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1.
Article in English | MEDLINE | ID: mdl-28513056

ABSTRACT

Indigenous patient navigator (IPN) programmes show promise in addressing barriers to cancer care and facilitation of patient self-efficacy. The purpose of this paper is to describe and reflect upon the experience of training an IPN and implementation of the intervention in the Australian context with Indigenous cancer patients. Randomised clinical trial might provide the best available evaluation measure of an intervention but caution should be taken in the implementation process. Socio-cultural aspects and training can affect the conduct of this type of intervention. We report here five issues needing consideration prior to implementing such intervention. Specifically: (1) recognition of the collective bonds within Indigenous community and understanding by IPN of the degree of personal assistance perceived as not intrusive by the patient; (2) conduct ongoing evaluation of the different role of an IPN involved in this intervention care provider vs. researcher. (3) meaningful engagement develops from a trusting/collaborative relationship between research team and study site staff which may not occur in the study time frame; (4) existing skills as well as training provided may not translate in the IPN understanding and aligning with the study objectives/research values; (5) recruitment of participants requires innovative and highly flexible strategies to be successful.


Subject(s)
Native Hawaiian or Other Pacific Islander , Neoplasms , Patient Navigation , Cultural Competency , Female , Humans , Interpersonal Relations , Male , Middle Aged , Needs Assessment , Pilot Projects , Program Development , Program Evaluation , Queensland , Research , Role , Self Efficacy
2.
Support Care Cancer ; 25(5): 1597-1605, 2017 05.
Article in English | MEDLINE | ID: mdl-28078479

ABSTRACT

PURPOSE: The purpose of this study was to explore Indigenous Australian cancer survivors' perspectives of follow-up cancer care and management.. METHODS: This is a qualitative study employing individual interviews with 21 Indigenous cancer survivors (13 females, 8 males) recruited from a rural primary health service and large tertiary hospital in Brisbane, Queensland. Yarning methods were used to conduct semi-structured interviews. Yarning is a culturally appropriate, informal conversational process emphasising the importance of storytelling. RESULTS: Findings describe a range of ways in which follow-up cancer care is experienced with four major categories elucidated, namely: links to tertiary health services, links to primary health services, communication between tertiary and primary health services, and lost in transition. Both positive and negative experiences were described; however, the importance of timely and informative discharge information, continuity of care, good communication between tertiary and primary health services, and strong therapeutic relationships were salient issues raised by participants. CONCLUSIONS: These findings highlight the importance of establishing strong therapeutic relationships between patients and tertiary and primary health professionals. Also important for survivorship is provision of discharge summaries or care plans at discharge for survivors and general practitioners as well as access to a range of allied health services. Alternative means for follow-up could be investigated for regional and rural survivors to facilitate convenient and cost-effective follow-up care. Finally, provision of responsive and flexible follow-up care to cater for the diverse range of needs and preferences of cancer survivors is required. A patient navigator available across the cancer continuum could go some way to addressing this.


Subject(s)
Neoplasms/ethnology , Adolescent , Adult , Aftercare , Aged , Female , Follow-Up Studies , Health Services, Indigenous , Humans , Male , Middle Aged , Native Hawaiian or Other Pacific Islander , Neoplasms/mortality , Qualitative Research , Survivors , Young Adult
3.
Eur J Cancer Care (Engl) ; 25(2): 242-53, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26918689

ABSTRACT

Little is known about the supportive care needs (SCN) of Australian Indigenous cancer patients. This cross-sectional study investigated the association between comorbidity and SCN among newly diagnosed Indigenous cancer patients in Queensland. Comorbidity was ascertained from medical chart review using the Charlson Comorbidity Index (CCI) and SCN were measured using the Supportive Care Needs Assessment Tool for Indigenous Peoples (SCNAT-IP). Of 183 participants, 76 (42%) had no comorbidity (CCI = 0), 60 (33%) had had a CCI score of 1 and 47 (26%) had a CCI of two or more, with the most common condition being diabetes (30%). The most common moderate-high unmet need items varied between comorbidity groups, although all patients most frequently reported moderate-high unmet need in the Physical and Psychological and the Practical and Cultural needs domains. Patients with the greatest comorbidity (CCI ≥ 2) had significantly more reduced odds of practical and cultural needs than patients without comorbidity (OR 0.28, 95% CI 0.11-0.75). This appeared to be partially explained by time since diagnosis, age, whether they were receiving current treatment and residential remoteness. Patients' experience of chronic disease, hospitals and the healthcare system may better prepare them for the practical and cultural aspects of their cancer journey.


Subject(s)
Activities of Daily Living , Communication , Health Services Needs and Demand , Native Hawaiian or Other Pacific Islander , Neoplasms/therapy , Patient Education as Topic , Social Support , Adult , Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/therapy , Comorbidity , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Female , Humans , Logistic Models , Male , Middle Aged , Needs Assessment , Neoplasms/epidemiology , Queensland , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/therapy
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