Implementing Optimal Care Pathways for Aboriginal and Torres Strait Islander People With Cancer: A Survey of Rural Health Professionals’ Self-Rated Learning Needs

Abstract

In 2018, the Optimal Care Pathway (OCP) for Aboriginal and Torres Strait Islander people with cancer was developed in Australia to improve the cancer care experiences and outcomes of Aboriginal and Torres Strait Islander people. Methods:Our study examined health professionals' learning needs to meet the clinical practice requirements of the new OCP. An electronic questionnaire was distributed to 120 health professionals providing oncology care in two rural areas in Victoria, Australia. Questions included demographics, practice, cancer OCPs and implementation recommendations. Descriptive, chi-square and thematic analyses were undertaken.Results: Fifty-two health professionals from medicine (21%), nursing (37%) and allied health (37%) responded. All OCP sub-categories were selected, with a mean of 23 sub-categories identified as areas requiring additional learning. Aboriginal and Torres Strait Islander Perspectives, Treatment, and End of Life were the categories of higher interest. Care After Initial Treatment and Recovery was the category of lower interest. For respondents without cultural training, sub-categories involving practical tasks were of significant interest. Cultural education, connecting with Aboriginal and Torres Strait Islander services, putting learning into practice and respect emerged as themes. Conclusion:Strategies to address gaps included cultural safety training, person and family centred practice, and partnerships and connections with Aboriginal and Torres Strait Islander people and organisations across primary and tertiary sectors.

Barriers and facilitators to adherence to Optimal Care Pathways for diagnosis and treatment of cancer for Aboriginal and Torres Strait Islander people

“…The importance of the familiarity and continuity of primary care, and strong therapeutic relationships was also noted in the review by Meiklejohn et al (2017) of perspectives of Aboriginal and Torres Strait Islander cancer survivors. A survey of Victorian health professionals conducted by Ristevski et al (2022) also confirmed that Aboriginal primary health services were appropriate locations for support outside of hospital. Systems barriers were most apparent around the delay in access to colonoscopy and financial access to surgical services.…”

Indigenous Australians’ Experiences of Cancer Care: A Narrative Literature Review

“…Delivering cultural safety training to hospitals or community services staff could be essential to improving the cultural safety of Indigenous people with cancer. A recent study found that around half of the healthcare professionals had attended cultural safety training to treat Indigenous people to better implement the optimal care of cancer pathways in primary healthcare [ 15 ]. Even a single workshop improved healthcare professionals’ confidence concerning cultural differences [ 46 ] and may improve healthcare professionals’ understanding of maintaining the privacy of cancer care [ 29 ].…”

“…Research focusing on healthcare professionals has also highlighted barriers to cancer outcomes for Indigenous peoples, including interactions between patients and healthcare professionals [ 5 , 6 ] and cultural sensitivity among healthcare providers [ 15 ]. A study of Indigenous cancer care providers highlighted essential cancer care components: culturally competent and responsive care; providing psychological support; ascertaining and responding to patient needs; delivery of practical assistance; and advocating for Indigenous health [ 16 ].…”