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

Abstract

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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“…The knowledge dimension scores are consistent with previous findings [ 23 – 25 ], but there is room for PHWs to improve on issues such as the definition and purpose of CPC as well as the management of pain and other symptoms. Jessop S et al [ 26 ] explored the barriers to palliative care encountered by PHWs caring for seriously ill children and found that inadequate pain management and hospice education were common; this paper was widely recognized and played an important role in the field after publication. Therefore, we need to further strengthen the training of PHWs in CPC, especially to popularize the concept and improve management of pain and related symptoms.The present study found better scores on the attitude dimension, which was higher than previous results [ 27 ].…”

Adapting the Voicing My CHOiCES Advance Care Planning Communication Guide for Australian Adolescents and Young Adults with Cancer: Appropriateness, Acceptability, and Considerations for Clinical Practice

“…Additionally, research needs to determine whether the VMC guide and approach is appropriate for sub-groups of Australians, such as culturally and linguistically diverse groups, and Indigenous AYAs, who experience poorer cancer outcomes compared to the general population of AYAs, [ 50 ] and who have unique needs to ensure culturally safe healthcare [ 51 , 52 ]. In particular, Australian health professionals report gaps in their comfort and experience communicating around spiritual and end-of-life topics with Indigenous Australian children receiving palliative and end-of-life care [ 53 ]. Further intersectional lenses could also be applied to research aimed at improving the acceptability of the Australian VMC for other minority groups with unique needs such as LGBTQI+ [ 54 ] and culturally and linguistically diverse communities [ 55 ].…”