Supportive Care in Cancer

, Volume 24, Issue 1, pp 215–223 | Cite as

Indigenous cancer patient and staff attitudes towards unmet needs screening using the SCNAT-IP

  • G. GarveyEmail author
  • B. Thewes
  • V. F. Y. He
  • E. Davis
  • A. Girgis
  • P. C. Valery
  • K. Giam
  • A. Hocking
  • J. Jackson
  • V. Jones
  • D. Yip
  • and the Members of the SCNAT-IP Implementation Group
Original Article



Indigenous Australians have a higher cancer incidence, worse mortality and are less likely to receive optimal cancer treatment compared with non-Indigenous Australians. Culturally appropriate supportive care helps ensure that Indigenous patients engage in and receive optimal care. However, many existing supportive care needs tools lack cultural relevance for Indigenous people, and their feasibility with Indigenous people has not been demonstrated. The Supportive Care Needs Assessment Tool for Indigenous People (SCNAT-IP) assesses the unmet supportive care needs of Indigenous cancer patients.


This descriptive study evaluates the clinical implementation of the SCNAT-IP in routine care.


Two large tertiary cancer treatment centres and two regional oncology clinics participated. Participants included 10 clinical staff and 36 adult Indigenous cancer patients (mean age 54 years). Patients and clinicians completed brief, purpose-designed questionnaires and interviews.


Patients reported high ratings (means >8/10) for acceptability, helpfulness and timing items. The majority (≥80 %) of staff agreed that the SCNAT-IP was useful to clinical practice, should be used in routine care and was acceptable to their patients.


The study provides empirical support for the feasibility and acceptability of the SCNAT-IP in routine cancer care with Indigenous Australians. Routine screening with the SCNAT-IP has the potential to improve cancer care for Indigenous people with cancer.


Indigenous Aboriginal Cancer Oncology Unmet needs Screening 



This research was funded by a grant from the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research. This study was undertaken under the auspices of the Centre of Research Excellence in Discovering Indigenous Strategies to improve Cancer Outcomes Via Engagement, Research Translation and Training (DISCOVER-TT CRE, funded by the National Health and Medical Research Council #1041111). PCV was supported by an Australian Research Council Future Fellowship (#FT100100511). The authors wish to thank Mrs. Margaret Lawton and Ms. Celia Moore (Indigenous consumer representatives) and Dr. Mick Adams for their assistance with developing training materials for this study. We also thank the Indigenous people with cancer and staff who participated in this study for their time and enthusiasm. The views expressed in this publication are those of the authors and do not necessarily reflect the views of the funding agencies. The content of the manuscript was subject to approval by the Aboriginal Health and Medical Research Council of NSW in accordance with the standard conditions of their ethical approval.

Conflict of interest

The authors have no conflicts of interest to declare.


  1. 1.
    Australian Institute of Health and Welfare (AIHW), The health and welfare of Australia’s Aboriginal and Torres Strait Islander people: an overview 2011. Australian Institute of Health and Welfare, Editor. 2011, AIHW: CanberraGoogle Scholar
  2. 2.
    Australian Institute of Health and Welfare, Cancer in Aboriginal and Torres Strait Islander peoples of Australia: an overview. Australian Institute of Health and Welfare (AIHW), Editor. 2013, AIHW: CanberraGoogle Scholar
  3. 3.
    Miller J, Knott V, Wilson C, Cunningham J, Condon J, Roder D (2010) Aboriginal and Torres Strait Islander Cancer Control Research Project, Cancer Australia Report: Sydney, NSWGoogle Scholar
  4. 4.
    Cunningham J, Rumbold AR, Zhang X, Condon JR (2008) Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia. Lancet Oncol 9(6):585–595CrossRefPubMedGoogle Scholar
  5. 5.
    Valery PC, Coory M, Stirling J, Green AC (2006) Cancer diagnosis, treatment, and survival in Indigenous and non-Indigenous Australians: a matched cohort study. Lancet 367(9525):1842–1848CrossRefPubMedGoogle Scholar
  6. 6.
    Shahid S, Thompson SC (2009) An overview of cancer and beliefs about the disease in Indigenous people of Australia, Canada, New Zealand and the US. Aust N Z J Public Health 33(2):109–118CrossRefPubMedGoogle Scholar
  7. 7.
    Shahid S, Finn L, Bessarab D, Thompson SC (2011) ‘Nowhere to room … nobody told them’: logistical and cultural impediments to Aboriginal peoples’ participation in cancer treatment. Aust Health Rev 35(2):235–241CrossRefPubMedGoogle Scholar
  8. 8.
    Garvey G, Beesley VL, Janda M, Jacka C, Green AC, O’Rourke P, Valery PC (2012) The development of a supportive care needs assessment tool for Indigenous people with cancer. BMC Cancer 12(300):1471–2407Google Scholar
  9. 9.
    Gould J, Sinding C, Mitchell TL, Gustafson DL, Peng I, McGillicuddy P, Fitch MI, Aronson J, Burhansstipanov L (2009) Below their notice: exploring women’s subjective experiences of cancer system exclusion. J Cancer Educ 24(4):308–314CrossRefPubMedGoogle Scholar
  10. 10.
    Hall B, Howard K, McCaffery K (2008) Do cervical cancer screening patient information leaflets meet the HPV information needs of women? Patient Educ Couns 72(1):78–87CrossRefPubMedGoogle Scholar
  11. 11.
    Johnston V, Westphal D, Glover M, Thomas D, Segan C, Walker N (2013) Reducing smoking among indigenous populations: new evidence from a review of trials. Nicotine Tabacco Res 15(8):132–1338Google Scholar
  12. 12.
    Reath J, Carey M (2008) Breast and cervical cancer in Indigenous women; overcoming barriers to early detection. Aust Fam Physician 37(3):178–182PubMedGoogle Scholar
  13. 13.
    Reath J, Usherwood T (1998) Improving cervical screening in a remote Aboriginal community. Aust N Z J Public Health 22(6):659–663CrossRefPubMedGoogle Scholar
  14. 14.
    Surbone A, Baider L, Weitzman TS, Brames MJ, Rittenberg CN, Johnson J (2010) Psychosocial care for patients and their families is integral to supportive care in cancer: MASCC position statement. Support Care Cancer 18(2):255–263CrossRefPubMedGoogle Scholar
  15. 15.
    Garvey G, Beesley VL, Janda M, O’Rourke P, He VYF, Hawkes AL, Elston J, Green AC, Cunningham J, Valery PC. Psychometric Properties of an Australian Supportive Care Needs Assessment Tool for Indigenous Patients With Cancer. BMC Cancer. doi: 10.1002/cncr.29433
  16. 16.
    Boyes A, Girgis A, Lecathelinais C (2009) Brief assessment of adult cancer patients’ perceived needs: development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34). J Eval Clin Pract 15(4):602–606CrossRefPubMedGoogle Scholar
  17. 17.
    Jacobsen P, Wagner L (2012) A new quality standard: the integration of psychosocial care into routine practice. J Clin Oncol 30(11):1154–1159CrossRefPubMedGoogle Scholar
  18. 18.
    Carlson LE, Waller A, Mitchell AJ (2012) Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol 30(11):1160–1177CrossRefPubMedGoogle Scholar
  19. 19.
    Carlson LE, Bultz BD (2003) Cancer distress screening. Needs, models, and methods. J Psychosom Res 55(5):403–409CrossRefPubMedGoogle Scholar
  20. 20.
    Snyder CF, Dy SM, Hendricks DE, Brahmer JR, Carducci MA, Wolff AC, Wu AW (2007) Asking the right questions: investigating needs assessments and health-related quality-of-life questionnaires for use in oncology clinical practice. Support Care Cancer 15(9):1075–1085CrossRefPubMedGoogle Scholar
  21. 21.
    Boyes A, Newell S, Girgis A, McElduff P, Sanson-Fisher R (2006) Does routine assessment and real-time feedback improve cancer patients’ psychosocial well-being? Eur J Cancer Care 15(2):163–171CrossRefGoogle Scholar
  22. 22.
    Thewes B, Garvey G, He V, Davis E, Girgis A, Valery PC, Giam K, Hocking A, Jackson J, Jones V, Yip D, and the SCNAT-IP Implementation Group, Indigenous patient and clinician attitudes to routine screening for unmet needs amongst: a qualitative study. J Cancer Survivorship, Under editorial reviewGoogle Scholar
  23. 23.
    Ristevski E, Regan M, Jones R, Breen S, Batson A, McGrail MR (2013) Cancer patient and clinician acceptability and feasibility of a supportive care screening and referral process. Health ExpectGoogle Scholar
  24. 24.
    National Comprehensive Cancer Network (NCCN), NCCN Clinical Practice Guidelines in Oncology Distress Management, Version 1, NCCN, Editor. 2008, National Comprehensive Cancer Network: Fort WashingtonGoogle Scholar
  25. 25.
    Andrews G, Slade T (2001) Interpreting scores on the Kessler psychological distress scale (K10). Austand N Z J Public Health Soc Care Community 25:494–497CrossRefGoogle Scholar
  26. 26.
    Bonevski B, Randell M, Paul C, Chapman K, Twyman L, Bryant J, Brozek I, Hughes C (2014) Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol 14:42PubMedCentralCrossRefPubMedGoogle Scholar
  27. 27.
    Taenzer P, Bultz BD, Carlson LE, Speca M, DeGagne T, Olson K, Doll R, Rosberger Z (2000) Impact of computerized quality of life screening on physician behaviour and patient satisfaction in lung cancer outpatients. Psycho-Oncology 9:203–213CrossRefPubMedGoogle Scholar
  28. 28.
    Thewes B, Butow P, Stuart-Harris R (2009) And greater southern area health service screening project committee, does routine psychological screening of newly diagnosed rural cancer patients lead to better patient outcomes? results of a pilot study. Aust J Rural Health 17(6):298–304CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • G. Garvey
    • 1
    Email author
  • B. Thewes
    • 1
  • V. F. Y. He
    • 1
  • E. Davis
    • 1
  • A. Girgis
    • 2
  • P. C. Valery
    • 1
  • K. Giam
    • 3
  • A. Hocking
    • 4
  • J. Jackson
    • 5
  • V. Jones
    • 5
  • D. Yip
    • 6
  • and the Members of the SCNAT-IP Implementation Group
  1. 1.Menzies School of Health ResearchBrisbaneAustralia
  2. 2.South Western Sydney Clinical SchoolUNSWSydneyAustralia
  3. 3.Alan Walker Cancer Care CentreRoyal Darwin HospitalDarwinAustralia
  4. 4.Peter MacCallum Cancer CentreMelbourneAustralia
  5. 5.Southern NSW Local Health DistrictQueanbeyan, NSWAustralia
  6. 6.ANU Medical SchoolAustralian National UniversityCanberraAustralia

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