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“I’m a Survivor”

Aboriginal and Torres Strait Islander Cancer Survivors’ Perspectives of Cancer Survivorship

Meiklejohn, Judith A., BHS, MASc; Bailie, Ross, PhD; Adams, Jon, PhD; Garvey, Gail, PhD; Bernardes, Christina M., RN, PhD; Williamson, Daniel, PhD; Marcusson, Beverly; Arley, Brian, BA; Martin, Jennifer H., PhD; Walpole, Euan T., MD, PhD; Valery, Patricia C., MD, MPH, PhD

doi: 10.1097/NCC.0000000000000671
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Background Disparity in outcomes between Indigenous and non-Indigenous people after cancer diagnosis is multifactorial, including lower cancer screening participation, later diagnosis, reduced access and uptake of cancer treatment, higher rate of comorbidities, and barriers accessing the health system. Little is known about cancer survivorship experiences.

Objective The aim of this study was to explore Indigenous Australian cancer survivor's perspectives of cancer survivorship.

Methods Indigenous people who completed cancer treatment 6 months to 5 years before fieldwork were recruited from a tertiary hospital and remote primary health service for this qualitative study. Data collection was guided by yarning methods, a culturally appropriate method emphasizing storytelling. Data were interpreted using a social constructionist framework.

Results Thirteen women and 6 men were interviewed. Participants' past experiences contributed to their specific identity as survivors. Participants described factors affecting a positive transition from cancer patient to cancer survivor and the importance of ongoing family support in helping to manage survivorship. Finally, participants described a range of community support they received and provided to others and how this improved their cancer survivorship.

Conclusion Although a range of experiences are presented, this study provides evidence that the survivorship perspectives of Indigenous cancer survivors may be, in part, shared by non-Indigenous cancer survivors.

Implications for Practice Acknowledging Indigenous cancer survivors' past experiences and how these influence their overall well-being is important for providing patient-centered and culturally appropriate care. Nurses and other healthcare professionals may use this knowledge to foster a range of coping strategies to assist Indigenous cancer survivors to live well.

Author Affiliations: Centre for Online Health, Faculty of Medicine Princess Alexandra Hospital, Woolloongabba, The University of Queensland (Ms Meiklejohn); University Centre for Rural Health, University of Sydney, New South Wales (Dr Bailie); Faculty of Health, University of Technology Sydney, New South Wales (Dr Jon Adams); Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT (Dr Garvey); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Queensland (Drs Bernardes and Valery, Ms Marcusson, and Mr Arley); Aboriginal and Torres Strait Islander Health Unit, Queensland Health, Brisbane, QLD (Dr Williamson); Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT (Mr Arley); University of Newcastle School of Medicine and Public Health, Callaghan, NSW; Southside Clinical School, University of Queensland, Brisbane, QLD (Dr Martin); Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD; Cancer Stream Leader–Metro South Health and Hospital Service; University of Queensland, Brisbane, QLD (Dr Walpole); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Queensland, Australia (Dr Valery).

This work was supported by the National Health and Medical Research Council (project no. 1044433). PCV was supported by a National Health and Medical Research Council (Career Development Fellowship no. 1083090). Ross Bailie's work is supported by an Australian Research Council Future Fellowship (100100087). Professor Gail Garvey is funded by a National Health and Medical Research Council Early Career Fellowship (no. 1105399). Jon Adams' work is supported by an Australian Research Council Future Fellowship (no. FT140100195).

The authors have no conflicts of interest to disclose.

Correspondence: Patricia C. Valery, MD, MPH, PhD, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Queensland, Australia QLD 4029 (patricia.valery@qimrberghofer.edu.au).

Accepted for publication August 22, 2018.

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