A study by researchers from The University of Western Australia has found Aboriginal and Torres Strait Islander patients experiences of undergoing cancer treatment are improved when health services spend extra time building relationships with patients, engage in culturally respectful communication and involve Indigenous health care professionals and the patient’s family.
Cultural understanding in health care delivery has long been identified as a key element needed to improve Indigenous health outcomes, but has been lacking in many hospitals and health care services. Cancer treatment can be particularly challenging for Indigenous patients, who often experience poorer outcomes from cancer, so offering culturally safe care is essential.
The researchers undertook a national study to identify cancer care services that were high- performing for Indigenous patients. They explored the experiences of Indigenous cancer patients and their families at two cancer care services that appeared to be particularly high performing - a large privately administered public inner-city hospital and a large public regional hospital.
The researchers found key areas that helped achieve effective, culturally-safe care included spending extra time with Indigenous patients to build rapport, involving patients in the decision-making process, having Indigenous staff (including Indigenous Liaison Officers) highly involved with care, involving and supporting family, and using telehealth to improve communication with patients and family located in regional or remote areas.
Lead author of the study and research officer Emma Taylor from the Western Australian Centre for Rural Health (WACRH) at UWA said in the past, Indigenous people had often reported negative experiences in mainstream health services.
“However, if these two very different health services can provide care that Indigenous patients believe to be of a high standard and report a positive experience then other health services can follow their lead,” Ms Taylor said.
“We found that sustainable improvements in this area require a commitment from the whole health service, not just from one or two committed individuals.”
The researchers also found that many participants reported difficulties navigating the health system. In the study, patients described the time between first experiencing symptoms and reaching the services as confusing and stressful, attributed in part to medical delays, poor continuity of care and poor communication from health service providers.
“This suggests that both primary and tertiary health care providers can do more to prepare Indigenous patients for the experience of admission to a tertiary cancer treatment service, including providing information about where to go, what to bring and the likely length of relocation or admission for treatment,” Ms Taylor said.
“The whole health system needs to change to improve communication and referrals between primary health care and tertiary cancer services.”
WACRH Director Professor Sandra Thompson said it was hoped that the strategies captured in the study are adopted and widely used by health services and cancer services.
“We hope the study will help inform policies and programs to provide culturally safe, people-centric care for Indigenous patients and their families,” Professor Thompson said.
The study has been published in BMC Health Services Research.