Considering Aboriginal palliative care models: the challenges for mainstream services

O’Brien, Anthony; Bloomer, Melissa; McGrath, Pamela Della; Clark, Katherine; Martin, Tony; Lock, Mark; Pidcock, Tina; Riet, Pamela van der; O'Connor, Margaret Mary

doi:10.22605/rrh2339

Cited by 15 publications

(26 citation statements)

References 20 publications

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“…There is also a critical need for research on Ma ¯ori wha ¯nau experiences of caregiving. Cultural education is needed to support health professionals to work successfully with indigenous people [37,40] particularly where cultural traditions and spirituality are concerned [41,42]. Cultural safety training would help to increase the sector's knowledge of the meanings Ma ¯ori attribute to their cultural values, beliefs and end-of-life care customs.…”

Section: Discussionmentioning

confidence: 99%

Māori: living and dying with cardiovascular disease in Aotearoa New Zealand

Mason

Toohey²,

Gott³

et al. 2019

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewThis article provides an informed perspective on cardiovascular disease (CVD) and palliative care need among Ma ¯ori New Zealanders. High Ma ¯ori CVD risk factors will contribute to a sharp increase in older Ma ¯ori deaths which has implications for health and palliative care service provision. Recent findingsCVD is New Zealand's leading cause of premature deaths and disability among Ma ¯ori. A projected rise in older Ma ¯ori deaths within the next 30 years will require increased palliative care. However, accessing palliative care and obtaining and understanding information can be challenging for families who are already often overburdened with high social and economic disadvantages. Meeting the high financial costs associated with end-of-life care make living with CVD challenging. Engaging with the health system's biomedical approach when holistic care is preferable can be a major barrier. SummaryMa ¯ori families provide the bulk of care at end-of-life, but they can become fatigued with the challenges that accompany long-term progressive illnesses, such as CVD. They are also burdened by the financial costs associated with end-of-life. It is often difficult for Ma ¯ori to access palliative care and to obtain and understand information about the illness and treatment. Navigating an unfamiliar and complex health system, low health literacy among Ma ¯ori and poor relationship building and communication skills of health professionals are significant barriers. Cultural safety training would help to increase health and cardiovascular professionals' cultural understanding of Ma ¯ori and their holistic end-of-life preferences; this could go some way to strengthen rapport building and communication skills necessary for effective engagement and informational exchanges. Increasing the Ma ¯ori palliative care workforce and introducing cultural safety training among health professionals could help to bridge the gap. A current study to gather traditional care customs and present these to wha ¯nau and the health and palliative care sectors in the form of an online resource could contribute to this decolonizing objective.

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Section: Discussionmentioning

confidence: 99%

Māori: living and dying with cardiovascular disease in Aotearoa New Zealand

Mason

Toohey²,

Gott³

et al. 2019

Current Opinion in Supportive &Amp; Palliative Care

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“…Evidence suggests that Aboriginal and Torres Strait Islander peoples face barriers to these services owing to a lack of awareness of service availability, difficulty accessing culturally trained health professionals, and fear influenced by a history of health service inequality 11 . Aboriginal and Torres Strait Islander peoples, clinicians and academics have consistently identified the need for better and more culturally relevant palliative care services 11‐13 .…”

mentioning

confidence: 99%

“…6,9,10 Evidence suggests that Aboriginal and Torres Strait Islander peoples face barriers to these services owing to a lack of awareness of service availability, difficulty accessing culturally trained health professionals, and fear influenced by a history of health service inequality. 11 Aboriginal and Torres Strait Islander peoples, clinicians and academics have consistently identified the need for better and more culturally relevant palliative care services. [11][12][13] Despite Aboriginal and Torres Strait Islander health workers and practitioners being well placed to act as a cultural connection, they remain under-represented in specialist palliative care settings, and many require further education and training in end-of-life care.…”

mentioning

confidence: 99%

“…11 Aboriginal and Torres Strait Islander peoples, clinicians and academics have consistently identified the need for better and more culturally relevant palliative care services. [11][12][13] Despite Aboriginal and Torres Strait Islander health workers and practitioners being well placed to act as a cultural connection, they remain under-represented in specialist palliative care settings, and many require further education and training in end-of-life care. 13 The Gwandalan National Palliative Care Project (NPCP), an initiative of Australian General Practice Accreditation Limited (AGPAL) and Palliative Care South Australia (funded by the Australian Government under the Public Health and Chronic Disease Care Grant, National Palliative Care Projects 2020-2023) addresses these concerns using value co-creation and user-centred design.…”

mentioning

confidence: 99%

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Building capacity in those who deliver palliative care services to Aboriginal and Torres Strait Islander peoples

Janamian

Dawda

Crawford

et al. 2022

Medical Journal of Australia

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“…The barriers to providing optimal health care to Aboriginal people have been documented, leading to poorer health outcomes when compared to other Australians 1–4 . Disparities in care can result from reduced access to health‐care services due to remote living, dislocation from culturally supportive systems and cross‐cultural misunderstandings 5,6 …”

mentioning

confidence: 99%

Health‐care workers' understanding of and barriers to palliative care services to Aboriginal children with cancer

Jessop

Phelan

2022

J Paediatrics Child Health

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Aim To identify barriers in the understanding and provision of optimal palliative care to Aboriginal children with cancer by health‐care staff, with the aim to support education and training that highlights the importance of cultural, physical and spiritual needs at end‐of‐life. Methods Medical and nursing staff working in Departments of Palliative Care, Metabolic Medicine and Haematology/Oncology at the Women's and Children's Hospital in Adelaide, South Australia, were asked to complete a survey regarding their experience in treating Aboriginal children receiving palliative care. The survey addressed the understanding of cultural and spiritual needs, barriers encountered and opinions for improved services. Results The survey was completed by 34 participants. 91.2% (n = 31) had provided care to Aboriginal children who were receiving care during palliative and end‐of‐life phases for a diagnosis of cancer, 58.8% (n = 20) of which had supported children returning home. Only 23.5% of participants reported comfort in communicating about spiritual/cultural needs with patients and families. There was minimal previous exposure to education (17.6%), yet all participants were interested in future education opportunities. Conclusion This study highlights a paucity in understanding and comfort among health‐care workers in treating Aboriginal children at end‐of‐life. New models, including the training of staff, educational resources and involvement of Aboriginal health‐care workers, may improve care.

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Considering Aboriginal palliative care models: the challenges for mainstream services

Cited by 15 publications

References 20 publications

Māori: living and dying with cardiovascular disease in Aotearoa New Zealand

Māori: living and dying with cardiovascular disease in Aotearoa New Zealand

Building capacity in those who deliver palliative care services to Aboriginal and Torres Strait Islander peoples

Health‐care workers' understanding of and barriers to palliative care services to Aboriginal children with cancer

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