AbstractA growing body of research has reported significant disparities in cancer outcomes between Indigenous and non-Indigenous Australians, in part a result of factors relating to the accessibility, acceptability and effectiveness of health services. Although these disparities are starting to be addressed, relatively little attention has been directed towards identifying and focusing on the psychosocial aspects of cancer for Indigenous patients, a critical component in improving cancer care and outcomes.
This thesis reports on the development of a new Supportive Care Needs Assessment Tool for Indigenous People (SCNAT-IP) and presents the first research on factors affecting the prevalence of unmet support needs, distress and quality of life (QOL) in a cohort of Indigenous adult cancer patients in Queensland, Australia. The main research findings were:
1. Current supportive care needs tools do not meet the needs of Indigenous people with cancer with regard to factors such as language, culture and customs.
2. The newly developed SCNAT-IP improves acceptability, relevance and face validity for Indigenous-specific concerns.
3. The prevalence of these patients’ unmet support needs is high, especially in the psychological and practical need domain.
4. The use of the SCNAT-IP in the usual cancer care setting is feasible and acceptable to users.
5. Health-related QOL is lower among Indigenous cancer patients compared to other Australians. Several factors are associated with a higher median QOL score and with the relative odds of having ‘excellent’ health-related QOL.
6. Clinically-significant distress among the Indigenous cancer patients studied is consistent with levels identified in the existing literature. Some socio-demographic and clinical characteristics are associated with higher median distress score and with the relative odds of having clinically-significant distress.
These findings have implications for clinical practice and can be used to improve the management and care of Indigenous adults with cancer and to inform targeted policy development.
Note: Please note that some published articles in the thesis are available in hard copy only.
|Date of Award
|Joan Cunningham (Supervisor)