Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services
Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services
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DOI：
10.1186/1472-6963-9-132
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发表时间：
2009-07-31
影响因子：
2.8
通讯作者：
Thompson, Sandra C.
中科院分区：
文献类型：
--
作者：
Shahid, Shaouli;Finn, Lizzie;Thompson, Sandra C.
背景资料：尽管总体发病率较低，但与非土著人口相比，土著澳大利亚人的癌症预后较差，表现为死亡率较高和5年存活率较低。较低的筛查参与率、较晚的癌症诊断、较差的护理连续性和较差的治疗依从性是导致这种不良结局的已知因素。然而，许多赤字仍然在理解的根本原因，建议进一步探索土著信仰和癌症的看法，以帮助了解他们的求医行为。这将有助于规划和提供更有效的干预措施，并为土著人口提供更好的服务。本研究探讨了西澳大利亚州（WA）土著人民的看法，信仰和理解cancer.Methods：共37个土著人从不同的地理区域内WA与癌症的直接或间接的经验，2006年3月至2007年9月之间进行了采访。访谈录音，逐字转录和编码独立的两名研究人员。NVivo7软件用于辅助数据管理和分析。社会建构主义框架为分析提供了理论基础。解释发生在研究小组与成员检查和参与的土著参考小组协助确保validity and reliability. Results：结果表明，误解，对死亡的恐惧，宿命论，羞耻，偏好传统的治疗，信仰，如癌症是传染性的和其他精神问题影响他们的决定周围访问服务。这些研究结果提供了重要的信息，为健康提供者参与癌症相关的服务delivery.Conclusion：这些基本的信念必须专门针对发展适当的教育，筛查和治疗方法，包括模式的护理和支持，促进更好地参与土著人民。需要发展更有利于文化的护理和支助模式，使保健专业人员考虑到土著和西方对健康的信念以及两者之间的关系，并使土著人民参与和包括在内。文化安全，消除系统障碍和技术/科学卓越对于确保土著人民利用医疗保健实现现代癌症治疗的好处都很重要。
Background: Despite a lower overall incidence, Aboriginal Australians experience poorer outcomes from cancer compared with the non-Aboriginal population as manifested by higher mortality and lower 5-year survival rates. Lower participation in screening, later diagnosis of cancer, poor continuity of care, and poorer compliance with treatment are known factors contributing to this poor outcome. Nevertheless, many deficits remain in understanding the underlying reasons, with the recommendation of further exploration of Aboriginal beliefs and perceptions of cancer to help understand their care-seeking behavior. This could assist with planning and delivery of more effective interventions and better services for the Aboriginal population. This research explored Western Australian (WA) Aboriginal peoples' perceptions, beliefs and understanding of cancer.Methods: A total of 37 Aboriginal people from various geographical areas within WA with a direct or indirect experience of cancer were interviewed between March 2006 and September 2007. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. A social constructionist framework provided a theoretical basis for analysis. Interpretation occurred within the research team with member checking and the involvement of an Aboriginal Reference Group assisting with ensuring validity and reliability.Results: Outcomes indicated that misunderstanding, fear of death, fatalism, shame, preference for traditional healing, beliefs such as cancer is contagious and other spiritual issues affected their decisions around accessing services. These findings provide important information for health providers who are involved in cancer-related service delivery.Conclusion: These underlying beliefs must be specifically addressed to develop appropriate educational, screening and treatment approaches including models of care and support that facilitate better engagement of Indigenous people. Models of care and support that are more culturally-friendly, where health professionals take account of both Indigenous and Western beliefs about health and the relationship between these, and which engage and include Indigenous people need to be developed. Cultural security, removing system barriers and technical/scientific excellence are all important to ensure Indigenous people utilise healthcare to realise the benefits of modern cancer treatments.