1
|
Fitzpatrick K, Lundstrom T, Osmar K, Mortimore E, McKennit HK, Lightning RM, Bolderston A, Fawcett S. Understanding Indigenous peoples experiences to inform recommendations for improving cultural safety and care in radiation therapy centres in Alberta, Canada. J Med Imaging Radiat Sci 2024; 55:101722. [PMID: 39089139 DOI: 10.1016/j.jmir.2024.101722] [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: 02/23/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 08/03/2024]
Abstract
INTRODUCTION Rates of common cancers are continuously increasing among Indigenous peoples and are above the incidence rates of non-Indigenous Canadians. When considering the intersecting social determinants of health such as culture, geography, funding, and access to basic health services, these all contribute to the unique cancer burden faced by Indigenous people. Indigenous patients sometimes feel alienated by the word "cancer", intimidated in the oncology setting and often avoid or delay seeking care, bypass screening and preventative care, and cease prescribed treatment before it is finished. Providing culturally competent, safe care to improve Indigenous health outcomes have been suggested and prioritized in health care systems across Canada. METHODS Using an Indigenous methodology, sharing circles were held in Northern Alberta, Canada. Five Indigenous survivors of cancer and two Indigenous caregivers shared their experiences with oncology treatment in the radiation therapy centre. Results were transcribed verbatim and thematic analysis was conducted. RESULTS This resulted in four main themes (1) historical and cultural understandings (2) reduce systemic harm by having dedicated Indigenous staff, cultural competency, and Indigenous specific supports (3) meaningful time commitment and relationship building (4) importance of kinship and Indigenous-centred, family-and-patient-centred care. These themes fed into the development of nine recommendations for policy and decision makers to improve cultural safety in the Alberta radiation therapy centres. CONCLUSION Support for Indigenous patients and caregivers is essential to improve care in the radiation therapy centres. The findings from this work will support recommendations for health decision and policy makers within radiation therapy centres, which may be transferable to other centres within oncology and health.
Collapse
Affiliation(s)
- Kayla Fitzpatrick
- Medical Student, Cumming School of Medicine, University of Calgary, Calgary, AB; Senior Research Associate, School of Public Health, University of Alberta (formerly) Research Assistant and Radiation Therapy Student, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB (formerly).
| | - Tracey Lundstrom
- Radiation Therapist, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB
| | - Kari Osmar
- Clinical Faculty, Radiation Therapy Program, Department of Oncology, Faculty of Medicine & Dentistry, Tom Baker Cancer Clinic
| | - Emma Mortimore
- Medical Student, Cumming School of Medicine, University of Calgary, Calgary, AB
| | - Hazel Kokum McKennit
- Elder in Residence, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB
| | - Rick Mosom Lightning
- Elder in Residence, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB
| | - Amanda Bolderston
- Faculty Educator Radiation Therapy Program, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB
| | - Susan Fawcett
- Radiation Therapy Program Director, Department of Oncology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB
| |
Collapse
|
2
|
Diaz Vega M, Santos JDM, Witham S, Friesen M, Brock T, Laroque S, Sedgewick J, Carr T, Groot G. Cancer Prevention and Cultural Continuity for Métis Peoples in Canada: A Scoping Review. Curr Oncol 2024; 31:3908-3922. [PMID: 39057161 PMCID: PMC11276589 DOI: 10.3390/curroncol31070289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
The purpose of this scoping review was to map the literature on the relationship between cultural continuity and health among Métis people as well as how this knowledge could be translated into cancer prevention initiatives. We included any Métis-specific literature evaluating connections between culture, health, and well-being. We conducted electronic searches of Medline, PubMed, Embase, PsychInfo, I-Portal, and hand-searched journals, and reviewed the grey literature. Based on our inclusion criteria, articles were screened and assessed for eligibility, resulting in a sample of 22 publications. Qualitative, quantitative, and mixed methods designs were considered. The 22 publications included in this review were diverse, ranging from population-based studies to reports and news articles. There were no limitations to publication year, and most of the data presented in this review were published more than five years ago. Nevertheless, the results demonstrate the potential role of Métis cultural continuity in cancer prevention. The scoping review revealed the current lack of Métis-specific data regarding health and its intersectionality with culture. However, the existing literature indicates that cultural continuity for Métis appears to influence health and well-being positively. As such, there may be benefits to incorporating cultural continuity in cancer prevention efforts.
Collapse
Affiliation(s)
- Maria Diaz Vega
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada (J.D.M.S.); (T.C.)
| | - José Diego Marques Santos
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada (J.D.M.S.); (T.C.)
| | - Stephanie Witham
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada (J.D.M.S.); (T.C.)
| | - Marg Friesen
- Ministry of Health, Métis Nation—Saskatchewan, Saskatoon, SK S7M 5X8, Canada
| | - Tegan Brock
- Ministry of Health, Métis Nation—Saskatchewan, Saskatoon, SK S7M 5X8, Canada
| | - Sheila Laroque
- Indigenous Studies, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Jennifer Sedgewick
- Schulich School of Business, York University Toronto, North York, ON M3J 1P3, Canada
| | - Tracey Carr
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada (J.D.M.S.); (T.C.)
| | - Gary Groot
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada (J.D.M.S.); (T.C.)
| |
Collapse
|
4
|
Chiu S, Fowler S, Bridges S, Hanson N, King J, Street S, Tait H, Irving K, McLean P, McLaughlin L, Gulliver A. A mixed-method study evaluating an innovative care model for rural patients undergoing outpatient breast surgery. Can J Surg 2024; 67:E77-E84. [PMID: 38453350 PMCID: PMC10927285 DOI: 10.1503/cjs.004923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The Delta Oasis program was launched in New Brunswick in 2006 to offer patients from rural areas who were undergoing breast cancer surgery and their families 1 night of free accommodations and a postoperative consultation with an extramural nurse. We sought to investigate patient experiences with this program. METHODS This mixed-method retrospective study took place from 2020 to 2022 and compared the preoperative anxiety and quality of recovery of program participants and control patients who were discharged home over 100 km from hospital. We conducted 2 × 2 analysis of variance to evaluate the effects of intervention group and surgery type. We conducted semistructured interviews with intervention participants, which we then thematically analyzed. Two patient partners were engaged during data synthesis to support the interpretation of results. RESULTS We included 34 patients who participated in the program and 18 control patients. No statistically significant differences were found between treatment groups in preoperative anxiety and quality of recovery, regardless of surgery type. Thematic analysis of interviews with 17 intervention participants revealed that they were highly satisfied with the program and that the experience helped reduce stress and discomfort related to their surgery. INTERPRETATION The Delta Oasis program is a cost-effective alternative to inpatient care after breast cancer surgery and is highly regarded by rural patients; expansion to other regions with the inclusion of additional low-risk surgeries could help address hospital capacity issues. This study contributes to our understanding of the patient experience with the Delta Oasis program and informs the development of similar programs elsewhere.
Collapse
Affiliation(s)
- Sharon Chiu
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Samantha Fowler
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Sarah Bridges
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Natasha Hanson
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Jordan King
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Sarah Street
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Heather Tait
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Karen Irving
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Peggy McLean
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Lauren McLaughlin
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| | - Adrienne Gulliver
- From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
| |
Collapse
|