'Nowhere to room … nobody told them': logistical and cultural impediments to Aboriginal peoples' participation in cancer treatment

Abstract

To improve cancer outcomes for Aboriginal people, logistical, infrastructure and cultural safety issues must be addressed. One way of ensuring this could be by dedicated support to better coordinate cancer diagnostic and treatment services with primary healthcare services.

“I can’t do this, it’s too much”: building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers

“…These findings support previous research (Shahid, Finn et al 2011) Socio-economic status has been widely documented as immediately and significantly associated with health care access and outcomes (Wilkinson 1999) and as fundamental to understanding social inclusion. A related issue to consider here is socio-economic security which can determine access to and use of a range of resources that provide protection from poverty and other forms of material disadvantage (Ward, Meyer et al 2011).…”

“…As these issues have been well covered in the literature (Shahid, Finn et al 2011), we will focus in this paper on the three process factors -socioeconomic status, knowing the system and trust -that offered a conceptual link to understanding how these key issues conspired to complicate the achievement of social inclusion for Aboriginal people in their cancer care services.…”

“…Engagement in cancer care for Aboriginal Australians is lower at all levels including screening, early presentation at diagnosis, continuity of care, compliance with treatment and five-year survival rates (Cunningham, Rumbold et al 2008). For example, Aboriginal Australians are less likely to be diagnosed with cancer, incidence rates of some cancers are significantly higher than for non-Aboriginal Australians (incidence of cervical cancer is three times higher for Aboriginal Australians and cancers of unknown primary site and of the lung are 2.0 and 1.6 times higher than non-Aboriginal Australians); Aboriginal women are less likely to be screened for breast cancer than non-Aboriginal women (36% vs 55%); and, Aboriginal Australians aged 35-64 years have higher cancer mortality rates than In recent years a significant body of work has emerged in Australia, particularly from Western Australia, examining the experience of Aboriginal people with cancer, including beliefs about cancer, communication issues, bush medicine and structural and practical concerns in relation to cancer treatment Shahid, Bleam et al 2010;Shahid, Finn et al 2011). This work critiqued current health systems for persisting with a focus on clinical competence of health professionals at the expense of psychosocial characteristics that engender trust in the patient ).…”

“Receptivity”: An Important Factor Affecting Supportive Care Provision

“…The notion of access has some relevance to this challenge. Although predominantly focused on clinical treatment and screening services (Baker & Schwartz, 2005;Couture, Nguyen, Alvarado, Velasquez, & Zunzunegui, 2008;Facione, 1999;Facione & Facione, 1997;Greiner, Engelman, Hall, & Ellerbeck, 2004;Haran, 2003;Jones et al, 2008;Mele, Archer, & Pusch, 2005;Reid & Porter, 2011;Shahid, Finn, Bessarab, & Thompson, 2011;Shepherd, Goldstein, Olver, & Parle, 2008;Wolff & Ellis, 2009), the research on access is predicated on the democratic principle that all should have equal access to service provision. However it is only recently that research focused on access issues has included the psychosocial aspects of care (Arber, Faithful, Plaskota, Lucas, & de Vries, 2010;O'Brien, Harris, King, & O'Brien, 2008;Whittier, Scharlach, & Dal Santo, 2005).…”

Working bi-culturally within a palliative care research context: the development of the Te Ārai Palliative Care and End of Life Research Group

“…For example, McGrath's development of the 'living model' for conducting research with indigenous groups, emphasises the importance of capturing the unique circumstances of each health care service working with indigenous/aboriginal peoples (McGrath, 2006(McGrath, , 2010. Similarly, Shadid et al in their survey of Native-American experiences at end of life have stressed the importance of 'build[ing] rapport and develop[ing] a relationship' with the communities they are researching (Decourtney, Branch, & Morgan, 2010;Shahid, Bessarab, van Schaik, Aoun, & Thompson, 2013;Shahid, Finn, Bessarab, & Thompson, 2011).…”