Communication, Collaboration and Care Coordination: The Three-Point Guide to Cancer Care Provision for Aboriginal and Torres Strait Islander Australians

Abstract

The coordination of cancer care for Indigenous Australians has been recognised as critical in addressing Indigenous patients' needs, for example in relation to navigating the health system, providing essential information and communication and ensuring cultural safety [1]. However, challenges to the provision of coordinated care to meet Indigenous cancer patients needs include: lack of communication between services; delays in receiving timely hospital information; language and cultural barriers; distance to treatment; as well as providing cultural support and having hospital facilities that accommodate extended families [1-4]. These challenges often stem from health system design, structures and limitations [1]. Quality cancer care for Indigenous Australians as defined by the National Aboriginal and Torres Strait Islander Cancer Framework is evidence-based, personcentred (incorporating the family and cultural roles) [5, 6], timely, equitable and delivered as close to home as safely as possible [5, 7, 8]. It is also multidisciplinary, integrated across the health sector (primary, secondary and tertiary), embedded within the community [5, 9] and also involves strong involvement and leadership from the Indigenous community [5, 10]. Pathways for accessing cancer care for Indigenous Australians can be more complex than for other Australians, with additional challenges for them relating to culture, language, and lack of familiarity with navigating services and institutions in the wider health care system [11]. Besides coming to terms with a cancer diagnosis,

Systematic review of Aboriginal and Torres Strait Islander peoples’ experiences and supportive care needs associated with cancer

“…The thematic analysis identified several concerns influencing the experiences of cancer for Aboriginal and Torres Strait Islander peoples relating to cultural insensitivity, including lack of culturally appropriate care services, language barriers, poor understanding of Aboriginal and Torres Strait Islander peoples’ perspectives about cancer and the importance of family and community involvement [ 22 , 27 , 32 , 40 , 46 , 61 – 64 ]. The majority of the included studies reported that care providers lacked an understanding of Aboriginal and Torres Strait Islander culture and how this shaped treatment decisions [ 42 , 46 , 65 ]. Included studies highlighted value differences between Aboriginal and Torres Strait Islander cultures and Western cultures [ 26 , 27 , 56 ].…”

Support along the cancer pathway for Aboriginal People

“…• Some studies found that limitations in the knowledge of health professionals about cancer and the importance of cancer screening, especially in rural and remote primary healthcare settings, have affected Aboriginal and Torres Strait Islander Australians' participation in cancer screening 6,8,9,25 • Fragmented care in primary, tertiary and specialist care settings, including a lack of coordination between health professionals in these three settings, has a negative impact on the care quality, continuity of cancer care and, ultimately, the cancer outcomes for Aboriginal and Torres Strait Islander peoples 5,26,27 • Several health system factors affect Indigenous patients' acceptance of healthcare facilities and influence clients' choices and decision-making. Some of these include underrepresentation and high turnover of Aboriginal and Torres Strait Islander health professionals 28 ; health professionals dealing with multiple clinical priorities and tasks concurrently due to a shortage of facilities and staff, which affects the quality of service delivery 29 ; a shortage of female practitioners 8,20,29 ; lack of flexibility within the system 29 ; clinical staff turnover 29 ; lack of well-maintained and efficient clinical information systems for notifying, recalling and reminding women (especially sending letters) of their screening due date or appointments 29 • Health professionals' lack of education and knowledge about Indigenous cultural beliefs, rituals and needs in general is a barrier to cancer screening and care.…”

Communication, Collaboration and Care Coordination: The Three-Point Guide to Cancer Care Provision for Aboriginal and Torres Strait Islander Australians

“…de Witt et al (2020) [ 1 ] was published with a typesetting error in the Results section. The original text states:…”