCID: PMC10731515 DOI: 10.7759/cureus.49088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Cancer-related stigmatization is a noteworthy phenomenon, yet it has not received sufficient attention in public health studies. Despite recent advancements in treatment and improvements in survival, the burden of stigma remains a challenging concern for individuals diagnosed with cancer. AIM This study aims to assess the presence of cancer stigma in the Saudi Arabian population by using the Cancer Stigma Scale (CASS). METHODS A cross-sectional study was conducted among the general population of Saudi Arabia. Data collection was facilitated through a self-administered online questionnaire, incorporating socio-demographic variables such as age, gender, and regional residence and employing the CASS instrument to gauge the prevalent attitudes and stigmas related to cancer. RESULTS Out of the 874 participants, a majority of 87.1% were female, with 60.2% aged between 20 and 39 years. Notably, 59% reported having a close friend or family member diagnosed with cancer. The average CASS score stood at 1.59 (SD 0.39) on a 5-point scale, with an overwhelming 97.1% registering scores under 2.5, suggesting a generally low stigma perception. In dissecting the CASS components, 'severity' recorded the highest mean score (mean: 2.23), followed by 'awkwardness' (mean: 1.86) and 'financial discrimination' (mean: 1.71). 'avoidance' registered the lowest mean score at 1.11. Notably, a trend of increasing stigma was observed with advancing age, and male respondents indicated a marginally higher propensity towards stigmatizing attitudes. CONCLUSION In Saudi Arabia, cancer-related stigma is generally low. However, 'severity' is the most prominent stigma aspect, with 'avoidance' being the least. Older individuals and males exhibit slightly higher stigmatizing attitudes. These insights highlight the need for targeted public health efforts to address remaining stigmatization, especially based on age and gender.
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Cummins R, Preston R, Topp SM, Taylor J, Larkins S, Callander E, Bell L, Arley B, Garvey G. A qualitative exploration of the non-financial costs of cancer care for Aboriginal and Torres Strait Islander Australians. Aust N Z J Public Health 2023; 47:100085. [PMID: 37688836 DOI: 10.1016/j.anzjph.2023.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 09/11/2023] Open
Abstract
OBJECTIVE Knowledge is growing about cancer care and financial costs for Aboriginal and Torres Strait Islander people. However, much remains unknown about the true costs of cancer care, encompassing financial, emotional, and spiritual aspects. We aimed to explore and explain how non-financial costs affect the health-seeking behaviours of these clients. METHODS Following Indigenous research protocols, this research was led by Aboriginal and Torres Strait Islander researchers and guided by Indigenous Hospital Liaison Officers. In-depth interviews and focus groups were conducted with 29 participants (Aboriginal and Torres Strait Islander cancer clients, their carers, and cancer-care professionals) at two Queensland public hospitals. RESULTS Four interwoven themes encompass non-financial costs of healthcare: leaving home and family; loss of control during cancer treatment; health of the spirit; social costs. The Aboriginal relational concept of 'being held' is useful in considering client, family, and carer as central to care with the Indigenous Hospital Liaison Officer two-way interpreting between the care and client team. IMPLICATIONS FOR PUBLIC HEALTH Framing the reasons that clients and carers have difficulty in engaging in treatment as 'costs' enables a focus on how the health system itself is implicated in the disengagement of Aboriginal and Torres Strait Islander clients from treatment.
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Affiliation(s)
- Rachel Cummins
- Djiru/Jirrabal/Bwgcolman, College of Medicine and Dentistry, Bebegu Yumba, James Cook University, Townsville, Australia
| | - Robyn Preston
- Public Health, College of Science and Sustainability, School of Health, Medical and Applied Sciences, CQUniversity, Townsville, Australia; College of Medicine and Dentistry, James Cook University, Townsville, Australia.
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Judy Taylor
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Emily Callander
- Monash University, School of Public Health and Preventive Medicine, Melbourne, VIC 3004, Australia; Health Services Management, University of Technology Sydney, School of Public Health, Sydney, Australia
| | - Lorraine Bell
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Australian e-Health Research Centre CSIRO, Brisbane, Queensland, Australia
| | - Brian Arley
- Daru, Tudugal, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Gail Garvey
- Menzies School of Health Research, Darwin, Northern Territory, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Darwin, Australia
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D'Costa I, Hunt I, Russell L, Adams K. A racial bias test with tertiary cancer centre employees: why anti-racist measures are required for First Nations Australians cancer care equity. AUST HEALTH REV 2023; 47:5-12. [PMID: 35477644 DOI: 10.1071/ah21113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 01/18/2022] [Indexed: 02/04/2023]
Abstract
Objective To examine implicit bias in employees at a cancer centre using an Australian race (Aboriginal-white) Implicit Association Test (IAT), in an attempt to understand a potential factor for inequitable outcomes of First Nations Australians cancer patients. Methods All employees at an Australian cancer centre were invited to take part in a web-based, cross-sectional study using an Australian race IAT. The results were analysed using Welch t-tests, linear regression and ANOVA. Results Overall, 538/2871 participants (19%) completed the IAT between January and June 2020. The mean IAT was 0.147 (s.d. 0.43, P < 0.001, 95% CI 0.11-0.18), and 60% had a preference for white over First Nations Australians. There was no significant mean difference in IAT scores between sub-groups of gender, age or clinical/non-clinical employees. 21% of employees (95% CI 17.65-24.53) had moderate to strong preference for white over First Nations Australians, compared to 7.1% with moderate to strong preference for First Nations over white Australians (95% CI 5.01-9.09). Conclusions Inequitable cancer survival for First Nations patients has been well established and cancer is now the leading cause of mortality. This paper documents the presence of racial bias in employees at one cancer centre. We argue that this cannot be understood outside the history of colonialism and its effects on First Nations Australians, healthcare workers and our society. Further research is required to evaluate measures of racism, its effect on health care, and how to eliminate it.
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Affiliation(s)
- I D'Costa
- School of Medicine, Nursing and Health Science, Monash University, Wellington Road, Clayton, Melbourne, Vic. 3800, Australia; and Peter MacCallum Cancer Centre, Melbourne, Vic. 3000, Australia
| | - I Hunt
- University of Tasmania, Launceston, Australia
| | - L Russell
- Monash Indigenous Studies Centre, School of Philosophical, Historical, and International Studies, and Australian Research Council Centre of Excellence in Australian Biodiversity and Heritage, Wellington Road, Clayton, Melbourne, Vic. 3800, Australia
| | - K Adams
- Gukwonderuk Indigenous Health Unit, The Faculty of Medicine, Nursing and Health Sciences School, Wellington Road, Clayton, Melbourne, Vic. 3800, Australia
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Sanjida S, Garvey G, Ward J, Bainbridge R, Shakeshaft A, Hadikusumo S, Nelson C, Thilakaratne P, Hou XY. Indigenous Australians' Experiences of Cancer Care: A Narrative Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416947. [PMID: 36554828 PMCID: PMC9779788 DOI: 10.3390/ijerph192416947] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/11/2022] [Accepted: 12/14/2022] [Indexed: 05/31/2023]
Abstract
To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples' cancer care experiences in the Australian healthcare system from the patient's point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in this review. The inductive approach was used for analysing qualitative data on cancer care experience in primary, tertiary and transitional care between systems. Three main themes were found in healthcare services from Indigenous cancer care experiences: communication, cultural safety, and access to services. Communication was an important theme for all healthcare systems, including language and literacy, understanding of cancer care pathways and hospital environment, and lack of information. Cultural safety was related to trust in the system, privacy, and racism. Access to health services was the main concern in transitional care between healthcare systems. While some challenges will need long-term and collective efforts, such as institutional racism as a downstream effect of colonisation, cultural training for healthcare providers and increasing the volume of the Indigenous workforce, such as Indigenous Liaison Officers or Indigenous Care Coordinators, could effectively address this inequity issue for Indigenous people with cancer in Australia in a timely manner.
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Affiliation(s)
- Saira Sanjida
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Gail Garvey
- School of Public Health, University of Queensland, Brisbane, QLD 4072, Australia
| | - James Ward
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Roxanne Bainbridge
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Anthony Shakeshaft
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Stephanie Hadikusumo
- Institute of Urban Indigenous Health, Windsor, Brisbane, QLD 4030, Australia
- Royal Brisbane and Women’s Hospital, Herston, Brisbane, QLD 4029, Australia
| | - Carmel Nelson
- Institute of Urban Indigenous Health, Windsor, Brisbane, QLD 4030, Australia
| | - Prabasha Thilakaratne
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Xiang-Yu Hou
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4072, Australia
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Laccos-Barrett K, Brown AE, Saunders V, Baldock KL, West R. Are We Teaching Nurses to Be Racist towards Aboriginal and Torres Strait Islander Peoples? A Critical Race Document Analysis of Discrete Aboriginal and Torres Strait Islander Health Courses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11455. [PMID: 36141728 PMCID: PMC9517025 DOI: 10.3390/ijerph191811455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Racism is responsible for health inequity and the harm perpetrated upon Aboriginal and Torres Strait Islander peoples by white institutions, building on attitudes and beliefs dominated by assumptions of white superiority. The National Aboriginal and Torres Strait Islander Health Curriculum Framework 'Curriculum Framework', released in 2014, was introduced to provide a framework for nursing programs and included the introduction of discrete Aboriginal and Torres Strait Islander health courses to draw attention to the relationship between racism health outcomes of Aboriginal and Torres Strait Islander peoples within health care settings. METHODS Using an Indigenist research paradigm with Colonial Critical Race Theory as the methodology and framework, this study presents a document analysis of discrete Aboriginal and Torres Strait Islander health courses taught in undergraduate nursing programs at 31 Australian Universities. RESULTS This work draws on the collective activism of Aboriginal and Torres Strait Islander nurses in challenging the systemic racism embedded in the Australian nursing curriculum. We demonstrate the utility of the Racial Segregation Audit Tool (RSAT), as an innovative approach to identify and respond to racism embedded in course learning outcomes. CONCLUSIONS This study explores and uncovers how the learning outcomes assert the social construction of race as a tool of oppressive segregation.
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Affiliation(s)
- Keera Laccos-Barrett
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Angela Elisabeth Brown
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Vicki Saunders
- Central Queensland University, Cairns, QLD 4870, Australia
| | | | - Roianne West
- Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, Murarrie, QLD 4172, Australia
- Workforce Innovation, Charles Darwin University, Darwin, NT 0810, Australia
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Bautista-Valarezo E, Vega Crespo B, Maldonado-Rengel R, Espinosa ME, Neira VA, Verhoeven V. Knowledge and Perceptions about Cervical Cancer and HPV Screening in Women in Rural Areas of Ecuador: A Qualitative Research Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11053. [PMID: 36078764 PMCID: PMC9517721 DOI: 10.3390/ijerph191711053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important tools to reduce the morbidity and mortality rates associated with this disease. The objective of this study is to explore the diverse knowledge and perceptions about cervical cancer and the different diagnostic tests for HPV of populations living in the rural parish "El Valle". METHOD A qualitative study was conducted through eight focus groups, which included 46 participants from mixed ethnic groups. A phenomenological analysis was performed. RESULTS Four topics and seven sub-topics were identified. By analyzing all the narratives, it was possible to identify that the perception of cervical cancer was focused on its severity, secondary to its infectious process and screening periodicity. However, despite the diverse knowledge, indigenous people do not relate it to the human papilloma virus; in addition, there is also certain resistance to undergo the Pap smear test, for reasons such as inaccessibility and its sampling process. CONCLUSIONS It is necessary to develop educational programs for the prevention of cervical cancer and to implement diagnostic alternatives to reach populations with precarious accessibility, as well as women who refuse to undergo the Pap smear test.
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Affiliation(s)
- Estefanía Bautista-Valarezo
- Facultad de Ciencias de la Salud, Universidad Técnica Particular de Loja, Loja 1101608, Ecuador; (R.M.-R.); (M.E.E.)
| | - Bernardo Vega Crespo
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador; (B.V.C.); (V.A.N.)
| | - Ruth Maldonado-Rengel
- Facultad de Ciencias de la Salud, Universidad Técnica Particular de Loja, Loja 1101608, Ecuador; (R.M.-R.); (M.E.E.)
- Programa de Doctorado en Ciencias Morfológicas, Universidad de la Frontera, Temuco 4811230, Chile
| | - María Elena Espinosa
- Facultad de Ciencias de la Salud, Universidad Técnica Particular de Loja, Loja 1101608, Ecuador; (R.M.-R.); (M.E.E.)
- Programa de Doctorado en Ciencias Médicas, Universidad de la Frontera, Temucho 4811230, Chile
| | - Vivian Alejandra Neira
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador; (B.V.C.); (V.A.N.)
| | - Veronique Verhoeven
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium;
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Are Australian Universities Perpetuating the Teaching of Racism in Their Undergraduate Nurses in Discrete Aboriginal and Torres Strait Islander Courses? A Critical Race Document Analysis Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137703. [PMID: 35805370 PMCID: PMC9266075 DOI: 10.3390/ijerph19137703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022]
Abstract
Systemic racism has a profound negative impact on the health outcomes of Australia’s First Nations peoples, hereafter referred to as Aboriginal and Torres Strait Islander peoples, where racism and white privilege have largely become normalised and socially facilitated. A national framework is being mobilised within the tertiary-level nursing curriculum to equip future health professionals with cultural capabilities to ensure culturally safe, equitable health care for Aboriginal and Torres Strait Islander peoples. In 2019, nurses comprised more than half of all registered health professionals in Australia, and current national standards for nursing state that Australian universities should be graduating registered nurses capable of delivering care that is received as culturally safe. It is therefore critical to evaluate where learning objectives within nursing curricula may lead to the reinforcement and teaching of racist ideologies to nursing students. This protocol outlines a framework and methodology that will inform a critical race document analysis to evaluate how learning objectives assert the social construction of “race” as a tool of oppressive segregation. The document analysis will include each discrete Aboriginal and Torres Strait Islander health course within all undergraduate nursing programs at Australian universities. The approach outlined within this protocol is developed according to an Indigenous research paradigm and Colonial Critical Race Theory as both the framework and methodology. The purpose of the framework is a means for improving health professional curriculum by reducing racism as highlighted in nation-wide strategies for curriculum reform.
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George M, Smith A, Ranmuthugula G, Sabesan S. Barriers to Accessing, Commencing and Completing Cancer Treatment Among Geriatric Patients in Rural Australia: A Qualitative Perspective. Int J Gen Med 2022; 15:1583-1594. [PMID: 35210830 PMCID: PMC8859537 DOI: 10.2147/ijgm.s338128] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/29/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore patients’, caregivers’, and health professionals’ perspectives on barriers and challenges to accessing, commencing and completing cancer therapy, with a focus on geriatric patients and the impacts of comorbidities and rurality. Patients and Methods A qualitative sub-study using focus group discussions was conducted in a regional cancer center and one of its outreach clinics in rural New South Wales, Australia. Five discussions with three distinct cohorts were undertaken, including: 1) geriatric cancer patients (two discussions); 2) caregivers (two discussions); and 3) health professionals (one discussion). Each focus group comprised eight to ten participants. A question guide was used to elicit participants’ experiences of receiving/providing cancer care and support during cancer treatment in a rural setting. Iterative thematic analysis was undertaken, with transcripts coded using NVivo software. Results Participants identified travel to larger regional centers and/or metropolitan areas and related arrangements as primary challenges to accessing diagnostic tests, surgeries, some treatments, and follow-up tests. Financial stress, and a lack of knowledge regarding available support services and mechanisms, was also a key issue for most patients and caregivers. Differences in availability of specific testing equipment, such as PET-CT, further complicated patients’ and caregivers’ experience of seeking diagnosis and management of cancer. While all interview cohorts identified positive rapport between clinicians and patients as a key characteristic of their experience of cancer management in rural and regional areas, difficulty in retaining clinical staff and related staffing levels at some health services were understood to negatively impact patients’ and caregivers’ experiences. Conclusion Overall, the study highlights the effects of geographical, social, and informational isolation on patients’ and caregivers’ experience of cancer diagnosis and management, and suggests several implications for further research and practice improvement.
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Affiliation(s)
- Mathew George
- Department of Medical Oncology, North West Cancer Centre, Tamworth, NSW, Australia
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
- Correspondence: Mathew George Tel +61 2 6767 7760Fax +61 2 6766 9173 Email
| | - Alexandra Smith
- Department of Medical Oncology, North West Cancer Centre, Tamworth, NSW, Australia
| | - Geetha Ranmuthugula
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - Sabe Sabesan
- Townsville Cancer Centre, Townsville University Hospital, Townsville, QLD, Australia
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Surgical Services for Breast Cancer Patients in Australia, is There a Gap for Aboriginal and/or Torres Strait Islander Women? World J Surg 2021; 46:612-621. [PMID: 34557943 DOI: 10.1007/s00268-021-06310-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Breast cancer is the most commonly diagnosed cancer in Aboriginal and/or Torres Strait Islander women. When compared to other Australians, Aboriginal and/or Torres Strait Islander women have a higher breast cancer mortality rate. This systematic literature review examined disparities in breast cancer surgical access and outcomes for Aboriginal and/or Torres Strait Islander women. METHODS This systematic literature review, following the PRISMA guidelines, compared measures of breast cancer surgical care for Aboriginal and/or Torres Strait Islander people and other Australians. RESULTS The 13 included studies were largely state-based retrospective reviews of data collected prior to the year 2012. Eight studies reported more advanced breast cancer presentation among Aboriginal and/or Torres Strait Islander women. Despite the increased distance to a multidisciplinary, specialist team, there were no disparities in seeing a surgeon, or in the time from diagnosis to surgical treatment. Two studies reported disparities in the receipt of surgery and two reported no variations. Three studies reported disparities in the receipt of mastectomy versus breast conserving surgery, whilst four studies reported no variations. No studies examined postoperative surgical outcomes. CONCLUSIONS Aboriginal and/or Torres Strait Islander women present with more advanced breast cancer. There may be disparities in the receipt of surgery and the type of surgery. However, the metrics tested were not related to optimal care guidelines, and the databases utilised contain limited data on individual factors contributing to surgical care decisions. It is therefore difficult to determine whether the reported differences in the receipt of surgical care reflect disparate or appropriate care.
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Garvey G, Cunningham J, Mayer C, Letendre A, Shaw J, Anderson K, Kelly B. Psychosocial Aspects of Delivering Cancer Care to Indigenous People: An Overview. JCO Glob Oncol 2021; 6:148-154. [PMID: 32031444 PMCID: PMC6998016 DOI: 10.1200/jgo.19.00130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Globally, a growing body of evidence has reported significant disparities in cancer outcomes between indigenous and nonindigenous people. Although some effort is being made to address these disparities, relatively little attention has been directed toward identifying and focusing on the psychosocial aspects of cancer care for indigenous patients, which are critical components in improving cancer care and outcomes. The purpose of this article is to describe the results of a scoping review of the psychosocial aspects of cancer care for indigenous people. We highlight considerations in undertaking research in this field with indigenous people and the implications for clinical practice.
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Affiliation(s)
- Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Carole Mayer
- Health Sciences North Research Institute, Sudbury, Ontario, Canada.,Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Angeline Letendre
- Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Edmonton, Alberta, Canada
| | - Joanne Shaw
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Kate Anderson
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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Taylor EV, Lyford M, Holloway M, Parsons L, Mason T, Sabesan S, Thompson SC. "The support has been brilliant": experiences of Aboriginal and Torres Strait Islander patients attending two high performing cancer services. BMC Health Serv Res 2021; 21:493. [PMID: 34030670 PMCID: PMC8142293 DOI: 10.1186/s12913-021-06535-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Improving health outcomes for Indigenous people by providing person-centred, culturally safe care is a crucial challenge for the health sector, both in Australia and internationally. Many cancer providers and support services are committed to providing high quality care, yet struggle with providing accessible, culturally safe cancer care to Indigenous Australians. Two Australian cancer services, one urban and one regional, were identified as particularly focused on providing culturally safe cancer care for Indigenous cancer patients and their families. The article explores the experiences of Indigenous cancer patients and their families within the cancer services and ascertains how their experiences of care matches with the cancer services' strategies to improve care. METHODS Services were identified as part of a national study designed to identify and assess innovative services for Indigenous cancer patients and their families. Case studies were conducted with a small number of identified services. In-depth interviews were conducted with Indigenous people affected by cancer and hospital staff. The interviews from two services, which stood out as particularly high performing, were analysed through the lens of the patient experience. RESULTS Eight Indigenous people affected by cancer and 23 hospital staff (Indigenous and non-Indigenous) were interviewed. Three experiences were shared by the majority of Indigenous cancer patients and family members interviewed in this study: a positive experience while receiving treatment at the cancer service; a challenging time between receiving diagnosis and reaching the cancer centre; and the importance of family support, while acknowledging the burden on family and carers. CONCLUSIONS This article is significant because it demonstrates that with a culturally appropriate and person-centred approach, involving patients, family members, Indigenous and non-Indigenous staff, it is possible for Indigenous people to have positive experiences of cancer care in mainstream, tertiary health services. If we are to improve health outcomes for Indigenous people it is vital more cancer services and hospitals follow the lead of these two services and make a sustained and ongoing commitment to strengthening the cultural safety of their service.
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Affiliation(s)
- Emma V Taylor
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia.
| | - Marilyn Lyford
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
| | - Michele Holloway
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
| | - Lorraine Parsons
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
| | - Toni Mason
- Aboriginal Health Unit, Mission, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Sabe Sabesan
- Townsville Cancer Centre, Townsville Hospital and Health Service, Douglas, Queensland, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
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18
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O'Brien P, Bunzli S, Lin I, Bessarab D, Coffin J, Dowsey MM, Choong PFM. Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action. ANZ J Surg 2021; 91:238-244. [PMID: 33506978 DOI: 10.1111/ans.16557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022]
Abstract
Aboriginal and Torres Strait Islander people continue to experience health inequity within the Australian health care system. Little research has examined how disparities in surgical care access and outcomes contribute to Aboriginal health. In this narrative review and call to action, we discuss five care points along the journey to high-quality surgical care: health care seeking, primary health care services, specialist services, surgery and surgical outcomes. We highlight barriers and disparities that exist along this journey, drawing examples from the field of joint replacement surgery. Finally, we present opportunities for change at the health system, health service and clinician level, calling upon researchers, clinicians and policy makers to confront the surgical disparities experienced by Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Penny O'Brien
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Juli Coffin
- Social and Emotional Wellbeing of Aboriginal Young People, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter F M Choong
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
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Whop LJ, Smith MA, Butler TL, Adcock A, Bartholomew K, Goodman MT, Winer RL, Milosevic E, Lawton B. Achieving cervical cancer elimination among Indigenous women. Prev Med 2021; 144:106314. [PMID: 33678228 DOI: 10.1016/j.ypmed.2020.106314] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/27/2020] [Accepted: 11/02/2020] [Indexed: 01/16/2023]
Abstract
Achieving the World Health Organisation (WHO) cervical cancer elimination target of fewer than four new cases per 100,000 woman-years requires scaling up HPV vaccination of girls, cervical screening, and pre-cancer and cancer treatment. We reviewed data from four high-income colonised countries (Australia, Canada, Aotearoa New Zealand (NZ), and the United States (US)) to identify how each is currently performing compared to the cervical cancer incidence elimination and triple-intervention targets, nationally and in Indigenous women. We also summarise barriers and enablers to meeting targets for Indigenous women. To achieve elimination, cervical cancer incidence must be reduced by 74% in Indigenous women in Australia, and 63% in Maori women in NZ; data were not published in sufficient detail to compare incidence in Indigenous women in Canada or the US to the WHO target. Only Australia meets the vaccination coverage target, but uptake appears comparatively equitable within Australia, NZ and the US, whereas there appears to be a substantial gap in Canada. Screening coverage is lower for Indigenous women in all four countries though the differential varies by country. Currently, only Australia universally offers HPV-based screening. Data on pre-cancer and cancer treatment were limited in all countries. Large inequities in cervical cancer currently exist for Indigenous peoples in Australia, Canada, New Zealand and the US, and elimination is not on track for all women in these countries. Current data gaps hinder improvements. These countries must urgently address their systemic failure to care and provide health care for Indigenous women.
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Affiliation(s)
- Lisa J Whop
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Megan A Smith
- Cancer Research Division, Cancer Council NSW, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Tamara L Butler
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Anna Adcock
- Te Tātai Hauora o Hine Centre for Women's Health Research, Victoria University of Wellington, New Zealand
| | - Karen Bartholomew
- Waitematā District Health Board (DHB) and Auckland DHB, Auckland, New Zealand
| | - Marc T Goodman
- Cedars-Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Elizabeth Milosevic
- Canadian Partnership Against Cancer, Toronto, Canada; Global Health Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Beverley Lawton
- Te Tātai Hauora o Hine Centre for Women's Health Research, Victoria University of Wellington, New Zealand
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Martinez Tyson D, Teran E, Đào LUL, Chee V, Hernández I, Flores M, Reina Ortiz M, Izurieta R, Baldwin JA. "Cancer is in style": lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador. ETHNICITY & HEALTH 2021; 26:153-167. [PMID: 29973064 DOI: 10.1080/13557858.2018.1493437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America.Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques.Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets.Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America.
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Affiliation(s)
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Vanessa Chee
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Isabel Hernández
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
- Facultad de Enfermería, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Mercedes Flores
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Ricardo Izurieta
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Julie A Baldwin
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
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Jones B, Heslop D, Harrison R. Seldom heard voices: a meta-narrative systematic review of Aboriginal and Torres Strait Islander peoples healthcare experiences. Int J Equity Health 2020; 19:222. [PMID: 33317556 PMCID: PMC7734845 DOI: 10.1186/s12939-020-01334-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 11/26/2020] [Indexed: 11/11/2022] Open
Abstract
Background It is well established that Aboriginal and Torres Strait Islander populations face considerable health inequities, exacerbated by poorer healthcare quality. Patient experience is recognised as a major contributing factor to healthcare quality and outcomes, therefore, enriched knowledge of the patient experiences of Aboriginal and Torres Strait Islander populations is critical to redress health inequities. This review synthesises evidence of the healthcare experiences amongst Aboriginal and Torres Strait Islander patients through a metanarrative synthesis of qualitative literature. Methods A systematic search strategy was developed and applied to six electronic databases between January 2000 and July 2019. Titles and abstracts were screened before applying the inclusion criteria to full text articles. A meta-narrative synthesis was undertaken. Results Fifty-four publications were identified from four research traditions; each with a unique conceptualisation of patient experience. Three themes emerged that demonstrate Aboriginal and Torres Strait Islander patient experiences are informed by 1) beliefs about wellbeing and healthcare provision, 2) their level of trust in the healthcare system, and 3) individual and community health system interactions. The findings highlight a range of aspects of patient experience that were important to participating Aboriginal and Torres Strait Islanders in the included studies but not captured currently in health system surveys. Conclusion This review highlights the influence of beliefs about health and wellbeing on the patient experience amongst Aboriginal and Torres Strait Islander populations in the Australian health system. Patient experiences were informed by past experience and their trust in the health system. The different factors influencing patient experience and the gravity of their influence must be considered in current approaches to capturing patient experience data collection methods. Trial registration PROSPERO (ID: CRD42019134765).
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Affiliation(s)
- Benjamin Jones
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
| | - David Heslop
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
| | - Reema Harrison
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia.
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Burt A, Mitchison D, Doyle K, Hay P. Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review. J Eat Disord 2020; 8:73. [PMID: 33292747 PMCID: PMC7708121 DOI: 10.1186/s40337-020-00346-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/23/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have poorer mental health compared to other Australians. Yet, there is a lack of research into mental disorders among this population, especially for eating disorders (ED), which are amongst the most lethal and debilitating mental disorders. AIM We aimed to answer 2 questions: 1. What is the volume and content of literature on ED among Indigenous Australians? 2. Has a screening or diagnostic tool/instrument been developed for the assessment of ED amongst Indigenous Australians? METHOD We conducted a scoping review of electronic databases (Pubmeb, Embase, PsychInfo, Proquest, Cochrane Library, Indigenous HealtInfoNet and Scopus), for studies addressing ED, body image, muscle dysmorphia, weight and shape concern among Indigenous Australians, as well as diagnostic and screening tools. All relevant studies were reviewed in full by 2 researchers. Narrative synthesis of the data was performed. RESULTS There is limited evidence for ED among Indigenous Australians, however, the evidence available strongly suggests that ED are more common among Indigenous Australians compared to other Australians. Eating disorders among Indigenous Australians are also associated with high levels of overvaluation of weight and shape. The increased risk of ED among Indigenous Australians was largely explained by factors such as poorer psychosocial wellbeing. No evidence was found for the existence of validated diagnostic or screening tools for ED in Indigenous Australians. CONCLUSION The evidence suggests ED are common among Indigenous Australians, and there are no diagnostic or screening tools available to assist clinicians in assessing them. More research is required in this field, especially towards the development of a validated and culturally specific screening or diagnostic tool for ED among Indigenous Australians.
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Affiliation(s)
- Adam Burt
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia.
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia.
| | - Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
- Campbelltown Hospital, SWSLHD, Campbelltown, Australia
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Older Aboriginal Australians' Health Concerns and Preferences for Healthy Ageing Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207390. [PMID: 33050541 PMCID: PMC7600369 DOI: 10.3390/ijerph17207390] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 12/18/2022]
Abstract
While there is strong evidence of the need for healthy ageing programs for older Aboriginal Australians, few are available. It is important to understand older Aboriginal Australians’ perspectives on healthy ageing in order to co-design culturally-appropriate programs, including views on technology use in this context. Semi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ health concerns, preferences for healthy ageing programs, and receptiveness to technology. Qualitative data were analyzed using a grounded theory approach. This study found that older Aboriginal Australians are concerned about chronic health conditions, social and emotional well-being, and difficulties accessing health services. A range of barriers and enablers to participation in current health programs were identified. From the perspective of older Aboriginal people, a successful healthy ageing program model includes physical and cognitive activities, social interaction, and health education. The program model also provides culturally safe care and transport for access as well as family, community, cultural identity, and empowerment regarding ageing well as central tenets. Technology could also be a viable approach for program delivery. These findings can be applied in the implementation and evaluation of culturally-appropriate, healthy ageing programs with older Aboriginal people.
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Butler TL, Anderson K, Condon JR, Garvey G, Brotherton JML, Cunningham J, Tong A, Moore SP, Maher CM, Mein JK, Warren EF, Whop LJ. Indigenous Australian women's experiences of participation in cervical screening. PLoS One 2020; 15:e0234536. [PMID: 32542004 PMCID: PMC7295213 DOI: 10.1371/journal.pone.0234536] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/27/2020] [Indexed: 01/09/2023] Open
Abstract
Aboriginal and Torres Strait Islander (collectively, Indigenous Australian) women experience a higher burden of cervical cancer than other women. The National Cervical Screening Program (NCSP) is failing to meet the needs of Indigenous Australian women, resulting in many women not regularly participating in cervical screening. However, one third of Indigenous Australian women do participate in cervical screening. The reasons that some women in this population commence and continue to screen remain unheard but could provide insights to support women who currently do not participate. We aimed to describe Indigenous Australian women’s experiences and views of participation in cervical screening by yarning (a culturally-appropriate interview technique) with 50 Indigenous Australian women aged 25–70 years who had completed cervical screening in the past five years, recruited via Primary Health Care Centres (PHCCs) from three jurisdictions. Aboriginal or Torres Strait Islander women researchers conducted the interviews. Thematic analysis identified six themes: screening as a means of staying strong and in control; overcoming fears, shame, and negative experiences of screening; needing to talk openly about screening; the value of trusting relationships with screening providers; logistical barriers; and overcoming privacy concerns for women employed at PHCCs. Despite describing screening as shameful, invasive, and uncomfortable, women perceived it as a way of staying healthy and exerting control over their health. This ultimately supported their participation and a sense of empowerment. Women valued open discussion about screening and strong relationships with health providers. We identified logistical barriers and specific barriers faced by women employed at PHCCs. This study is strengthened by a research approach that centred Indigenous Australian women’s voices. Understanding the experiences of Indigenous Australian women who participate in screening will help screening providers support women to start and continue to screen regularly. Recommendations for practice are provided.
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Affiliation(s)
- Tamara L Butler
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kate Anderson
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - John R Condon
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | - Joan Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Suzanne P Moore
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Clare M Maher
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Brisbane, Queensland, Australia
| | | | - Eloise F Warren
- Yerin Eleanor Duncan Aboriginal Health Centre, Wyong, New South Wales, Australia
| | - Lisa J Whop
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Taher M, Pashaeypoor S, Cheraghi MA, Karimy M, Hoseini ASS. Superstition in health beliefs: Concept exploration and development. J Family Med Prim Care 2020; 9:1325-1330. [PMID: 32509611 PMCID: PMC7266200 DOI: 10.4103/jfmpc.jfmpc_871_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/30/2020] [Accepted: 02/05/2020] [Indexed: 12/04/2022] Open
Abstract
Concept exploration and development of superstition is the aim of this research. Superstition is a complex concept, needs to be clarity, removes it from its mundane state, and gives it a scientific richness. To use a list of questions extracted from a review of the literature to analyze, develop, and explore superstition. It was assessed according to studies conducted in three fields sociology, psychology, and nursing. The maturity of the concept was determined in four areas, epistemology, practicability, semantics, and deduction/logic. Nurses must discover people's beliefs and superstitions. Although the concept of superstition is commonly used, many of its features and aspects were still unclear.
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Affiliation(s)
- Mohammad Taher
- Intensive Care and Management Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pashaeypoor
- Public Health of Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Intensive Care and Management Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Karimy
- Health Education and Health Promotion Department, Saveh University of Medical Sciences, Saveh, Iran
| | - Akram Sadat Sadat Hoseini
- Pediatrics of Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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26
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McInerney-Leo AM, West J, Meiser B, West M, Brown MA, Duncan E. Causal Attributions in an Australian Aboriginal Family With Marfan Syndrome: A Qualitative Study. Front Genet 2020; 11:461. [PMID: 32457804 PMCID: PMC7221064 DOI: 10.3389/fgene.2020.00461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/14/2020] [Indexed: 12/02/2022] Open
Abstract
Causal attributions are important determinants of how health threats are processed and affect health-related behaviors. To date, there has been no research on causal attributions in genetic conditions in Aboriginal Australians. Forty members of a large Aboriginal Australian family with Marfan syndrome (MFS) were invited to participate in an ethically approved study exploring causal attributions, including perceived causes of phenotypic variability within the family. Eighteen individuals consented to conduct semi-structured qualitative interviews, which were recorded, transcribed verbatim and analyzed thematically. Most participants knew that MFS was genetic, but there were diverse theories about inheritance, including beliefs that it skipped generations, was affected by birth order and/or gender, and that it co-occurred with inheritance of blue eyes within this family. The mutation was thought to have been inherited from British settlers and initially triggered by disease or diet. Factors believed to modify disease severity included other genes and lifestyle factors, particularly alcohol and substance abuse and stress. Generally, this family did not endorse “blaming” chance or a higher power for phenotypic variability, though some felt that the spirits or a deity may have played a role. In conclusion, although participants knew MFS was a genetic condition, many speculated about the role of non-genetic causes in initiating the original mutation; and the gene-environment interaction was thought to affect severity. This study demonstrates a successful approach for exploring causal attributions in other genetic conditions in First Australians.
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Affiliation(s)
- Aideen M McInerney-Leo
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Jennifer West
- Prince Charles Hospital Clinical Unit, School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Bettina Meiser
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Malcolm West
- Prince Charles Hospital Clinical Unit, School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Matthew A Brown
- Translational Genomics Group, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Guy's and St Thomas' NHS Foundation Trust and King's College London NIHR Biomedical Research Centre, London, United Kingdom
| | - Emma Duncan
- Translational Genomics Group, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Endocrinology, James Mayne Building, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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Nwagbara UI, Ginindza TG, Hlongwana KW. Health systems influence on the pathways of care for lung cancer in low- and middle-income countries: a scoping review. Global Health 2020; 16:23. [PMID: 32188467 PMCID: PMC7081618 DOI: 10.1186/s12992-020-00553-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background Globally, lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths. Many health systems in low- and middle-income countries, including sub-Saharan Africa have weak organizational structure, which results in delayed lead time for lung cancer patient care continuum from diagnosis to palliative care. Aim To map evidence on the health systems issues impacting on the delays in timely lung cancer care continuum from diagnosis to palliative care in LMICs, including sub-Saharan Africa. Methods A scoping review was performed following the method of Arksey and O’Malley. Systematic searches were performed using EBSCOhost platform, a keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT). Results A total of 2886 articles were screened, and 236 met the eligibility criteria for this scoping review study. Furthermore, 155 articles were also excluded following abstract screening. Eighty-one articles were selected for full-article screening by two researchers with 10 being selected for independent detailed data extraction for synthesis. These studies were also subjected to methodological quality assessment. All included studies were conducted in LMICs mostly Asia, the Middle East, and Latin America and published between January 2008 and June 2018. The ten included studies described at least one interval in lung cancer care. Conclusions Reducing wait time across this care continuum is needed to improve easy access to healthcare, quality care, survival and patient outcomes, as many patients still face longer wait times for diagnosis and treatment of lung cancer than recommended in several healthcare settings. A multidisciplinary team approach will help to reduce wait time and ensure that all patients receive appropriate care. Interventions are needed to address delays in lung cancer care in LMICs. Health-care providers at all levels of care should be educated and equipped with skills to identify lung cancer symptoms and perform or refer for appropriate diagnostic tests.
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Affiliation(s)
- Ugochinyere I Nwagbara
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa.
| | - Themba G Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa
| | - Khumbulani W Hlongwana
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa
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Gonzalez T, Harris R, Williams R, Wadwell R, Barlow-Stewart K, Fleming J, Buckman M. Exploring the barriers preventing Indigenous Australians from accessing cancer genetic counseling. J Genet Couns 2020; 29:542-552. [PMID: 32173983 DOI: 10.1002/jgc4.1251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/14/2020] [Accepted: 02/24/2020] [Indexed: 12/23/2022]
Abstract
In Australia, individuals of Aboriginal and Torres Strait Islander descent (Indigenous Australians) have poorer health outcomes than the general population, including higher incidence of cancer and reduced life expectancy up to 14 years compared to non-Indigenous Australians. Although differences in engagement with healthcare and beliefs about disease/cancer exist between Indigenous communities, a number of common barriers have been identified hindering attendance at mainstream health services. To inform exploration of barriers that may impact access to a cancer genetic counseling service, consultations with Aboriginal stakeholders were undertaken. Ethical principles for studies that engage Indigenous communities were followed throughout the research endeavor. Using a stakeholder-endorsed focus group approach, the views of an Aboriginal Elders group (n = 9) were sought with additional semi-structured interviews with social science and genetics researchers working with Indigenous communities in Australia (n = 7). Thematic analysis of the results identified three themes: explanatory models of illness, barriers to keeping well and attending services, and recommendations for improvements to access/attendance. Barriers common to accessing both mainstream health services and clinical genetic services were identified, including attributions of illness and cancer. Specific genetic counseling barriers included the cultural inclusivity and accessibility of services, and a lack of awareness of genetic counseling both in the community and by clinicians unfamiliar with genetics. Recommendations included developing flexible service delivery models and culturally appropriate resources for Indigenous patients. These findings may inform future studies to improve Indigenous health outcomes and promote a more accessible, culturally appropriate approach to provision of cancer genetics services for Australia's First Peoples.
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Affiliation(s)
- Tina Gonzalez
- Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Camperdown, NSW, Australia.,Prince of Wales Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Rebecca Harris
- Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Camperdown, NSW, Australia.,Westmead Familial Cancer Service, Westmead Hospital, Westmead, NSW, Australia
| | - Rachel Williams
- Prince of Wales Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia.,Faculty of Medicine, Prince of Wales Clinical School, University of New South Wales, Randwick, NSW, Australia
| | - Rose Wadwell
- Aboriginal Health Unit, Tamworth Rural Referral Hospital, Tamworth, NSW, Australia
| | - Kristine Barlow-Stewart
- Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Camperdown, NSW, Australia
| | - Jane Fleming
- Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Camperdown, NSW, Australia
| | - Melissa Buckman
- Tamworth Genetics Service, Tamworth Community Health Centre, Tamworth, NSW, Australia
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29
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Farley E, Lenglet A, Abubakar A, Bil K, Fotso A, Oluyide B, Tirima S, Mehta U, Stringer B. Language and beliefs in relation to noma: a qualitative study, northwest Nigeria. PLoS Negl Trop Dis 2020; 14:e0007972. [PMID: 31971944 PMCID: PMC6999908 DOI: 10.1371/journal.pntd.0007972] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/04/2020] [Accepted: 12/05/2019] [Indexed: 11/28/2022] Open
Abstract
Background Noma is an orofacial gangrene that rapidly disintegrates the tissues of the face. Little is known about noma, as most patients live in underserved and inaccessible regions. We aimed to assess the descriptive language used and beliefs around noma, at the Noma Children’s Hospital in Sokoto, Nigeria. Findings will be used to inform prevention programs. Methods Five focus group discussions (FGD) were held with caretakers of patients with noma who were admitted to the hospital at the time of interview, and 12 in-depth interviews (IDI) were held with staff at the hospital. Topic guides used for interviews were adapted to encourage the natural flow of conversation. Emergent codes, patterns and themes were deciphered from the data derived from IDI’s and FGDs. Results Our study uncovered two main themes: names, descriptions and explanations for the disease, and risks and consequences of noma. Naming of the disease differed between caretakers and heath care workers. The general names used for noma illustrate the beliefs and social system used to explain the disease. Beliefs were varied; participant responses demonstrate a wide range of understanding of the disease and its causes. Difficulty in accessing care for patients with noma was evident and the findings suggest a variety of actions taking place before reaching a health center or health worker. Patient caretakers mentioned that barriers to care included a lack of knowledge regarding this medical condition, as well as a lack of trust in seeking medical care. Participants in our study spoke of the mental health strain the disease placed on them, particularly due to the stigma that is associated with noma. Conclusions Caretaker and practitioner perspectives enhance our understanding of the disease in this context and can be used to improve treatment and prevention programs, and to better understand barriers to accessing health care. Differences in disease naming illustrate the difference in beliefs about the disease. This has an impact on health seeking behaviours, which for noma cases has important ramifications on outcomes, due to the rapid progression of the disease. Noma (cancrum oris) is an orofacial gangrene that rapidly disintegrates the hard and soft tissues of the face. Little is known about noma as most cases live in underserved and inaccessible regions. We aimed to assess the language used and beliefs around noma, in northwest Nigeria. Findings will be used to inform prevention programs. Five focus group discussions were held with caretakers of patients with noma admitted to the hospital at the time of interview, and 12 in-depth interviews were held with staff at the hospital. Our study uncovered two main themes: names; descriptions and explanations for the disease, and risks and consequences of noma. Naming of the disease differed between caretakers and heath care workers. Difficulty in accessing care for patients with noma was evident. Barriers to care and lack of knowledge and trust were evident. The impact of noma was not limited to physical presentation; stigmatisation was mentioned as a key difficulty. Differences in disease naming illustrate the difference in beliefs and has an impact on health seeking behaviour, which for noma cases, has severe ramifications due to the rapid progression of the disease.
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Affiliation(s)
- Elise Farley
- Médecins Sans Frontières, Nigeria
- Department of Public Health Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Annick Lenglet
- Médecins Sans Frontières, Amsterdam, The Netherlands
- Department of Medical Microbiology, Radboud University Medical Center, The Netherlands
| | | | - Karla Bil
- Médecins Sans Frontières, Amsterdam, The Netherlands
| | | | | | | | - Ushma Mehta
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town
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Yashadhana A, Fields T, Blitner G, Stanley R, Zwi AB. Trust, culture and communication: determinants of eye health and care among Indigenous people with diabetes in Australia. BMJ Glob Health 2020; 5:e001999. [PMID: 32133172 PMCID: PMC7042588 DOI: 10.1136/bmjgh-2019-001999] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 12/27/2022] Open
Abstract
Introduction Our study aimed to identify factors that influence access to eye care and eye health outcomes for remote Indigenous Australians living with diabetes. Methods In collaboration with Indigenous Community-Based Researchers (CBR) and Aboriginal Community Controlled Health Services (ACCHS), a qualitative, participatory action research approach was taken, drawing on Indigenist and decolonising methodologies. The study was undertaken in four remote communities, in the Katherine region, Northern Territory and north-western New South Wales, Australia. Interviews and focus groups were undertaken with Indigenous adults aged ≥40 years living with diabetes (n=110), and primary care clinicians working in ACCHSs (n=37). A series of interviews with CBRs (n=13) were undertaken before and after data collection to add cultural insights and validation to participant accounts. Data were analysed inductively using grounded theory, in-depth discussion and NVivo V.11. Results More than one-third of all patients had little to no knowledge of how diabetes affects eye health. Limited access to health information and interpreters, language barriers, distrust of health providers and services, and limited cultural responsivity among non-Indigenous clinicians, were identified as determining factors in eye health and care. Discussion We outline a need to address gaps in trust and communication, through increased access to and resourcing of Indigenous language interpreters and cultural brokers, understandable and culturally sensitive diabetic eye health information and cultural responsivity training for non-Indigenous clinicians. Centring Indigenous cultures in healthcare practice will enable a shared understanding between clinicians and Indigenous patients, and subsequently more equitable eye health outcomes.
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Affiliation(s)
- Aryati Yashadhana
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Vision Cooperative Research Centre, Sydney, New South Wales, Australia
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia
| | - Ted Fields
- Vision Cooperative Research Centre, Sydney, New South Wales, Australia
| | - Godfrey Blitner
- Vision Cooperative Research Centre, Sydney, New South Wales, Australia
| | - Ruby Stanley
- Vision Cooperative Research Centre, Sydney, New South Wales, Australia
| | - Anthony B Zwi
- Faculty of Arts and Social Sciences, School of Social Sciences, The University of New South Wales, Sydney, New South Wales, Australia
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Larson S, Stoeckl N, Jarvis D, Addison J, Grainger D, Watkin Lui F. Indigenous Land and Sea Management Programs (ILSMPs) Enhance the Wellbeing of Indigenous Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010125. [PMID: 31878049 PMCID: PMC6981778 DOI: 10.3390/ijerph17010125] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/24/2019] [Accepted: 12/20/2019] [Indexed: 11/28/2022]
Abstract
Conservation and environmental management have been reported as offering opportunities to substantially improve the wellbeing of Indigenous people. Using the holistic wellbeing impact evaluation (W-IE) approach—well suited for use in Indigenous communities—we interviewed 190 Indigenous Australians across four communities. All communities were involved in the Indigenous land and sea management programs (ILSMPs). Our study explored the conceptualisation of ‘wellbeing’ by participants. In particular, we were interested in the aspects of wellbeing perceived to be affected by ILSMPs. Out of the 26 wellbeing factors explored, ‘Health centres’; ‘Language’; ‘Schools’; and ‘Safe community’ emerged as being of highest importance to the largest percentage of the respondents. When grouped using principle components analysis (PCA), the ‘Community and society’ domain emerged as the most important; accounting for 52% of the overall importance of all wellbeing factors. The second most important domain was the ‘Country and culture’, contributing 31%. Lastly, ‘Economic aspects’ contributed only 17%. Respondents believed that ILSMPs have played a considerable causal role in improving wellbeing, by positively changing factors most important to them. Specifically, 73% of perceived causal links were related to improvements in the ‘Country and Culture’ and 23% to ‘Community and Society’ domain. We thus conclude that land management for Indigenous people is much more than ecological or environmental management with ILSMPs, perceived to cause a wide range of cultural and social benefits. We also propose ways in which the future design of such programs could be improved to further increase benefits.
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Affiliation(s)
- Silva Larson
- College of Business, Law and Governance, James Cook University and the Cairns Institute, Townsville, QLD 4811, Australia
- Correspondence:
| | - Natalie Stoeckl
- College of Business and Economics, University of Tasmania, Hobart, TAS 7005, Australia
| | - Diane Jarvis
- College of Business, Law and Governance, James Cook University and CSIRO Land and Water, Townsville, QLD 4811, Australia; (D.J.); (J.A.)
| | - Jane Addison
- College of Business, Law and Governance, James Cook University and CSIRO Land and Water, Townsville, QLD 4811, Australia; (D.J.); (J.A.)
| | - Daniel Grainger
- College of Business, Law and Governance and the Indigenous Education and Research Centre, James Cook University, Townsville, QLD 4811, Australia;
| | - Felecia Watkin Lui
- Indigenous Education and Research Centre, James Cook University and the Cairns Institute, Cairns, QLD 4870, Australia;
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Sivertsen N, Harrington A, Hamiduzzaman M. ‘Two-eyed seeing’: the integration of spiritual care in Aboriginal residential aged care in South Australia. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2019. [DOI: 10.1080/15528030.2019.1669515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gall A, Anderson K, Adams J, Matthews V, Garvey G. An exploration of healthcare providers' experiences and perspectives of Traditional and complementary medicine usage and disclosure by Indigenous cancer patients. Altern Ther Health Med 2019; 19:259. [PMID: 31533782 PMCID: PMC6751784 DOI: 10.1186/s12906-019-2665-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 08/30/2019] [Indexed: 11/10/2022]
Abstract
Background Traditional and complementary medicines (T&CM) are any form of medicine, practice, treatment, product, technology, knowledge system or ceremony outside of conventional medical practice that aims to prevent and/or treat illness and/or promote well-being. Alongside conventional cancer treatments, T&CM usage is increasing; with 19% of indigenous Australians with cancer reporting using T&CM. There is limited evidence surrounding T&CM use and disclosure by indigenous patients. Our aim was to explore healthcare providers’ views about usage, disclosure/non-disclosure of T&CM by Indigenous cancer patients. Methods Semi-structured, in-depth interviews with 18 healthcare providers, including three indigenous providers, at a large urban hospital providing care to Indigenous cancer patients were conducted to explore providers’ experiences and attitudes towards T&CM use by Indigenous cancer patients. An interpretive phenomenological approach was used to thematically analyse the data. Results Analysis revealed six themes: concern about risk; no ‘real’ benefits; perception of T&CM and conventional medicine as antithetical; barriers to disclosure; ‘patients’ choice’ a double-edged sword; and providers’ lack of knowledge about T&CM. Healthcare providers perceived discord between T&CM and conventional medicine. Most lacked knowledge of T&CM, and had concerns around negative-interactions with conventional treatments. They considered T&CM outside their role, citing this as reasoning for their lack of knowledge. Indigenous healthcare providers had greater understanding and openness towards T&CM. Conclusions Given the potential usage of T&CM by Indigenous cancer patients, providers need a more comprehensive understanding of T&CM in order to inform discussion and facilitate effective disclosure on this topic. If indigenous Australians with cancer feel that cancer care providers are unreceptive to discussing T&CM, patient care risks being compromised; particularly given the potential for negative interactions between T&CM and conventional cancer treatments. Fostering health care interactions where indigenous patients feel comfortable to discuss T&CM usage should be a priority for all cancer care services.
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Bartholomew K, Zhou L, Crengle S, Buswell E, Buckley A, Sandiford P. A targeted promotional DVD fails to improve Māori and Pacific participation rates in the New Zealand bowel screening pilot: results from a pseudo-randomised controlled trial. BMC Public Health 2019; 19:1245. [PMID: 31500594 PMCID: PMC6734461 DOI: 10.1186/s12889-019-7582-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 08/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New Zealand's Bowel Screening Pilot (BSP) used a mailed invitation to return a faecal immunochemical test. As a pilot it offered opportunities to test interventions for reducing ethnic inequities in colorectal cancer screening prior to nationwide programme introduction. Small media interventions (e.g. educational material and DVDs) have been used at both community and participant level to improve uptake. We tested whether a DVD originally produced to raise community awareness among the Māori population would have a positive impact on participation and reduce the proportion of incorrectly performed tests (spoiled kits) if mailed out with the usual reminder letter. METHODS The study was a parallel groups pseudo-randomised controlled trial. Over 12 months, all Māori and Pacific ethnicity non-responders four weeks after being mailed the test kit were allocated on alternate weeks to be sent, or not, the DVD intervention with the usual reminder letter. The objective was to determine changes in participation and spoiled kit rates in each ethnic group, determined three months from the date the reminder letter was sent. Participants and those recording the outcomes (receipt of a spoiled or non-spoiled test kit) were blinded to group assignment. RESULTS 2333 Māori and 2938 Pacific people participated (11 withdrew). Those who were sent the DVD (1029 Māori and 1359 Pacific) were less likely to participate in screening than those who were not (1304 Māori and 1579 Pacific). Screening participation was reduced by 12.3% (95% CI 9.1-15.5%) in Māori (13.6% versus 25.9%) and 8.3% (95% CI 5.8-10.8%) in Pacific (10.1% versus 18.4%). However, spoiled kit rates (first return) were significantly higher among those not sent the DVD (33.1% versus 12.4% in Māori and 42.1% versus 21.9% in Pacific). CONCLUSION The DVD sent with the reminder letter to BSP non-responders reduced screening participation to an extent that more than offset the lower rate of spoiled kits. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry ACTRN12612001259831 . Registered 30 November 2013.
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Affiliation(s)
- Karen Bartholomew
- Waitematā District Health Board, 15 Shea Terrace, Takapuna, Auckland, 0740, New Zealand
| | - Lifeng Zhou
- Waitematā District Health Board, 15 Shea Terrace, Takapuna, Auckland, 0740, New Zealand
| | - Sue Crengle
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand
| | - Elizabeth Buswell
- Waitematā District Health Board, 15 Shea Terrace, Takapuna, Auckland, 0740, New Zealand
| | - Anne Buckley
- Waitematā District Health Board, 15 Shea Terrace, Takapuna, Auckland, 0740, New Zealand
| | - Peter Sandiford
- Waitematā District Health Board, 15 Shea Terrace, Takapuna, Auckland, 0740, New Zealand. .,School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
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A Qualitative Study on the Transition Support Needs of Indigenous Australians Following Traumatic Brain Injury. BRAIN IMPAIR 2019. [DOI: 10.1017/brimp.2019.24] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:A growing body of qualitative literature globally describes post-hospital experiences during early recovery from a traumatic brain injury. For Indigenous Australians, however, little published information is available. This study aimed to understand the lived experiences of Indigenous Australians during the 6 months post-discharge, identify the help and supports accessed during transition and understand the gaps in service provision or difficulties experienced.Methods and Procedure:Semi-structured interviews were conducted at 6 months after hospital discharge to gain an understanding of the needs and lived experiences of 11 Aboriginal and Torres Strait Islander Australians who had suffered traumatic brain injury in Queensland and Northern Territory, Australia. Data were analysed using thematic analysis.Results:Five major themes were identified within the data. These were labelled ‘hospital experiences’, ‘engaging with medical and community-based supports’, ‘health and wellbeing impacts from the injury’, ‘everyday living’ and ‘family adjustments post-injury’.Conclusions:While some of the transition experiences for Indigenous Australians were similar to those found in other populations, the transition period for Indigenous Australians is influenced by additional factors in hospital and during their recovery process. Lack of meaningful interaction with treating clinicians in hospital, challenges managing direct contact with multiple service providers and the injury-related psychological impacts are some of the factors that could prevent Indigenous Australians from receiving the supports they require to achieve their best possible health outcomes in the long term. A holistic approach to care, with an individualised, coordinated transition support, may reduce the risks for re-admission with further head injuries.
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Drosdowsky A, Mathieson J, Milne D. Australian Indigenous Communities: Efforts to Improve Cancer Care. Clin J Oncol Nurs 2019; 23:443-446. [PMID: 31322614 DOI: 10.1188/19.cjon.443-446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aboriginal and Torres Strait Islander people are the Indigenous inhabitants of Australia who face many inequities regarding cancer care and outcomes. They are more likely to be diagnosed with cancer than non-Indigenous Australians and have not experienced the improvement in survival that non-Indigenous Australians have.
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Sivertsen N, Harrington A, Hamiduzzaman M. Exploring Aboriginal aged care residents' cultural and spiritual needs in South Australia. BMC Health Serv Res 2019; 19:477. [PMID: 31299950 PMCID: PMC6624992 DOI: 10.1186/s12913-019-4322-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 07/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background Attention to culture and its impact on health care can improve the quality of care given, add to our understanding of health care among culturally diverse populations, and encourage a more holistic approach to health care within general care. Connection to culture is important to Aboriginal peoples, and integrating Aboriginal culture into general care in residential aged care facilities may contribute to improving care delivery and outcomes for residents. The literature to date revealed a lack of understanding of the capacity of residential aged care and the health practices of carers in relation to providing cultural care for Aboriginal people. This study aimed to explore how cultural care needs are maintained for Aboriginal residents from their own and their carers’ perspectives. Methods Applying an Aboriginal centered research method, an Interpretive Descriptive Approach was used as a theoretical framework to explore data in this study. Semi structured audio-recorded interviews were conducted. An additional file provides a complete description of the interview questions used as a guide for the study [see Additional file 1]. Three Residential Aged Care Centres, in South Australia were used i.e., two rural from centres and one urban metropolitan centre. Seven Aboriginal residents and 19 carers participated in interviews. Data was transcribed and an interpretive analysis was employed to code the transcribed data for themes and sub-themes. The study was guided by an Aboriginal community advisory group with an aim to work under the principle of reciprocity; giving back to the communities, participants and those where the research results may have been relevant. Results Three themes emerged from the views of the residents and carers: (i) lack of resources and funding; (ii) care practice; and (iii) marginalisation of Aboriginal culture within aged care facilities. Conclusion The findings suggest that carers and residents believe cultural inclusion in general care practices may enrich Aboriginal residents’ daily life, health and well-being in residential aged care facilities. This study may provide carers, aged care centre managers and policy makers with information on the need of resources, funding, organised care plan and management, and cultural competency of carers to be considered to improve Aboriginal aged care protocols for integrating cultural care into practice. Electronic supplementary material The online version of this article (10.1186/s12913-019-4322-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nina Sivertsen
- College of Nursing and Health Sciences, Flinders University, GPO BOX 2100, Adelaide, South Australia, 5001, Australia.
| | - Ann Harrington
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Mohammad Hamiduzzaman
- Flinders Rural Health SA, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Burnette CE, Roh S, Liddell J, Lee YS. American Indian women cancer survivors' coping with depressive symptoms. J Psychosoc Oncol 2019; 37:494-508. [PMID: 30590999 PMCID: PMC6529281 DOI: 10.1080/07347332.2018.1525467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Depressive symptoms have been identified as a primary predictor of quality of life among cancer patients. Depression and cancer are co-occurring and disproportionately elevated for American Indian and Alaska Native (AI/AN) women. The purpose of this article is to examine American Indian (AI) women cancer survivors' coping mechanisms for depressive symptoms. RESEARCH APPROACH The methodology included a qualitative descriptive approach with conventional content analysis to examine the coping strategies of AI women cancer survivors associated with depressive symptoms. The interview guide was semi-structured and developed in collaboration with a community advisory board (CAB). Data-derived qualitative analysis was used to generate codes inductively from the data. PARTICIPANTS A sample of 43 AI women cancer survivors (n = 14 cervical cancer, n = 14 breast cancer, and n = 15 other cancers) from the Northern Plains region, in the state of South Dakota were interviewed. Data were collected from June 2014 to February 2015. Methodological approach: Qualitative content analysis was used for data analysis, which allowed themes to emerge inductively from the data. Analysis revealed 430 preliminary codes. After de-briefing, validation, and discussion among coauthors, these were then sorted into 67 codes. Member checks with all available participants were conducted to minimize misinterpretation. FINDINGS A total of 26 participants (62%) indicated they had feelings of depression since their cancer diagnosis. Women coped with depressive feelings by (a) participating in faith traditions; (b) seeking creative and positive outlets; (c) martialing family and social support; and (d) keeping busy with other life activities. INTERPRETATION AI women experienced depressive symptoms following a cancer diagnosis and used a variety of positive coping mechanisms to create personal meaning. Implications for Psychosocial Providers or Policy: AI women may need unique support following a cancer diagnosis, and interventions should incorporate AI beliefs and traditions, such as storytelling and talking with family and community members.
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Affiliation(s)
- Catherine E. Burnette
- School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, 1400 West 22 Street, Sioux Falls, SD 57105, Phone: 605-357-1593,
| | - Jessica Liddell
- City, Community, and Culture PhD Program, School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132, Phone: 415-405-0944,
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Carruthers S, Pennefather M, Ward L, Giam K, Penniment M. Measuring (and narrowing) the gap: The experience with attendance of Indigenous cancer patients for Radiation Therapy in the Northern Territory. J Med Imaging Radiat Oncol 2019; 63:510-516. [PMID: 31081995 DOI: 10.1111/1754-9485.12887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/10/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Barriers exist for both Indigenous and remote patients attending cancer care facilities. We sought to measure clinical attendance of all patients referred for consideration of radiation therapy (RT) at the single radiation therapy centre in the Northern Territory (NT), with particular attention to a comparison of Indigenous and non-Indigenous patients, and to analyse methods introduced to address the attendance of patients. METHODS Patients referred for radiation therapy over a 5 year period from the commencement of the Alan Walker Cancer Care Centre (AWCCC), NT, were analysed for attendance, and for possible improvement over time. RESULTS Multivariate analysis of non-attendance prior to RT (pre-RT) showed significance for Indigenous status (P < 0.001), and female gender (P < 0.001), and during RT showed significance for Indigenous status (P < 0.001) and curative intent RT (P = 0.012). Attendance during RT over the 5 years showed significant improvement over time for Indigenous patients from 70.6% to 81.6% (P = 0.038). There was no significant improvement with pre-RT attendance for either the Indigenous or non-Indigenous cohort. CONCLUSION Indigenous patients experienced a lower level of attendance during RT, but this has significantly improved over the first 5 years of operation at AWCCC, as recognition and management of contributing factors has improved.
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Affiliation(s)
- Scott Carruthers
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Mary Pennefather
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Linda Ward
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kar Giam
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Michael Penniment
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
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Green M, Anderson K, Griffiths K, Garvey G, Cunningham J. Understanding Indigenous Australians' experiences of cancer care: stakeholders' views on what to measure and how to measure it. BMC Health Serv Res 2018; 18:982. [PMID: 30567564 PMCID: PMC6299947 DOI: 10.1186/s12913-018-3780-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/28/2018] [Indexed: 12/22/2022] Open
Abstract
Background Disparities in cancer outcomes amongst Indigenous Australians reflect a pattern of reduced access to and engagement with health services. A growing emphasis on patient-centred care has increased efforts to measure patient experiences, but it is unclear whether existing approaches: a) assess the most critical aspects of care that shape the experiences of Indigenous people with cancer; and b) facilitate the engagement and participation of Indigenous people with the measurement of care experiences. Methods Two rounds of semi-structured interviews and focus groups were used to elicit stakeholders’ views on priorities for measuring the cancer care experiences of Indigenous cancer patients and on the acceptability of various methods for capturing such information. Participants included Indigenous people affected by cancer (n = 17), health professionals (n = 28) and individuals in both groups (n = 7). Recruitment occurred through a national web-based network and through four cancer services in urban and regional areas in three jurisdictions across Australia. Results Several aspects of cancer care were identified as critical in shaping Indigenous patients’ experiences. Key themes included: feeling safe in the system; importance of Indigenous staff; barriers to care; the role of family and friends; effective communication and education; and coordination of care and transition between services. Those participants affected by carers’ wellbeing and palliative care strongly advocated for the importance of these topics. Participants expressed support for a face-to-face interview with a trusted person as the most appropriate means of collecting cancer care experience information. Conclusions While existing experience measurement tools would partially capture some important aspects of care, other critical areas would likely be missed. Appropriate tools and approaches, developed by and with Indigenous people, are urgently needed to determine the extent to which health services are meeting the needs of Indigenous people with cancer, and to identify areas for action to improve these services.
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Affiliation(s)
- Monica Green
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia. .,Menzies School of Health Research, Level 1, 147 Wharf Street, Spring Hill, QLD, 4000, Australia.
| | - Kate Anderson
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
| | - Kalinda Griffiths
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia.,Faculty of Health Sciences, University of Sydney, Camperdown, NSW, 2006, Australia.,Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
| | - Joan Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
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de Witt A, Cunningham FC, Bailie R, Percival N, Adams J, Valery PC. " It's Just Presence," the Contributions of Aboriginal and Torres Strait Islander Health Professionals in Cancer Care in Queensland. Front Public Health 2018; 6:344. [PMID: 30619801 PMCID: PMC6307500 DOI: 10.3389/fpubh.2018.00344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/05/2018] [Indexed: 12/29/2022] Open
Abstract
Objectives: The aim of this research was to explore health professionals' perspectives on the provision of follow-up cancer care for Aboriginal and Torres Strait Islander patients in Queensland. Methods: Semi-structured interviews were conducted with Indigenous and non-Indigenous health professionals who had experience providing care for Indigenous cancer patients in the primary health care and hospital setting. Results: Participants were recruited from six Aboriginal Community Controlled Health Services (n = 17) and from a tertiary hospital (n = 9) across urban, regional, and remote geographical settings. Culturally safe care, psychological support, determining patient needs, practical assistance, and advocating for Indigenous health were identified as enablers to support the needs of Indigenous patients when accessing cancer care, and Indigenous health professionals were identified as the key enabler. Conclusion: Indigenous health professionals significantly contribute to the provision of culturally competent follow-up cancer care by increasing the accessibility of follow-up cancer care services and by supporting the needs of Indigenous cancer patients. All health professionals need to work together and be sufficiently skilled in the delivery of culturally competent care to improve the Indigenous cancer journey and outcomes for Indigenous people. Effective organizational policies and practices are crucial to enable all health professionals to provide culturally competent and responsive cancer care to Indigenous Australians.
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Affiliation(s)
- Audra de Witt
- Menzies School of Health Research, Brisbane, QLD, Australia.,Division of Epidemiology and Health Systems, Centre for Primary Health Care Systems, Charles Darwin University, Darwin, NT, Australia.,Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Frances C Cunningham
- Menzies School of Health Research, Brisbane, QLD, Australia.,Division of Epidemiology and Health Systems, Centre for Primary Health Care Systems, Charles Darwin University, Darwin, NT, Australia
| | - Ross Bailie
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
| | - Nikki Percival
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jon Adams
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Patricia C Valery
- Menzies School of Health Research, Brisbane, QLD, Australia.,Division of Epidemiology and Health Systems, Centre for Primary Health Care Systems, Charles Darwin University, Darwin, NT, Australia.,Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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de Arruda-Colli MNF, Sansom-Daly U, Dos Santos MA, Wiener L. Considerations for the cross-cultural adaptation of an advance care planning guide for youth with cancer. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2018; 6:341-354. [PMID: 30859018 PMCID: PMC6407880 DOI: 10.1037/cpp0000254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Adolescent and young adults' (AYAs) involvement in advance care planning and end-of-life discussions may enhance the decision-making process, reduce stress and improve the patient's quality of life. Given the importance of establishing adequate communication and having culturally-appropriate tools to introduce advance care planning, our paper will describe the cross-cultural adaptation of the advance care planning guide, Voicing My CHOiCES ™ in Australia and in Brazil. METHODS In Brazil, the process involved initially translating the document to Portuguese followed by evaluation by a group of providers and patients (aged 18-39) undergoing cancer treatment. The document was revised based on the feedback received, then back-translated to English and discussed with Voicing My CHOiCES ™ ' authors to refine the final version in Portuguese. In Australia, a multi-perspective interview-based study was undertaken with AYA cancer patients/survivors (aged 15-25), siblings, parents, and a range of healthcare providers from the oncology setting, to determine the perceived acceptability of the tool within the Australian clinical context. RESULTS These interviews pointed to a variety of recommended adaptations ranging from the aesthetic and linguistic, through to the re-structuring of content within the tool. Adaptations for the Australian setting were then revised in an iterative capacity within several focus groups of AYA participants and healthcare providers. CONCLUSIONS The processes used in both countries highlight ways to engage youth living with a life-limiting illness in conversations about advance care planning and how to develop culturally-appropriate clinical tools.
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Affiliation(s)
- Marina Noronha Ferraz de Arruda-Colli
- Department of Psychology, Faculty of Philosophy, Sciences, and Letters at Ribeirao Preto, University of São Paulo (Brazil)
- Psychosocial Support and Research Program, Pediatric Oncology Branch, Center for Cancer Research, National Institutes of Health (United States)
| | - Ursula Sansom-Daly
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital (Australia)
- Sydney Youth Cancer Service, Prince of Wales Hospital, Randwick (Australia)
| | - Manoel Antônio Dos Santos
- Department of Psychology, Faculty of Philosophy, Sciences, and Letters at Ribeirao Preto, University of São Paulo (Brazil)
| | - Lori Wiener
- Psychosocial Support and Research Program, Pediatric Oncology Branch, Center for Cancer Research, National Institutes of Health (United States)
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Taylor EV, Haigh MM, Shahid S, Garvey G, Cunningham J, Holloway M, Thompson SC. Australian cancer services: a survey of providers’ efforts to meet the needs of Indigenous patients. Aust N Z J Public Health 2018; 42:547-552. [DOI: 10.1111/1753-6405.12843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/01/2018] [Accepted: 09/01/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Emma V. Taylor
- Western Australian Centre for Rural Health, The University of Western Australia
| | - Margaret M. Haigh
- Western Australian Centre for Rural Health, The University of Western Australia
- School of Nursing and Midwifery, Trinity College, The University of Dublin, Ireland
| | - Shaouli Shahid
- Western Australian Centre for Rural Health, The University of Western Australia
- Centre for Aboriginal Studies, Curtin University, Western Australia
| | - Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Northern Territory
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Northern Territory
| | - Michele Holloway
- Western Australian Centre for Rural Health, The University of Western Australia
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, The University of Western Australia
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Shaw T, Ishak D, Lie D, Menon S, Courtney E, Li ST, Ngeow J. The influence of Malay cultural beliefs on breast cancer screening and genetic testing: A focus group study. Psychooncology 2018; 27:2855-2861. [PMID: 30264524 DOI: 10.1002/pon.4902] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/30/2018] [Accepted: 09/24/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Malays comprise an Asian cultural group reported to have low breast cancer screening uptake rates and poor cancer outcomes. Little is known about Malay cultural factors influencing beliefs and practice of cancer screening and genetic testing. Our study aims to explore health beliefs of Malay women around breast cancer screening and genetic testing. METHODS We conducted focus groups among healthy English-speaking Malay women in Singapore, aged 40 to 69 years, using a structured guide developed through literature review, expertise input and participant refinement. Thematic analysis was conducted to extract dominant themes representing key motivators and barriers to screening and genetic testing. We used grounded theory to interpret results and derive a framework of understanding, with implications for improving uptake of services. RESULTS Five focus groups (four to six participants per group) comprising 27 women were conducted to theme saturation. Major themes were (a) spiritual and religious beliefs act as barriers towards uptake of screening and genetic testing; (b) preference for traditional medicine competes with Western medicine recommendations; (c) family and community influence health-related decisions, complexed by differences in intergenerational beliefs creating contrasting attitudes towards screening and prevention. CONCLUSIONS Decisions to participate in breast cancer screening and genetic testing are influenced by cultural, traditional, spiritual/religious, and intergenerational beliefs. Strategies to increase uptake should include acknowledgement and integration of these beliefs into counseling and education and collaboration with key influential Malay stakeholders and leaders.
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Affiliation(s)
- Tarryn Shaw
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
| | - Diana Ishak
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
| | - Désirée Lie
- Office of Clinical Sciences, Duke-NUS Medical School, Singapore
| | - Sapna Menon
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
| | - Eliza Courtney
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
| | - Shao-Tzu Li
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore.,Institute of Molecular and Cell Biology, Agency for Science Technology and Research (A*Star), Singapore
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Thewes B, McCaffery K, Davis E, Garvey G. Insufficient evidence on health literacy amongst Indigenous people with cancer: a systematic literature review. Health Promot Int 2018; 33:195-218. [PMID: 27543930 DOI: 10.1093/heapro/daw066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Indigenous people experience poorer cancer survival outcomes compared with non-Indigenous people. Currently, there is growing awareness of poor health literacy as a determinant of cancer outcomes. However, little attention has been given to researching cancer-related health literacy amongst Indigenous people. Objectives To systematically review empirical studies of cancer health literacy amongst Indigenous people worldwide. Methods Articles were identified in Medline (1946-2013); Pre-Medline; CINAHL; PsycINFO (1967-2013); PubMed; Current Contents/All Editions (1993-2013); Allied Health and Complimentary Medicine (1985-2013), and in the reference lists of retrieved articles and by expert consultation. 64 abstracts were screened for inclusion and 16 articles were retained. Results There is a paucity of high-quality research concerning of health literacy amongst Indigenous cancer patients. No articles used formal measures of health literacy and data on the prevalence of health literacy was not reported. Of the 7 articles describing interventions only one included a control group and the remainder employed quasi-experimental methods. Conclusions Research is needed to explore the cultural relevance of existing measures of health literacy and to document the prevalence of health literacy amongst Indigenous people with cancer. A better understanding of Indigenous cancer patients' health literacy is required before health literacy interventions can be designed to improve Indigenous cancer outcomes.
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Affiliation(s)
- Belinda Thewes
- Menzies School of Health Research, Brisbane, Australia.,Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Esther Davis
- Menzies School of Health Research, Brisbane, Australia
| | - Gail Garvey
- Menzies School of Health Research, Brisbane, Australia
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Julien N, Lacasse A, Labra O, Asselin H. Review of chronic non-cancer pain research among Aboriginal people in Canada. Int J Qual Health Care 2018; 30:178-185. [PMID: 29346613 DOI: 10.1093/intqhc/mzx195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022] Open
Abstract
Purpose Aboriginal people in Canada are disproportionately affected by chronic illnesses, compared to non-Aboriginal Canadians. The purpose of this review was to determine whether differences exist between the two groups with respect to chronic non-cancer pain (CNCP) in order to better inform clinical practice and to identify research gaps. Data sources Four electronic databases were searched for the period of 1990-2015. Study selection Only English and French language original studies that examined CNCP prevalence, assessment tools and beliefs among Aboriginal people in Canada were considered. Data extraction Data extracted included Aboriginal group, geographic location, study setting and pain definition (for prevalence studies only). Results of data synthesis A total of 11 studies matched the selection criteria: 10 reported estimates of chronic pain prevalence among Aboriginal people in Canada, 1 was about a culturally adapted pain assessment tool, and no study was found about CNCP beliefs within Aboriginal people. Conclusion CNCP among Aboriginal people is still a largely unexplored research field. The limited evidence available so far does not allow us to conclude that CNCP affects a higher proportion of Aboriginal than non-Aboriginal people in Canada. However, arthritis, a specific condition associated with chronic pain, is more prevalent in Aboriginal than non-Aboriginal people. Additional research is needed on other CNCP types and conditions. Furthermore, pain assessment tools are not culturally adapted and clinicians should inquire more about the beliefs of Aboriginal patients to make them feel safer and to better target interventions.
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Affiliation(s)
- Nancy Julien
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, 445, boulevard de l'Université, Rouyn-Noranda, Quebec, Canada J9X 5E4
| | - Anaïs Lacasse
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, 445, boulevard de l'Université, Rouyn-Noranda, Quebec, Canada J9X 5E4
| | - Oscar Labra
- Département des sciences du développement humain et social, Université du Québec en Abitibi-Témiscamingue, 445, boulevard de l'Université, Rouyn-Noranda, Quebec, Canada J9X 5E4
| | - Hugo Asselin
- École d'études autochtones, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada J9X 5E4.,Chaire de recherche du Canada en foresterie autochtone, Université du Québec en Abitibi-Témiscamingue, 445, boulevard de l'Université, Rouyn-Noranda, Quebec, Canada J9X 5E4
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Gall A, Leske S, Adams J, Matthews V, Anderson K, Lawler S, Garvey G. Traditional and Complementary Medicine Use Among Indigenous Cancer Patients in Australia, Canada, New Zealand, and the United States: A Systematic Review. Integr Cancer Ther 2018; 17:568-581. [PMID: 29779402 PMCID: PMC6142081 DOI: 10.1177/1534735418775821] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cancer 'patients' are increasingly using traditional indigenous and complementary medicines (T&CM) alongside conventional medical treatments to both cure and cope with their cancer diagnoses. To date T&CM use among Indigenous cancer patients from Australia, Canada, New Zealand, and the United States has not been systematically reviewed. METHODS We systematically searched bibliographic databases to identify original research published between January 2000 and October 2017 regarding T&CM use by Indigenous cancer patients in Australia, Canada, New Zealand, and the United States. Data from records meeting eligibility criteria were extracted and appraised for quality by 2 independent reviewers. RESULTS Twenty-one journal articles from 18 studies across all 4 countries met our inclusion criteria. T&CM use ranged from 19% to 57.7% (differing across countries). T&CM was mostly used concurrently with conventional cancer treatments to meet their spiritual, emotional, social, and cultural needs; however, bush, traditional, and herbal medicines were used in a minority of cases as an alternative. CONCLUSIONS Our findings highlight the importance of T&CM use to Indigenous cancer patients across these 4 countries; we identified multiple perceived spiritual, emotional and cultural benefits to its use. The patient's perception of their health professional's attitudes toward T&CM in some cases hindered or encouraged the patient's disclosure. Additional research is required to further explore the use and disclosure of T&CM among Indigenous cancer patients to help inform and ensure effective, safe, coordinated care for Indigenous cancer patients that relies on shared open decision making and communication across patients, communities, and providers.
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Affiliation(s)
- Alana Gall
- 1 Charles Darwin University, Brisbane, Queensland, Australia
| | - Stuart Leske
- 1 Charles Darwin University, Brisbane, Queensland, Australia
| | - Jon Adams
- 2 University of Technology Sydney, Sydney, New South Wales, Australia
| | - Veronica Matthews
- 3 University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Kate Anderson
- 1 Charles Darwin University, Brisbane, Queensland, Australia
| | | | - Gail Garvey
- 1 Charles Darwin University, Brisbane, Queensland, Australia
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Taylor EV, Haigh MM, Shahid S, Garvey G, Cunningham J, Thompson SC. Cancer Services and Their Initiatives to Improve the Care of Indigenous Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040717. [PMID: 29641441 PMCID: PMC5923759 DOI: 10.3390/ijerph15040717] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/07/2018] [Accepted: 04/08/2018] [Indexed: 02/02/2023]
Abstract
Indigenous Australians continue to experience significantly poorer outcomes from cancer than non-Indigenous Australians. Despite the importance of culturally appropriate cancer services in improving outcomes, there is a lack of awareness of current programs and initiatives that are aimed at meeting the needs of Indigenous patients. Telephone interviews were used to identify and describe the Indigenous-specific programs and initiatives that are implemented in a subset of the services that participated in a larger national online survey of cancer treatment services. Fourteen services located across Australia participated in the interviews. Participants identified a number of factors that were seen as critical to delivering culturally appropriate treatment and support, including having a trained workforce with effective cross-cultural communication skills, providing best practice care, and improving the knowledge, attitudes, and understanding of cancer by Indigenous people. However, over a third of participants were not sure how their service compared with others, indicating that they were not aware of how other services are doing in this field. There are currently many Indigenous-specific programs and initiatives that are aimed at providing culturally appropriate treatment and supporting Indigenous people affected by cancer across Australia. However, details of these initiatives are not widely known and barriers to information sharing exist. Further research in this area is needed to evaluate programs and initiatives and showcase the effective approaches to Indigenous cancer care.
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Affiliation(s)
- Emma V Taylor
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia.
| | - Margaret M Haigh
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia.
| | - Shaouli Shahid
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia.
- Centre for Aboriginal Studies, Curtin University, Kent Street, Perth, WA 6102, Australia.
| | - Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia.
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia.
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia.
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Lyford M, Haigh MM, Baxi S, Cheetham S, Shahid S, Thompson SC. An Exploration of Underrepresentation of Aboriginal Cancer Patients Attending a Regional Radiotherapy Service in Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E337. [PMID: 29443892 PMCID: PMC5858406 DOI: 10.3390/ijerph15020337] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/30/2018] [Accepted: 02/07/2018] [Indexed: 12/17/2022]
Abstract
Travel logistics impede Aboriginal patients' uptake of cancer treatments and is one reason for the poorer outcomes of Aboriginal people with cancer. This research examined benefits of a newly established rurally based radiotherapy unit in southwest Western Australia (WA), and included exploring the experience of Aboriginal patients and possible reasons for Aboriginal people's underrepresentation in treatment. Semi-structured in-depth interviews with 21 service providers involved in the treatment and care of people with cancer, and 3 Aboriginal patients with cancer who undertook radiotherapy at the Service were undertaken. Data were subject to thematic analysis involving immersion in the data for familiarization, inductive coding, investigator discussion and refining of emerging themes and triangulation of patient and provider interviews. Aboriginal cancer patients were positive about the treatment and support they had received, highlighting the often complex challenges faced by rural Aboriginal cancer patients in accessing and maintaining treatment. Service providers offered suggestions for small numbers presenting to the Service, including late presentation, potential perceptions of cultural insensitivity on the part of service providers, out-of-pocket costs and under-ascertainment of Aboriginal status. The Service has put in place practices and initiatives to support patient health and wellbeing, including making the facility more welcoming towards Aboriginal people and ensuring culturally appropriate care.
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Affiliation(s)
- Marilyn Lyford
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia 6530, Australia.
| | - Margaret M Haigh
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia 6530, Australia.
| | - Siddhartha Baxi
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia 6530, Australia.
- Radiation Oncology, South West Radiation Oncology Service, South West Health Campus, Corner of Bussell Hwy & Robertson Drive, Bunbury, Western Australia 6230, Australia.
| | - Shelley Cheetham
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia 6530, Australia.
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent Street, Perth, Western Australia 6102, Australia.
| | - Shaouli Shahid
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia 6530, Australia.
- Centre for Aboriginal Studies, Curtin University, Kent Street, Perth, Western Australia 6102, Australia.
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia 6530, Australia.
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