“支持非常出色”：原住民和托雷斯海峡岛民患者在两家高效癌症服务机构就诊的经历
"The support has been brilliant": experiences of Aboriginal and Torres Strait Islander patients attending two high performing cancer services.
作者信息
Taylor Emma V, Lyford Marilyn, Holloway Michele, Parsons Lorraine, Mason Toni, Sabesan Sabe, Thompson Sandra C
机构信息
Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia.
Aboriginal Health Unit, Mission, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
出版信息
BMC Health Serv Res. 2021 May 24;21(1):493. doi: 10.1186/s12913-021-06535-9.
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.
背景
通过提供以患者为中心、具有文化安全性的护理来改善原住民的健康状况，这对澳大利亚乃至国际的卫生部门而言都是一项至关重要的挑战。许多癌症医疗服务提供者和支持服务机构致力于提供高质量护理，但在为澳大利亚原住民提供可及的、具有文化安全性的癌症护理方面却面临困难。澳大利亚的两家癌症服务机构，一家位于城市，一家位于地区，被认为特别专注于为原住民癌症患者及其家庭提供具有文化安全性的癌症护理。本文探讨了原住民癌症患者及其家庭在癌症服务机构中的经历，并确定他们的护理体验与癌症服务机构改善护理的策略之间的匹配程度。
方法
这些服务机构是一项全国性研究的一部分，该研究旨在识别和评估针对原住民癌症患者及其家庭的创新服务。对少数选定的服务机构进行了案例研究。对受癌症影响的原住民和医院工作人员进行了深入访谈。通过患者体验的视角，对两家表现尤为突出的服务机构的访谈进行了分析。
结果
采访了8名受癌症影响的原住民和23名医院工作人员（包括原住民和非原住民）。参与本研究的大多数原住民癌症患者和家庭成员分享了三种经历：在癌症服务机构接受治疗时的积极体验；从确诊到抵达癌症中心期间的艰难时期；以及家庭支持的重要性，同时也认识到这给家庭和护理人员带来的负担。
结论
本文具有重要意义，因为它表明，通过采用文化适宜且以患者为中心的方法，让患者、家庭成员、原住民和非原住民工作人员都参与进来，原住民有可能在主流的三级医疗服务中获得积极的癌症护理体验。如果我们要改善原住民的健康状况，至关重要的是，更多的癌症服务机构和医院应效仿这两家服务机构的做法，持续不断地致力于加强其服务的文化安全性。
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