“The support has been brilliant”: experiences of Aboriginal and Torres Strait Islander patients attending two high performing cancer services

Abstract

Background Improving health outcomes for Indigenous people by providing person-centred, culturally safe care is a crucial challenge for the health sector, both in Australia and internationally. Many cancer providers and support services are committed to providing high quality care, yet struggle with providing accessible, culturally safe cancer care to Indigenous Australians. Two Australian cancer services, one urban and one regional, were identified as particularly focused on providing culturally safe cancer care for Indigenous cancer patients and their families. The article explores the experiences of Indigenous cancer patients and their families within the cancer services and ascertains how their experiences of care matches with the cancer services’ strategies to improve care. Methods Services were identified as part of a national study designed to identify and assess innovative services for Indigenous cancer patients and their families. Case studies were conducted with a small number of identified services. In-depth interviews were conducted with Indigenous people affected by cancer and hospital staff. The interviews from two services, which stood out as particularly high performing, were analysed through the lens of the patient experience. Results Eight Indigenous people affected by cancer and 23 hospital staff (Indigenous and non-Indigenous) were interviewed. Three experiences were shared by the majority of Indigenous cancer patients and family members interviewed in this study: a positive experience while receiving treatment at the cancer service; a challenging time between receiving diagnosis and reaching the cancer centre; and the importance of family support, while acknowledging the burden on family and carers. Conclusions This article is significant because it demonstrates that with a culturally appropriate and person-centred approach, involving patients, family members, Indigenous and non-Indigenous staff, it is possible for Indigenous people to have positive experiences of cancer care in mainstream, tertiary health services. If we are to improve health outcomes for Indigenous people it is vital more cancer services and hospitals follow the lead of these two services and make a sustained and ongoing commitment to strengthening the cultural safety of their service.

Putting Policy into Practice: How Three Cancer Services Perform against Indigenous Health and Cancer Frameworks

“…The efforts of Services A and C to ensure that Indigenous people receive best practice care, and Indigenous people’s perceptions of that care, have been described previously [ 22 ]. This article concluded that positive patient outcomes can be achieved when Indigenous staff are actively involved in the care of Indigenous people, emphasising the importance of ILOs in a navigator role supporting Indigenous people throughout their cancer journey and the provision of more holistic support.…”

“…Finally, centres which reported promising practices were identified, with four services agreeing to participate in more detailed study around their specific practice and innovation. Two of the services have been previously reported, with findings on Indigenous workforce policies and experiences of Indigenous cancer patients and their families [ 21 , 22 ]. One service is still undergoing data collection and analysis and therefore was not able to be included.…”

“…This analysis was also informed by the seven steps of the Cancer Pathway (all of which fall within the Cancer Framework), but due to the complete overlap with the Cancer Framework, the Cancer Pathway was not used for categorising the data. Based on our previous findings about the strong and positive influence of the tertiary health services on two of the cancer services studied [ 21 , 22 ], the data were also analysed and grouped using the six actions of the NSQHS User Guide. The overlap and inter-relation between these three national best practice guidelines are represented graphically in Figure 1 .…”

Cancer Survivors in Saint Lucia Deeply Value Social Support: Considerations for Cancer Control in Under-Resourced Communities

“…We have knowledge of cancer care experience from pacific islanders [ 7 ] and other populations from small islands and under-resourced populations [ 8 , 9 , 10 ]. Survivors from these populations have expressed financial barriers to care, difficulties navigating the health system, and travelling long distances for care due to geographic isolation.…”

“…These survivors rely heavily on assistance and encouragement from family, and members from the community and faith-based organizations as a means of psycho-social support. Patient navigation programs are also highly valued by these survivors, and have been used to improve equity with counterparts from high-resource settings [ 6 , 7 ].…”