Abstract
BackgroundIn Saskatchewan, Canada, Indigenous cancer care services at the municipal, provincial, and federal levels are intended to improve quality care but can result in a complex, fragmented, and multi-jurisdictional health care system. A multi-phase needs assessment project was initiated to document Indigenous cancer care needs. Guided by Indigenous patient partners, clinicians, academics, and policy makers, the present study reflects a needs assessment of Indigenous cancer supports from the perspectives of cancer care service providers.MethodsQualitative data were collected through three focus groups with 20 service providers for cancer patients and their families at three Saskatchewan cities. Participants included chemotherapy and radiation nurses, social workers, a patient navigator, dieticians, and practicum students. A semi-structured interview guide was used to conduct the sessions to allow for freedom of responses. Data were recorded, transcribed verbatim, and analyzed using thematic analysis.ResultsService providers’ perspectives were categorized into five themes: 1) addressing travel-related issues, 2) logistical challenges, 3) improvements to Indigenous-specific health care supports, 4) cultural sensitivity in health care, and 5) consistency in care. Supports provided differed for the two Indigenous groups, First Nations and Métis. Service providers made recommendations regarding how needs could be met. They saw language translation providers and Elder supports as important. Recommendations for improving travel were for medical taxis to include breaks so that passengers may alleviate any uncomfortable side effects of their cancer treatment. Further, Indigenous-specific accommodations were recommended for those requiring medical travel. These recommendations aligned with supports that are available in four other Canadian provinces.ConclusionsThese results identified gaps in supports and outlined recommendations to address barriers to cancer care from the perspectives of service providers. These recommendations may inform evidence-based health system interventions for Indigenous cancer patients and ultimately aim to improve cancer care services, quality of life, and health outcomes of Indigenous patients throughout their cancer journey.
Highlights
In Saskatchewan, Canada, Indigenous cancer care services at the municipal, provincial, and federal levels are intended to improve quality care but can result in a complex, fragmented, and multi-jurisdictional health care system
Criteria includes ensuring that researchers were active in the research process, that balance between analytical narratives and illustrative extracts are provided, and that data were interpreted rather than described. Service providers shared their perceptions of barriers to cancer care for Indigenous people in Saskatchewan and discussed support needs that correspond to the barriers
Support needs in light of these challenges are summarized in the following subthemes: properly resourced medical taxis, Indigenousspecific accommodations, and expansion of formal and informal supports to northern communities
Summary
In Saskatchewan, Canada, Indigenous cancer care services at the municipal, provincial, and federal levels are intended to improve quality care but can result in a complex, fragmented, and multi-jurisdictional health care system. From Ontario’s health status data from 2001 to 2010, new cancer diagnoses and mortality rates continue to be significantly higher for First Nations in comparison to non-First Nations Ontarians [5] These outcomes extend beyond Ontario, as data from 2004 to 2011 in the province of Manitoba reveal that First Nations (vs non-Indigenous Manitobans) were diagnosed with cancer significantly younger, had higher late-stage cancer diagnoses, and had higher mortality rates [6]. First Nations in Manitoba living on reserve had higher proportions of late-stage diagnoses than First Nations living off reserve [7] These findings suggest that cancer is an increasingly relevant health issue for Indigenous people in Canada, making optimal care for Indigenous cancer patients a significant concern to address
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