Chynoweth Jennifer, McCambridge Meaghan M, Zorbas Helen M, Elston Jacinta K, Thomas Robert J S, Glasson William J H, Coutts Joanna M, Daveson Barbara A, Whitfield Kathryn M
Cancer Australia, Surry Hills, NSW, Australia.
Monash University, Clayton, VIC, Australia.
JCO Glob Oncol. 2020 Feb;6:108-114. doi: 10.1200/JGO.19.00076.
To improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care.
An iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers.
The OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men's and women's business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway.
The development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.
通过制定并获得国家认可的首个针对特定人群的最佳护理路径（OCP），以改善原住民和托雷斯海峡岛民的癌症治疗效果，该路径旨在指导提供高质量、符合文化习惯且基于证据的癌症护理。
在两年时间内采用了迭代方法，来自不同文化、地理和部门背景的70多个组织和个人提供了意见。澳大利亚癌症协会审查了护理经验和证据基础，并与原住民卫生部门和社区、卫生专业人员及专业学院进行了全国性公众咨询。原住民和托雷斯海峡岛民卫生专家及消费者的领导作用对OCP的制定至关重要。
OCP获得了所有联邦、州和领地卫生部长的一致认可。OCP的关键要素包括关注医疗保健环境的文化适宜性；改善跨文化沟通；与当地社区建立关系；优化健康素养；认识男女事务；以及使用符合文化习惯的资源的必要性。OCP可作为卫生服务机构和卫生专业人员识别当前癌症服务差距并为护理路径各方面质量改进举措提供信息的工具。
OCP的制定确定了一些需要优先处理的领域。确保文化上安全且可及的卫生服务对于支持早期就诊和诊断至关重要。所有原住民和托雷斯海峡岛民，无论身处何地，都需要多学科治疗规划和以患者为中心的护理。卫生规划者和政府认识到变革的紧迫性，并已表示坚定致力于与澳大利亚原住民合作，以提高癌症护理的可及性、文化适宜性和质量。
