Abstract:
Background: There are disparities in outcomes for Aboriginal children with acute leukaemia, with reduced enrolment onto clinical trials and increased rates of loss to follow-up. Inequalities can result from reduced access to health-care services due to remote living, cross-cultural misunderstandings and poor understanding surrounding a cancer diagnosis.
Objective: To understand the barriers and challenges associated with an Aboriginal child being diagnosed with cancer, in the hope to lead local, national and international initiatives for change.
Method: This service provision audit was conducted out of the Women’s and Children’s Hospital (WCH). Patients identifying as Aboriginal Australians, and healthcare staff, including Aboriginal healthcare workers, were approached to participate. Families of deceased patients were ineligible. Consenting participants were interviewed (face-to-face or via telephone) by study members on the cancer journey.
Results: Between 2006 and 2021, 65 families undergoing cancer treatment at the WCH identified as Aboriginal. 53 were ineligible (deceased, relapsed during study, under child protection, did not attend, un-contactable). 12 participants were interviewed (9 families, 3 healthcare staff). Main themes identified were delayed diagnoses, hardships with travel, lack of access to support services and poor communication surrounding the cancer diagnosis and treatment. Positives included local network involvement, telehealth services, social work input and support from Non-Government Organisations.
Conclusion: There are many challenges faced by Aboriginal families when a child is diagnosed with cancer. Our results support the necessity to implement changes surrounding cultural sensitivity, communication and culturally adapted education of patients, and improve assistance with travel and accommodation for the patient and wider family.
Audience Take Away Notes:
- There are disparities in outcomes for Aboriginal children with cancer, particularly leukaemia, along with reduced enrolment on clinical trials and increased rates of loss to follow up
- There is inequitable service provision to Aboriginal patients and families, including poor cultural sensitivity, inadequate communication, education and support schemes
- We need to raise awareness of the gap in cares, affecting outcomes
- Cultural awareness and respect is inadequate amongst healthcare staff
- Healthcare staff need to advocate for local, national and international initiatives for improvements in service provision
