MA22.07 A Culturally Safe Advocacy Model of Care for Inuit Cancer Patients and Their Families

Abstract

The Ottawa Hospital is the tertiary care center for Inuit living in the Baffin Island region of Nunavut, in Canada’s far North. Inuit – once relatively cancer free – now have among the highest lung cancer rates in the world (Young et al., 2016). Approximately 30% of Inuit diagnosed with cancer between 2000 and 2010 did not access any cancer services (Asmis, 2016), for which they must travel thousands of kilometers where they are displaced from family, community and culture. Colonization has had a detrimental impact on the social determinants of health for Inuit in Nunavut and has created a lack of trust in government institutions. This context creates an advocacy need at the individual and systems level to address access and equity issues, with the goal of advancing positive health outcomes. The Champlain Indigenous Cancer Program (CICP) team has developed a patient-centered, culturally appropriate, land-based approach to support Inuit patients using the principles of the “Supportive Care Framework” (Fitch, 1994) as a guiding ideology. Recognizing the social and economic inequities (Inuit Tapiriit Kanatami, 2019), the Nurse Navigator developed an unconventional approach to connect with Inuit patients. She prioritizes developing therapeutic, trusting relationships with patients and families based on the observation that Inuit patients often feel most comfortable outside the confines of a hospital office. Developing these relationships on the land has become a cornerstone of her work. The approach that the CICP has implemented has achieved far-reaching success. Between the first six months and latest six months of tracking (through 2017-2018) there has been a 400%+ increase in patient encounters with the Nurse Navigator role. Clinicians report an increased awareness and understanding of the unique context of Inuit patients and families, resulting in increased numbers of referrals to CICP. Within the Inuit community, there is a recognition and appreciation of the Inuit-specific approach, leading to an increase in self-referrals. The CICP is continuing to actively pursue tracking and reporting initiatives to demonstrate a shift in access to cancer care and the long-term outcomes for Inuit patients and families. The program is also continuing to increase access to cultural awareness education for staff to combat misunderstandings about Inuit. By sharing experiences and stories garnered through this work, the Nurse Navigator will help attendees to question and redefine the perception of the traditional role of a cancer nurse.