Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
REVIEW

Indigenous women’s expectations of clinical care during treatment for a gynaecological cancer: rural and remote differences in expectations

Eileen M. Willis A D , Judith Dwyer A , Kei Owada B , Leah Couzner A , Debra King C and Jo Wainer B

A School of Medicine, Flinders University, Adelaide, SA 2001, Australia.

B Eastern Health Clinical School, Monash University, VIC 3128, Australia.

C National Institute of Labour Studies, Flinders University, Adelaide, SA 2001, Australia.

D Corresponding author. Email: eileen.willis@flinders.edu.au

Australian Health Review 35(1) 99-103 http://dx.doi.org/10.1071/AH09800
Submitted: 28 June 2009  Accepted: 18 May 2010   Published: 25 February 2011

Abstract

Objectives. To report on differences in Indigenous women’s expectations of clinical care during treatment for a gynaecological cancer in rural and remote regions.

Design. Qualitative interviews were conducted in New South Wales, Victoria, South Australia and the Northern Territory in 2008 with 37 clinicians working in gynaecological cancer and 24 women with a gynaecological cancer. Three of the participants were Indigenous women living in large rural towns (others were non-Indigenous), whereas six of the 37 clinicians interviewed worked closely with Indigenous women in remote settings. Indigenous women were contacted through an Indigenous researcher. Interviews were analysed for emerging themes, then compared with each other and with the research literature for similarities and differences.

Results. There is considerable variation between clinician observations of the expectations of Indigenous women in remote regions, and the views of Aboriginal women in rural settings.

Conclusion. Indigenous women in rural settings have specific views about quality medical care. These include expectations of timely and culturally appropriate care, and strong ties to family and kin, but do not accord with other research findings that suggest Aboriginal women must receive care from same sex clinicians or that care is often delayed. The paper alerts practitioners to the fact that culturally appropriate care will vary from group to group, particularly between remote, rural and urban populations.

What is known about this topic? Cross-cultural health care research recognises that health professionals need to be attuned to the cultural preferences and needs of Indigenous patients.

What does this paper add? This study warns against assuming all Indigenous people are the same, or have the same expectations about quality health care. It notes that little guidance is offered to clinicians on how Indigenous responses to Western bio-medical care might differ across the country. The paper identifies some differences and proposes strategies for understanding local preferences.

What are the implications for practitioners? This paper alerts practitioners to the fact that although Indigenous patients share many cultural similarities, clinicians should not make assumptions about what is appropriate culturally safe care. Culturally appropriate care will vary from group to group, particularly between remote, rural and urban populations in terms of timely access, culturally appropriate care and educational materials, the role of family and Aboriginal Health Workers, and sex preferences.


References

[1]  Reath J. Preventing cervical cancer: strategies for a remote Aboriginal community. ATSL Health Worker J 1999; 23 7–10. open url image1

[2]  O’Brien ED, Bailie RS, Jelfs PL. Cervical cancer mortality in Australia: contrasting risk by Aboriginality, age and rurality. Int Epidemiol Assoc 2000; 29 813–6.
Cervical cancer mortality in Australia: contrasting risk by Aboriginality, age and rurality.CrossRef | 1:STN:280:DC%2BD3M%2FltlWiug%3D%3D&md5=125019fd21ea9b370ea976656ee9b906CAS | open url image1

[3]  Condon JR, Armstrong BK, Barnes T, Zhao Y. Cancer incidence and survival for Aboriginal Australians in the Northern Territory. Aust N Z Public Health 2005; 29 123–8.
Cancer incidence and survival for Aboriginal Australians in the Northern Territory.CrossRef | open url image1

[4]  McGrath P, Holewa H, Kail-Buckley S. They should come out here: research findings on lack of local palliative care services for Australian Aboriginal people. Am J Hospice and Palliat Medicine 2007; 24 105–13.
They should come out here: research findings on lack of local palliative care services for Australian Aboriginal people.CrossRef | open url image1

[5]  Olver IN, Selva-Nayagam S, Fried O, Davy M, Barton M, et al Some of us know some things and some of us know others – reducing the impact of cancer of Aboriginal and Torres Strait Islander communities. Can Forum 2005; 29 12–3. open url image1

[6]  Prior D. Don’t mention the ‘C’ word: Aboriginal women’s views of cancer. ATSI Health Worker Journal 2005; 29 7–10. open url image1

[7]  McGrath P, Patton MA. Relocation for specialist treatment for Aboriginal people: escort issues. J Rural and Tropical Health 2006; 5 16–26. open url image1

[8]  Wray N, Markovic M, Manderson L. Discourses of normality and difference: responses to diagnosis and treatment of gynaecological cancer of Australian women. Soc Sci Med 2007; 64 2260–71.
Discourses of normality and difference: responses to diagnosis and treatment of gynaecological cancer of Australian women.CrossRef | 17399878PubMed | open url image1

[9]  King D, Martin B, Dwyer J, Healy J, Owada K, Smith L, Sun L, Van Deth A, Wainer J, Willis E. A Review of the Gynaecological Cancer Workforce. Cancer Australia and the National Institute of Labour Studies; 2008.

[10]  Laurvick CL, Semmens JB, Holman CD, Leung YC. Ovarian cancer in Western Australian (1982–98): incidence, mortality and survival. Aust N Z Public Health 2003; 27 588–95.
Ovarian cancer in Western Australian (1982–98): incidence, mortality and survival.CrossRef | open url image1

[11]  McGrath CL. Issues influencing the provision of palliative care services to remote Aboriginal communities in the Northern Territory. Aust J Rural Health 2000; 8 47–51.
Issues influencing the provision of palliative care services to remote Aboriginal communities in the Northern Territory.CrossRef | 1:STN:280:DC%2BD3MzgvVSrsw%3D%3D&md5=64c0758555bbb768ac224c5f1b6cc096CAS | 11040580PubMed | open url image1

[12]  Mak D, Straton J. Effects and sustainability of a cervical cancer screening program in remote Aboriginal Australia. Aust N Z Public Health 1997; 21 67–70.
Effects and sustainability of a cervical cancer screening program in remote Aboriginal Australia.CrossRef | 1:STN:280:DyaK2s3os1Grtw%3D%3D&md5=71c244693ce9a73cc0429b2af397b7ddCAS | open url image1

[13]  Hunt JM, Lawton GG, Straton J. Pap smear screening at an urban Aboriginal health service: report of a practice audit and an evaluation of recruitment strategies Aust N Z Public Health 1998; 22 720–5.
Pap smear screening at an urban Aboriginal health service: report of a practice audit and an evaluation of recruitment strategiesCrossRef | 1:STN:280:DyaK1M%2FmsFyiuw%3D%3D&md5=ba2b0102ada10933e6296d7a98ca3767CAS | open url image1

[14]  Jackson LR, Ward JE. An analysis of resources for Aboriginal women in NSW about cervical screening. Aust N Z Public Health 2000; 24 327–30.
An analysis of resources for Aboriginal women in NSW about cervical screening.CrossRef | 1:STN:280:DC%2BD3cvisFygsA%3D%3D&md5=4c3217965c8e0afa87fb78e9c006625dCAS | open url image1

[15]  Thurecht K. Aboriginal women talk about pap smear screening for cervical cancer in south-east Queensland. ATSI Health Worker J 2000; 24 21–3. open url image1

[16]  Newman J, Ackiln F, Trindall A, Arbon V, Brock K, Bermingham M, Thompson C. Story-telling: Australian Aboriginal women’s means of health promotion. ATSI Health Worker J 1999; 23 18–22. open url image1

[17]  Toussaint S, Mak D, Straton J. Marnin business: anthropological interpretations of cervical screening among Australian Aboriginal women. Aust J Prim Health Interchange 1998; 4 43–52.
Marnin business: anthropological interpretations of cervical screening among Australian Aboriginal women.CrossRef | open url image1

[18]  Maher P. A review of traditional Aboriginal health beliefs. Aust J Rural Health 1999; 7 229–36.
A review of traditional Aboriginal health beliefs.CrossRef | 1:STN:280:DC%2BD3c7pslSltg%3D%3D&md5=0b7236e5331045c2f10b49483466c086CAS | 10732513PubMed | open url image1

[19]  Morgan DL, Slade MD. Aboriginal philosophy and its impact on health care. Aust N Z Public Health 1997; 21 597–601.
Aboriginal philosophy and its impact on health care.CrossRef | 1:STN:280:DyaK1c7jtFSnsw%3D%3D&md5=faf1a9d1543493369fbfa476df80b074CAS | open url image1

[20]  Hunt JM, Geia LK. Can we better meet the health care needs of Aboriginal and Torres Strait Islander women? Med J Aust 2002; 177 533–4.
| 12428998PubMed | open url image1

[21]  Fredericks B. Which way? Educating for nursing Aboriginal and Torres Strait Islander peoples. Contemp Nurse 2006; 23 87–99.
Which way? Educating for nursing Aboriginal and Torres Strait Islander peoples.CrossRef | 17083322PubMed | open url image1

[22]  Crouch M, McKenzie H. The logic of small samples in qualitative research Soc Sci Inf 2006; 45 483–99.
The logic of small samples in qualitative researchCrossRef | open url image1

[23]  Kirk MK. First report on cervical cancer in Queensland’s Aboriginal communities. ATSI Health Worker J 1998; 22 3–4. open url image1



Export Citation