Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA 6530, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
Int J Environ Res Public Health. 2022 Jan 6;19(2):633. doi: 10.3390/ijerph19020633.
Improving cancer outcomes for Indigenous people by providing culturally safe, patient-centred care is a critical challenge for health services worldwide. This article explores how three Australian cancer services perform when compared to two national best practice guidelines: the National Aboriginal and Torres Strait Islander Cancer Framework (Cancer Framework) and the National Safety and Quality Health Service (NSQHS) User Guide for Aboriginal and Torres Strait Islander Health (User Guide). The services were identified through a nationwide project undertaken to identify cancer services providing treatment to Indigenous cancer patients. A small number of services which were identified as particularly focused on providing culturally safe cancer care participated in case studies. Interviews were conducted with 35 hospital staff (Indigenous and non-Indigenous) and 8 Indigenous people affected by cancer from the three services. The interviews were analysed and scored using a traffic light system according to the seven priorities of the Cancer Framework and the six actions of the NSQHS User Guide. While two services performed well against the User Guide, all three struggled with the upstream elements of the Cancer Framework, suggesting that the treatment-focused Optimal Care Pathway for Aboriginal and Torres Strait Islander People with Cancer (Cancer Pathway) may be a more appropriate framework for tertiary services. This article highlights the importance of a whole-of-organisation approach when addressing and embedding the six actions of the User Guide. Health services which have successfully implemented the User Guide are in a stronger position to implement the Cancer Framework and Cancer Pathway.
为原住民提供文化安全、以患者为中心的护理，以改善癌症治疗结果，是全球卫生服务面临的一项重大挑战。本文探讨了澳大利亚的三个癌症服务机构在与两个国家最佳实践指南的比较中表现如何：国家原住民和托雷斯海峡岛民癌症框架（癌症框架）和国家安全和质量卫生服务（NSQHS）原住民和托雷斯海峡岛民健康用户指南（用户指南）。这些服务是通过一项全国性项目确定的，该项目旨在确定为原住民癌症患者提供治疗的癌症服务。少数被确定为特别专注于提供文化安全癌症护理的服务机构参与了案例研究。对来自三个服务机构的 35 名医院工作人员（原住民和非原住民）和 8 名受癌症影响的原住民进行了访谈。根据癌症框架的七个优先事项和 NSQHS 用户指南的六个行动，使用红绿灯系统对访谈进行了分析和评分。虽然有两个服务在用户指南方面表现良好，但所有三个服务都在癌症框架的上游要素方面遇到困难，这表明针对原住民和托雷斯海峡岛民癌症患者的优化护理途径（癌症途径）可能更适合三级服务。本文强调了在解决和嵌入用户指南的六个行动时，采取全组织方法的重要性。成功实施用户指南的卫生服务机构更有能力实施癌症框架和癌症途径。
