Self-reported health-related quality-of-life issues for Aboriginal and Torres Strait Islander patients with experience of cancer in Australia

Abstract

Previous literature suggests that there is urgency for improved communication and cultural competency in cancer care for Aboriginal and Torres Strait Islander patients in Australia, with a stronger focus on meeting patient needs and improving HRQL. This review has provided insight into HRQL issues for Aboriginal and Torres Strait Islander patients with cancer in Australia. Further work using patient-reported outcomes measures would provide greater insight into the impact of cancer and biomedical treatments on Aboriginal and Torres Strait Islander patients' HRQL.

Communicating cancer and its treatment to Australian Aboriginal and Torres Strait Islander patients with cancer: a qualitative study

“…What healthcare workers told us about patient consultations reflected ideal communication practices that should be employed broadly. Conversations should be centred on patients and what they want to know, with regular checking on what they understand and paraphrasing to avoid medical jargon [3,12]. Our study highlights specific illustrations that have been used to successfully explain cancer and its treatment by experienced healthcare workers.…”

“…A major finding is the need to consider the cultural context of a cancer consultation. The strong connection with country, family and community which often forms identity can be a cause of great discomfort and/or conflict when Aboriginal and Torres Strait Islander patients are separated from them for medical care [3,9]. However, awareness of this can assist in finding ways to maintain connection, within the constraints of treatment protocols.…”

“…The cultural concept of cancer itself was raised as having a bearing on communication. Not only can views such as the causation of cancer being a punishment or a result of magic and a cause of shame make the offer of surgery, radiotherapy and chemotherapy seem misplaced, but an ingrained view that equates cancer to a death sentence must be confronted appropriately to promote informed treatment choices [3,5]. To understand beliefs about cancer from the perspective of Aboriginal and Torres Strait Islander people, other studies have suggested using photovoice and yarning circles to capture images and stories that represent cancer beliefs [5,10,11].…”

“…Barriers to Aboriginal and Torres Strait Islander people engaging in cancer treatment vary, but may include perceptions of cancer as a 'death sentence', as contagious, as due to 'payback' or sorcery or inappropriate behaviour and/or as shameful [3].…”

Accessibility of Cancer Treatment Services for Indigenous Australians in the Northern Territory: Perspectives of Patients and Care Providers

“…The following factors have been identi ed over the past two decades as affecting Indigenous Australians access to CTS: di culties navigating the health system; low health literacy; logistical impediments; remote living location; gaps in care between primary and tertiary health services; [14][15][16] a historically-based wariness of government organisations; 17 fatalistic perceptions of cancer; 3,18 differing health paradigms; 19 cultural diversity; and language differences. 15,20 The extent to which CTS have adapted to overcome these and other barriers to improve access for Indigenous people is unclear and further research is needed to better understand and respond to issues of accessibility to CTS, particularly in more remote locations where people are likely to face multiple challenges.…”