ABSTRACT

Aboriginal and Torres Strait Islander people experience significant disparities in accessing cancer care and in cancer outcomes when compared with non-Indigenous Australians. Social workers and Aboriginal Hospital Liaison Officers from an inner-city hospital partnered with local Aboriginal organisations to develop, implement, and evaluate a culturally informed model of supportive cancer care. The initiative adopted an “appreciative inquiry” approach and engagement with Indigenous stakeholders, drawing on the Aboriginal and Torres Strait Islander Quality Improvement Framework and Toolkit for Hospital Staff (AQIFTHS, 2015). Using a process of codesign, strategies were developed with consumers to address the social and cultural determinants of health across the cancer journey. The new evidence-based model of care incorporated culturally informed identification of needs, culturally appropriate engagement, and maintenance of respectful connections to develop codesigned care plans with tailored information and provide practical support and advocacy. Findings illustrate the complex challenges faced by Aboriginal and Torres Strait Islander people living with cancer as well as their strengths. AQIFTHS processes and model of care provide guidance for social workers and other health professionals seeking to partner with stakeholders to promote health equity and improve supportive cancer care in accordance with optimal care guidelines and national quality standards.

IMPLICATIONS

• Supportive care needs of Aboriginal and Torres Strait Islander people living with cancer are often complex and multifaceted, but links with community and culture are noted strengths.

• Social workers in Australian health settings have an important role in improving access and promoting a culturally responsive model of care for this population.

• Appropriate support can only occur when it is codesigned with the individual patient and their family members, Aboriginal Hospital Liaison Officers, and community.

摘要

与非土著澳大利亚人相比，土著和托雷斯海峡岛民在获得癌症护理和癌症结果方面存在显着差异。来自市中心医院的社会工作者和原住民医院联络官与当地原住民组织合作，开发、实施和评估支持性癌症护理的文化信息模型。该倡议采用了“欣赏式探究”方法，并利用土著和托雷斯海峡岛民质量改进框架和医院工作人员工具包与土著利益相关者进行接触（AQIFTHS，2015 年）。使用协同设计过程，与消费者一起制定策略，以解决癌症旅程中健康的社会和文化决定因素。新的以证据为基础的护理模式结合了对需求的文化知情识别、文化上适当的参与和保持尊重的联系，以制定具有定制信息的共同设计的护理计划，并提供实际的支持和宣传。调查结果说明了原住民和托雷斯海峡岛民癌症患者所面临的复杂挑战以及他们的优势。AQIFTHS 流程和护理模式为寻求与利益相关者合作的社会工作者和其他卫生专业人员提供指导，以根据最佳护理指南和国家质量标准促进健康公平并改善支持性癌症护理。维护相互尊重的联系，以制定具有定制信息的共同设计的护理计划，并提供实际支持和宣传。调查结果说明了原住民和托雷斯海峡岛民癌症患者所面临的复杂挑战以及他们的优势。AQIFTHS 流程和护理模式为寻求与利益相关者合作的社会工作者和其他卫生专业人员提供指导，以根据最佳护理指南和国家质量标准促进健康公平并改善支持性癌症护理。维护相互尊重的联系，以制定具有定制信息的共同设计的护理计划，并提供实际支持和宣传。调查结果说明了原住民和托雷斯海峡岛民癌症患者所面临的复杂挑战以及他们的优势。AQIFTHS 流程和护理模式为寻求与利益相关者合作的社会工作者和其他卫生专业人员提供指导，以根据最佳护理指南和国家质量标准促进健康公平并改善支持性癌症护理。

影响

• 患有癌症的土著和托雷斯海峡岛民的支持性护理需求通常是复杂和多方面的，但与社区和文化的联系是显着的优势。

• 澳大利亚卫生机构中的社会工作者在改善可及性和促进针对该人群的文化响应模式方面发挥着重要作用。

• 只有在与个别患者及其家人、土著医院联络官和社区共同签署时，才能提供适当的支持。