Cycles of silence: First Nations women overcoming social and historical barriers in supportive cancer care

Hammond, Chad; Thomas, Roanne; Gifford, Wendy; Poudrier, Jennifer; Hamilton, Ryan; Brooks, Carolyn; Morrison, Tricia; Scott, Tracy; Warner, Doris

doi:10.1002/pon.4335

Cited by 32 publications

(61 citation statements)

References 31 publications

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“…This study builds on our foundational studies which overwhelmingly identified a gap in the delivery of culturally safe cancer survivorship support for First Nations and Métis people [18, 20–24]. One of the first opportunities to voice their survivorship experiences, our first study (funded by Canadian Cancer Society), highlighted the profound failures of healthcare services to recognize the distinct ethnic, cultural, and socio-historical positioning of First Nations and Métis people.…”

Section: Introductionmentioning

confidence: 98%

“…One of the first opportunities to voice their survivorship experiences, our first study (funded by Canadian Cancer Society), highlighted the profound failures of healthcare services to recognize the distinct ethnic, cultural, and socio-historical positioning of First Nations and Métis people. It revealed that stigmatization, fear of disclosing cancer, and culturally insensitive healthcare approaches prevent Indigenous people from receiving survivorship care, including follow-up and regular monitoring for early detection and survivorship interventions for enhancing quality of life [21, 22, 25, 26].…”

Section: Introductionmentioning

confidence: 99%

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Providing culturally safe cancer survivorship care with Indigenous communities: study protocol for an integrated knowledge translation study

Gifford

Thomas

Barton

et al. 2019

Pilot Feasibility Stud

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Background Cancer among Indigenous people is increasing faster than overall Canadian rates. Lack of survivorship support, including screening and follow-up for recurrences, contributes to poor health outcomes and low 5-year survival rates. Historical trauma from colonization and lack of culturally safe and responsive healthcare has negatively affected Indigenous peoples’ access to survivorship supports. Nurses are typically the sole practitioners of health services in rural and remote Indigenous communities and can enhance the development, implementation, and delivery of culturally safe survivorship supports. However, the implementation of culturally safe healthcare in Indigenous communities is not well developed. This is the third study in a larger program of research with an overarching goal to improve healthcare delivery and outcomes with Indigenous people in Canada. In this study, we will field test nurses’ implementation of cancer survivorship care with Indigenous people in Ontario, Canada. Methods The study is a descriptive participatory mixed methods research design involving a systematic review, field testing implementation of cancer survivorship supports in two communities, focus groups, and qualitative interviews. Outcomes include feasibility of implementation, acceptability of the strategies, and perceived impact on healing and psychosocial support. Discussion Results will advance knowledge about implementing culturally safe cancer survivorship supports with Indigenous people in Ontario. A toolkit will be developed to inform nursing practices, programs, and policies to improve cancer survivorship supports and strategies with Indigenous people. Findings will inform a large-scale implementation study to reduce healthcare disadvantages and disparities within Indigenous communities across Canada.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Providing culturally safe cancer survivorship care with Indigenous communities: study protocol for an integrated knowledge translation study

Gifford

Thomas

Barton

et al. 2019

Pilot Feasibility Stud

Self Cite

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“…It is widely recognised that, as with health services in general, there is a lack of culturally appropriate cancer services to engage Indigenous peoples. Fear or lack of trust of mainstream health facilities, lack of understanding or respect being shown by health care providers, poor communication by health care providers, fatalistic or differing cultural beliefs about cancer, and logistical difficulties in accessing screening and treatment services have been identified as inhibiting Indigenous people’s engagement with cancer care [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. It has been noted that attention should focus on how cancer service providers deliver services to their Indigenous patients and on ways in which they can improve to better meet the needs of Indigenous peoples [ 12 , 13 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Fear or lack of trust of mainstream health facilities, lack of understanding or respect being shown by health care providers, poor communication by health care providers, fatalistic or differing cultural beliefs about cancer, and logistical difficulties in accessing screening and treatment services have been identified as inhibiting Indigenous people’s engagement with cancer care [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. It has been noted that attention should focus on how cancer service providers deliver services to their Indigenous patients and on ways in which they can improve to better meet the needs of Indigenous peoples [ 12 , 13 , 17 ]. In Australia, the National Aboriginal and Torres Strait Islander Cancer Framework has identified that “culturally safe services and a culturally competent workforce… are core requirements for improving cancer outcomes” [ 19 ] (p. 15), highlighting the essential role that cancer service providers have in encouraging and maintaining Indigenous Australians’ attendance at cancer services to gain the benefits of modern cancer treatments.…”

Section: Introductionmentioning

confidence: 99%

Cancer Services and Their Initiatives to Improve the Care of Indigenous Australians

Taylor

Haigh

Shahid

et al. 2018

IJERPH

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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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“…Cultural safety is an approach to delivering care that is based on establishing trusting and reciprocal relationships between a patient and their healthcare provider [49]. Lack of culturally safe care has been noted to be a barrier to accessing cancer care among FN people [34, 45, 50, 51]. Racism, discrimination, and fear of judgment have been noted to impede access to both primary care [37, 38] and cancer care [32, 47, 50, 52, 53], by causing patients to delay or avoid accessing care.…”

Section: Discussionmentioning

confidence: 99%

Comparing cancer incidence, stage at diagnosis and outcomes of First Nations and all other Manitobans: a retrospective analysis

et al. 2019

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BackgroundGlobally, epidemiological evidence suggests cancer incidence and outcomes among Indigenous peoples are a growing concern. Although historically cancer among First Nations (FN) peoples in Canada was relatively unknown, recent epidemiological evidence reveals a widening of cancer related disparities. However evidence at the population level is limited. The aim of this study was to explore cancer incidence, stage at diagnosis, and outcomes among status FN peoples in comparison with all other Manitobans (AOM).MethodsAll cancers diagnosed between April 1, 2004 and March 31, 2011 were linked with the Indian Registry System and five provincial healthcare databases to compare differences in characteristics, cancer incidence, and stage at diagnosis and mortality of the FN and AOM cohorts. Cox proportional hazard regression models were used to examine mortality.ResultsThe FN cohort was significantly younger, with higher comorbidities than AOM. A higher proportion of FN people were diagnosed with cancer at stages III (18.7% vs. 15.4%) and IV (22.4% vs. 19.9%). Cancer incidence was significantly lower in the FN cohort, however, there were no significant differences between the two cohorts after adjusting for age, sex, income and area of residence. No significant trends in cancer incidence were identified in either cohort over time. Mortality was generally higher in the FN cohort.ConclusionsDespite similar cancer incidence, FN peoples in Manitoba experience poorer survival. The underlying causes of these disparities are not yet understood, particularly in relation to the impact of colonization and other determinants of health.

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Cycles of silence: First Nations women overcoming social and historical barriers in supportive cancer care

Cited by 32 publications

References 31 publications

Providing culturally safe cancer survivorship care with Indigenous communities: study protocol for an integrated knowledge translation study

Providing culturally safe cancer survivorship care with Indigenous communities: study protocol for an integrated knowledge translation study

Cancer Services and Their Initiatives to Improve the Care of Indigenous Australians

Comparing cancer incidence, stage at diagnosis and outcomes of First Nations and all other Manitobans: a retrospective analysis

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