Abstract
Travel logistics impede Aboriginal patients’ uptake of cancer treatments and is one reason for the poorer outcomes of Aboriginal people with cancer. This research examined benefits of a newly established rurally based radiotherapy unit in southwest Western Australia (WA), and included exploring the experience of Aboriginal patients and possible reasons for Aboriginal people’s underrepresentation in treatment. Semi-structured in-depth interviews with 21 service providers involved in the treatment and care of people with cancer, and 3 Aboriginal patients with cancer who undertook radiotherapy at the Service were undertaken. Data were subject to thematic analysis involving immersion in the data for familiarization, inductive coding, investigator discussion and refining of emerging themes and triangulation of patient and provider interviews. Aboriginal cancer patients were positive about the treatment and support they had received, highlighting the often complex challenges faced by rural Aboriginal cancer patients in accessing and maintaining treatment. Service providers offered suggestions for small numbers presenting to the Service, including late presentation, potential perceptions of cultural insensitivity on the part of service providers, out-of-pocket costs and under-ascertainment of Aboriginal status. The Service has put in place practices and initiatives to support patient health and wellbeing, including making the facility more welcoming towards Aboriginal people and ensuring culturally appropriate care.
Highlights
Despite progress in cancer diagnostic and treatment services in Australia, cancer patients living in regional and remote areas still have poorer outcomes than their urban counterparts [1,2,3,4]
One study which examined Aboriginal participation in radiotherapy treatment showed compliance levels on a par with non-Aboriginal patients [28]. This suggests that when Aboriginal patients do engage in radiotherapy, their levels of satisfaction with the treatment are comparable with those of non-Aboriginal patients and that it is the pre-treatment phase of care that is the most difficult and presents most challenges
Their stories serve to highlight the often complex challenges faced by rural Aboriginal cancer patients in accessing and maintaining treatment
Summary
Despite progress in cancer diagnostic and treatment services in Australia, cancer patients living in regional and remote areas still have poorer outcomes than their urban counterparts [1,2,3,4]. Some of the factors leading to disparities in outcomes include more advanced cancer at diagnosis and greater challenges in access to and uptake of treatment [5]. Radiotherapy is an important component of treatment options, shown to contribute to improving health outcomes and quality of care in people with cancer [5]. The significant logistical and financial challenges this presents for rural patients [5,7,8,9,10] can be. Public Health 2018, 15, 337; doi:10.3390/ijerph15020337 www.mdpi.com/journal/ijerph
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