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Communicating cancer and its treatment to Australian Aboriginal and Torres Strait Islander patients with cancer: a qualitative study

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Abstract

Purpose

To investigate the successful strategies of health workers who support and regularly communicate with Aboriginal and Torres Strait Islander people about cancer and its treatment.

Methods

Semi-structured interviews were conducted face-to face or via telephone and audio-recorded with twenty-three health professionals (medical and radiation oncologists, oncology nurses and Aboriginal Health Workers), 5 identifying as Aboriginal or Torres Strait Islander in the Northern Territory and South Australia. When data saturation was reached, thematic analysis using a bottom up, essentialist/realist approach was used.

Results

Six themes emerged. (1) Create a safe environment, engender trust and build rapport. This involves considering the physical environment and allowing time in interviews to establish a relationship. (2) Employ specific communication strategies to explain cancer, treatment and its side effects through language choices and employing visual aids such as drawings, metaphors and relatable analogies. (3) Obtain support from Aboriginal and Torres Strait Islander staff and patient escorts who can assist in communication. (4) Consider culture which involves collective decision making, strong connection to country and community, with cultural obligations and a unique understanding of cancer. (5) Anticipate the contextual complexities of conflicts between Western medicine and Aboriginal culture, practitioner bias and difficulty maintaining contact with patients. (6) Develop personal qualities of good communicators, including being patient-centred, showing respect, patience, empathy and honesty.

Conclusion

These insights will help foster more positive interactions with the health system and promote optimal outcomes for Aboriginal and Torres Strait Islander people with cancer.

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Data availability

Data will be stored at University of South Australia for 15 years and available on request to the corresponding author.

Code availability

Not applicable.

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Acknowledgements

We acknowledge the contribution of Gwenda Gilligan, who as a post graduate student participated in the early planning of the study and completed the first interview.

Funding

Joan Cunningham was funded by NHMRC Research Fellowship #1058244. This study was supported by the NHMRC-funded Centre of Research Excellence DISCOVER-TT (#1041111). The views expressed in this publication are those of the authors and do not necessarily reflect the views of the funder.

Author information

Authors and Affiliations

  1. School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia

    Ian Olver

  2. Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia

    Kate M. Gunn & Kristiaan Spronk

  3. Division of Health Sciences, University of South Australia, Adelaide, Australia

    Alwin Chong

  4. Psychological Sciences, Australian College of Applied Psychology, Brisbane, Australia

    Vikki Knott

  5. Prideaux Health Professions Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia

    Nayia Cominos

  6. Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia

    Joan Cunningham

Authors
  1. Ian Olver
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  2. Kate M. Gunn
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  3. Alwin Chong
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  4. Vikki Knott
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  6. Nayia Cominos
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  7. Joan Cunningham
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Contributions

The authors whose names appear on the submission made substantial contributions to the conception of the work and the acquisition of data (Ian Olver, Kate Gunn, Vikki Knott, Joan Cunningham, Alwin Chong), analysed the data (Kate Gunn, Ian Olver, Kristian Spronk) drafted the work (Ian Olver) or revised it critically for important intellectual content (Kate Gunn, Alwin Chong, Vikki Knott, Kristiaan Spronk, Nayia Cominos, Joan Cunningham). The first draft was written by Ian Olver All approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Ian Olver.

Ethics declarations

Ethics approval

Ethics approval was granted by the University of South Australia Research Ethics Committee and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, and we certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

Participants provided written consent to semi-structured interviews either in person or by phone and to those interviews being audio-recorded.

Consent for publication

All authors and participants agreed to the publication of this paper.

Conflicts of interest

The authors declare no competing interests.

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Olver, I., Gunn, K.M., Chong, A. et al. Communicating cancer and its treatment to Australian Aboriginal and Torres Strait Islander patients with cancer: a qualitative study. Support Care Cancer 30, 431–438 (2022). https://doi.org/10.1007/s00520-021-06430-3

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  • DOI: https://doi.org/10.1007/s00520-021-06430-3

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