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Carlson TA, Liddell JL. The importance of community support for women in a Gulf Coast Indigenous tribe. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2023; 16:162-175. [PMID: 38770245 PMCID: PMC11104765 DOI: 10.1108/ijhrh-06-2022-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose – Community support is an integral aspect of health and well-being for Indigenous peoples. The purpose of this paper is to demonstrate the valuable role of community support for Indigenous women specifically, who experience reproductive health disparities at alarming rates. This study helps fill an important gap in Indigenous scholarship by centering the resilience of women and Indigenous tribes and by using a framework that is consistent with Indigenous holistic views of health. Design/methodology/approach – The data for this paper was collected as part of a larger study exploring the reproductive health experiences of a state-recognized Gulf Coast tribe. A total of 31 semi-structured interviews were conducted with individuals who identify as women and as members of this tribe using qualitative descriptive methodology. This method is recommended for research with Indigenous communities. A community advisory board with representatives from this tribe provided feedback throughout the project. Findings – Themes expressed by participants included Community Closeness and Support; Community Support in Raising Children; Informal Adoption Common; and Community Values of Mutual Aid and Self-Sufficiency. The findings support current literature noting the value of generational and communal ties for Indigenous peoples. Implications of this research include the need to value and support community networks in programs serving tribes, in addition to meaningfully including Indigenous communities in developing interventions. Originality/value – This paper centers Indigenous women's resilience, approaches the health and well-being of Indigenous tribes holistically and helps to fill an important gap in literature describing informal adoption (outside the legal system) in state-recognized Indigenous communities.
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Affiliation(s)
- Tess A Carlson
- School of Social Work, University of Montana, Missoula, Montana, USA
| | - Jessica L Liddell
- School of Social Work, University of Montana, Missoula, Montana, USA
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Burnette CE, Liddell J, Roh S, Lee YS, Lee HY. American Indian women cancer survivors' perceptions and experiences with conventional and non-conventional mental health care for depressive symptoms. ETHNICITY & HEALTH 2021; 26:186-205. [PMID: 29962228 PMCID: PMC6314900 DOI: 10.1080/13557858.2018.1493439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/06/2018] [Indexed: 05/12/2023]
Abstract
Background: Despite cancer and depression being disproportionately high for American Indian and Alaska Native (AI/AN) women, such cancer survivors' help-seeking practices and perceptions related to depression are absent in extant research. A broader context of historical oppression has set the stage for unequal health outcomes and access to quality services. The purpose of this article was to explore AI women cancer survivors' experiences with conventional mental health services and informal and tribally-based assistance, as well as barriers related to mental health service utilization.Methods: A qualitative descriptive study methodology, with qualitative content analysis, was used to examine the experiences of AI women cancer survivors as they related to help-seeking experiences for depressive symptoms. The sample included 43 AI women cancer survivors (n = 14 breast cancer, n = 14 cervical cancer, and n = 15 colon and other types of cancer survivors).Results: Since receiving a cancer diagnosis, 26 (62%) participants indicated they had feelings of depression. Some participants (n = 13) described mixed perceptions of the mental health service system. Generally, participants viewed families and informal support systems as primary forms of assistance, whereas conventional services were reported as a supplementary or 'as needed' forms of support, particularly when the informal support system was lacking. Participants received help in the forms of psychotropic medications and psychotherapy, as well as help from family and AI-specific healing modalities (e.g. sweat lodges and healing ceremonies). Stigma and confidentiality concerns were primary barriers to utilizing conventional services as described by 12 (29%) participants.Discussion: Participants' help primarily came from family and tribally-based entities, with conventional mental health care being more salient when informal supports were lacking. The mixed perceptions espoused by participants may be related to a broader context of historical oppression; family and social support and tribally-based services may be protective factors for cancer survivors with depression.
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Affiliation(s)
- Catherine E. Burnette
- School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Jessica Liddell
- City, Community, and Culture PhD Program, School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, 1400 West 22 Street, Sioux Falls, SD 57105, Phone: 605-357-1593,
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132, Phone: 415-405-0944,
| | - Hee Yun Lee
- School of Social work, The University of Alabama, 1022 Little Hall, Box 870314, Tuscaloosa, AL 35487, Phone: 205-348-6553,
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Hansen F, Berntsen GR, Salamonsen A. Medical pluralism in the aftermath of cancer: health seeking actions and cancer patients' shaping of trajectories to healing. Anthropol Med 2020; 27:330-346. [PMID: 31986904 DOI: 10.1080/13648470.2019.1676637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Improved treatment methods for cancer are increasing the number of survivals in Norway. In turn, the group of people struggling with late effects after the treatment is growing. Late effects could be physical, psychological or existential conditions caused by treatment or the experience of illness. This qualitative study explores health-seeking actions among nine Norwegian people with cancer, and how they shape their trajectories to healing. Various health-seeking actions were identified through content analysis, and categorized as conventional, CAM, self-care, religious coping and traditional healing. Medical pluralism particularly flourished in the aftermath of cancer. We found that the phenomenon is characterized by: 1) implementation of contradicting models of reality and making pragmatic choices, 2) continuity and change of health seeking actions, 3) medical pluralism as a process, and 4) increased use of CAM and self-care to improve health and well-being in situations where the conventional care system has few available treatment options. To support people with long-term conditions, we need to know how they choose and make sense of their health-seeking activities. We argue that trajectories to healing are dynamic and shaped by people making choices. This process could be understood in greater depth by applying the concept of medical landscapes.
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Affiliation(s)
- Frank Hansen
- National Research Center in Complementary and Alternative Medicine, Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Gro Rosvold Berntsen
- The Primary Care Research group, Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.,Norwegian Center for e-Health Research, University Hospital of Northern Norway, Tromsø, Norway
| | - Anita Salamonsen
- RKBU North - Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Interdisciplinary Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Burnette CE, Roh S, Liddell J, Lee YS. American Indian women cancer survivors' coping with depressive symptoms. J Psychosoc Oncol 2019; 37:494-508. [PMID: 30590999 PMCID: PMC6529281 DOI: 10.1080/07347332.2018.1525467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Depressive symptoms have been identified as a primary predictor of quality of life among cancer patients. Depression and cancer are co-occurring and disproportionately elevated for American Indian and Alaska Native (AI/AN) women. The purpose of this article is to examine American Indian (AI) women cancer survivors' coping mechanisms for depressive symptoms. RESEARCH APPROACH The methodology included a qualitative descriptive approach with conventional content analysis to examine the coping strategies of AI women cancer survivors associated with depressive symptoms. The interview guide was semi-structured and developed in collaboration with a community advisory board (CAB). Data-derived qualitative analysis was used to generate codes inductively from the data. PARTICIPANTS A sample of 43 AI women cancer survivors (n = 14 cervical cancer, n = 14 breast cancer, and n = 15 other cancers) from the Northern Plains region, in the state of South Dakota were interviewed. Data were collected from June 2014 to February 2015. Methodological approach: Qualitative content analysis was used for data analysis, which allowed themes to emerge inductively from the data. Analysis revealed 430 preliminary codes. After de-briefing, validation, and discussion among coauthors, these were then sorted into 67 codes. Member checks with all available participants were conducted to minimize misinterpretation. FINDINGS A total of 26 participants (62%) indicated they had feelings of depression since their cancer diagnosis. Women coped with depressive feelings by (a) participating in faith traditions; (b) seeking creative and positive outlets; (c) martialing family and social support; and (d) keeping busy with other life activities. INTERPRETATION AI women experienced depressive symptoms following a cancer diagnosis and used a variety of positive coping mechanisms to create personal meaning. Implications for Psychosocial Providers or Policy: AI women may need unique support following a cancer diagnosis, and interventions should incorporate AI beliefs and traditions, such as storytelling and talking with family and community members.
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Affiliation(s)
- Catherine E. Burnette
- School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, 1400 West 22 Street, Sioux Falls, SD 57105, Phone: 605-357-1593,
| | - Jessica Liddell
- City, Community, and Culture PhD Program, School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132, Phone: 415-405-0944,
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Gifford W, Thomas O, Thomas R, Grandpierre V, Ukagwu C. Spirituality in cancer survivorship with First Nations people in Canada. Support Care Cancer 2018; 27:2969-2976. [PMID: 30564938 DOI: 10.1007/s00520-018-4609-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 12/11/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Advancements in cancer survivorship care have shown that holistic approaches, tailored to people's unique survivorship needs, can decrease cancer burden and enhance well-being and quality of life. The purpose of this study was to explore the meanings of spirituality in cancer survivorship for First Nations people, the largest Indigenous population in Canada, and describe how spiritual practices are incorporated into healing. METHODS This study is part of a larger arts-based project about cancer survivorship with First Nations people. Thirty-one cancer survivors discussed spirituality as part of their cancer survivorship experiences. Data were generated through sharing sessions (n = 8) and individual interviews (n = 31). Qualitative descriptive analysis was conducted. RESULTS Three themes emerged about the meaning of spirituality in cancer survivorship. Spirituality was expressed as a complex phenomenon that (1) interconnected self with traditional roots and culture, (2) merged the body and mind, and (3) gave meaning, strength, and faith in the cancer journey. First Nations people incorporated spirituality into cancer survivorship by giving thanks, attending places of spiritual connectedness, singing, praying, speaking to the Creator, and engaging the sun and moon. CONCLUSION First Nations cancer survivors have viewed cancer as an opportunity for emotional and spiritual growth that enabled healing. Understanding the role of spirituality in cancer survivorship is important to develop and deliver culturally safe health services that reduce the burden of cancer and ultimately improve outcomes for First Nations people in Canada.
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Affiliation(s)
- Wendy Gifford
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada.
| | - Ovini Thomas
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Roanne Thomas
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Grandpierre
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Chijindu Ukagwu
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Kidd J, Raphael D, Cassim S, Black S, Blundell R, Egan R. Health service provider responses to indigenous peoples with cancer: An integrative review. Eur J Cancer Care (Engl) 2018; 28:e12975. [PMID: 30537074 DOI: 10.1111/ecc.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 07/12/2018] [Accepted: 10/27/2018] [Indexed: 11/27/2022]
Abstract
Indigenous populations around the world have a higher burden of cancer incidence, severity and mortality. This integrative review aims to identify and appraise the evidence of health providers' responses to the issue of indigenous peoples with cancer. A surprisingly small number of studies were found (n = 9) that reported on programmes and interventions for indigenous people with cancer, the majority of which were from the USA. Our review shows that a service delivery approach that is focused on the indigenous population and includes culturally appropriate activities, resources and environments resulted in an increase in cancer knowledge, reduction in treatment interruption, improved access to cancer care and enrolment in clinical cancer trials, and increased satisfaction with health care. However, the question of why there are so few published studies needs further consideration.
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Affiliation(s)
- Jacquie Kidd
- Auckland University of Technology, Auckland, New Zealand
| | - Deborah Raphael
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Shemana Cassim
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Stella Black
- School of Nursing, University of Auckland, Auckland, New Zealand
| | | | - Richard Egan
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Grimes C, Dankovchik J, Cahn M, Warren-Mears V. American Indian and Alaska Native Cancer Patients' Perceptions of a Culturally Specific Patient Navigator Program. J Prim Prev 2017; 38:121-135. [PMID: 27838858 PMCID: PMC5313295 DOI: 10.1007/s10935-016-0458-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Lack of access to care, funding limitations, cultural, and social barriers are challenges specific to tribal communities that have led to adverse cancer outcomes among American Indians/Alaska Natives (AI/AN). While the cancer navigator model has been shown to be effective in other underserved communities, it has not been widely implemented in Indian Country. We conducted in-depth interviews with 40 AI/AN patients at tribal clinics in Idaho and Oregon. We developed the survey instrument in partnership with community members to ensure a culturally appropriate semi-structured questionnaire. Questions explored barriers to accessing care, perceptions of the navigator program, satisfaction, and recommendations. AI/AN cancer patients reported physical, emotional, financial, and transportation barriers to care, but most did not feel there were any cultural barriers to receiving care. Navigator services most commonly used included decision making, referrals, transportation, scheduling appointments, and communication. Satisfaction with the program was high. Our study provides a template to develop a culturally appropriate survey instrument for use with an AI/AN population, which could be adapted for use with other indigenous patient populations. Although our sample was small, our qualitative analysis facilitated a deeper understanding of the barriers faced by this population and how a navigator program may best address them. The results reveal the strengths and weakness of this program, and provide baseline patient satisfaction numbers which will allow future patient navigator programs to better create evaluation benchmarks.
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Affiliation(s)
- Carol Grimes
- Northwest Portland Area Indian Health Board, 918 NE Rosa Parks Way, Portland, OR, 97211, USA
| | - Jenine Dankovchik
- Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR, 97201, USA.
| | - Megan Cahn
- College of Public Health and Human Sciences, Oregon State University, 6430 SE Ogden St., Portland, OR, 97206, USA
| | - Victoria Warren-Mears
- Northwest Tribal Epidemiology Center, 2121 SW Broadway, Suite 300, Portland, OR, 97201, USA
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Hohl S, Molina Y, Koepl L, Lopez K, Vinson E, Linden H, Ramsey S. Satisfaction with cancer care among American Indian and Alaska Natives in Oregon and Washington State: a qualitative study of survivor and caregiver perspectives. Support Care Cancer 2016; 24:2437-44. [PMID: 26638004 PMCID: PMC4846546 DOI: 10.1007/s00520-015-3041-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To better understand satisfaction with care among American Indian and Alaska Native (AI/AN) persons with cancer, we explored dimensions of the provider relationship that contributed to satisfaction among caregivers and survivors who received cancer treatment in Oregon and Washington State. METHODS Between November 2011 and April 2013, the project team interviewed 11 caregivers and 71 AI/AN cancer survivors residing in Oregon and Washington State. Interview questions aimed to elicit participant experiences with care providers and factors associated with cancer care satisfaction. Interviews were analyzed using an inductive content analysis approach in which concepts were identified and themes derived from interview data. RESULTS Three overarching themes, each with two sub-themes, emerged from the data: (1) universal factors: bolstering understanding, involvement, and empathy in care; (2) minority-specific factors: incorporating culture and community into care; and (3) AI/AN-unique factors: interacting with Indian health clinics and Indian Health Service (IHS). CONCLUSIONS The results of our study suggest that satisfaction with care among survivors and their caregivers must be examined within the context of culture and community, particularly among minority patients. Our study demonstrates providers' critical role in ensuring AI/AN patients emerge satisfied with cancer treatment by honoring their AI/AN-specific needs, such as respect for integration of traditional healing modalities and navigation of specialty care coordination.
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Affiliation(s)
- Sarah Hohl
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA.
- School of Public Health, Department of Health Services, University of Washington, Seattle, WA, USA.
| | - Yamile Molina
- School of Public Health, Center for Research on Women and Gender, Cancer Center, University of Illinois-Chicago, Chicago, IL, USA
| | - Lisel Koepl
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA
| | - Kerri Lopez
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Eric Vinson
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Hannah Linden
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Scott Ramsey
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA
- School of Medicine, University of Washington, Seattle, WA, USA
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Robson B, Ellison-Loschmann L. Māori and cancer care in Aotearoa/New Zealand - responses to disparities. Eur J Cancer Care (Engl) 2016; 25:214-8. [DOI: 10.1111/ecc.12472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 12/22/2022]
Affiliation(s)
- B. Robson
- Eru Pōmare Māori Health Research Centre; University of Otago; Wellington
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10
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Cancer survivorship services for indigenous peoples: where we stand, where to improve? A systematic review. J Cancer Surviv 2015; 10:330-41. [DOI: 10.1007/s11764-015-0479-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
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Warren-Mears V, Dankovchik J, Patil M, Fu R. Impact of patient navigation on cancer diagnostic resolution among Northwest Tribal communities. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:109-18. [PMID: 23242563 PMCID: PMC3610770 DOI: 10.1007/s13187-012-0436-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The patient navigator model has not been widely implemented in American Indian/Alaska Native (AI/AN) communities, but may be effective in improving cancer outcomes for this population. Subjects were enrolled from eight clinics at Tribes throughout the Northwest (n = 1,187). Four clinics received navigation. Time between abnormal finding and definitive diagnosis was recorded. We examined whether odds of obtaining definitive diagnosis by 60, 90, and 365 days differed between the two groups. The odds of definitive diagnosis within 365 days for navigated subjects was 3.6 times (95 % CI, 1.47, 8.88; p = 0.01) the odds for control subjects. The outcome at 60 and 90 days did not significantly differ between the two groups. Our findings indicate that patient navigation did not significantly impact chance of diagnosis by 60 or 90 days from abnormal finding. However, it did improve the chance of avoiding extreme delays in obtaining a definitive diagnosis.
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Affiliation(s)
- Victoria Warren-Mears
- Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, Oregon 97201
| | - Jenine Dankovchik
- Northwest Tribal Cancer Navigator Program & NW IDEA Project, Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR 97201, Ph# 503-416-3265, Fax # 503-228-8182,
| | - Meena Patil
- Northwest Tribal Cancer Navigator Program, Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, Oregon 97201, Ph# 503-416-3265, Fax # 503-228-8182,
| | - Rongwei Fu
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, Ph# 503-494-6069,
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van Schaik KD, Thompson SC. Indigenous beliefs about biomedical and bush medicine treatment efficacy for indigenous cancer patients: a review of the literature. Intern Med J 2012; 42:184-91. [PMID: 21981135 DOI: 10.1111/j.1445-5994.2011.02598.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Australia's indigenous people suffer from higher cancer mortality than non-indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both 'bush medicine' and biomedical, in order to provide recommendations to healthcare providers about accommodating indigenous beliefs when treating cancer. METHODS A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. RESULTS Literature suggests that indigenous beliefs about treatment efficacy for cancer involve five themes: (i) concerns about the toxicity of treatment; (ii) disconnect with the physician; (iii) fears about absence from home during treatment; (iv) different beliefs about disease aetiology; (v) biomedical cancer treatments failing to address holistic health. CONCLUSIONS Although some information is known about indigenous Australian healing beliefs and practices associated with cancer treatment, few studies have addressed ways in which indigenous and biomedical approaches to cancer treatment might be integrated. Some recent work has examined the role of belief in cancer treatment, specifically bush medicine, but more research is required.
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Affiliation(s)
- K D van Schaik
- Harvard University Medical School, Boston, Massachusetts, USA.
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Eschiti V, Burhansstipanov L, Watanabe-Galloway S. Native cancer navigation: the state of the science. Clin J Oncol Nurs 2012; 16:73-82, 89. [PMID: 22297010 DOI: 10.1188/12.cjon.73-82] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this literature review is to determine the current state of the science for the effectiveness of patient navigation on improving outcomes of cancer care across the continuum among Native Americans. The research will help healthcare professionals ascertain potential evidence-based practice guidelines and gaps in knowledge, which may provide direction for future research. Data synthesis included the use of Native navigation for cancer care, which has been demonstrated in limited, nonrandomized studies to improve cancer knowledge, access to care, and quality of life for Native Americans. Those studies had limitations, including small sample size, self-report of outcome measures, and lack of randomization. Evidence is insufficient to conclude that the use of Native navigation is superior to usual cancer care for Native American patients. Oncology nurses have a role in training personnel to serve as cancer navigators. Nurses need to be supportive of culturally appropriate navigation programs and know about services provided by navigators. In addition, nurse educators need to encourage Native Americans in their communities to consider choosing nursing as a profession. If an oncology nurse has an interest in research, opportunities exist to assist with or conduct research projects regarding Native cancer navigation. A particular need exists for addressing the gaps in research identified in this article.
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Affiliation(s)
- Valerie Eschiti
- College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
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Burhansstipanov L, Dignan M, Jones KL, Krebs LU, Marchionda P, Kaur JS. Comparison of quality of life between Native and non-Native cancer survivors: Native and non-Native cancer survivors' QOL. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:S106-13. [PMID: 22302431 PMCID: PMC3544405 DOI: 10.1007/s13187-012-0318-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
This paper compares quality of life (QOL) outcomes between Native American and non-Native cancer survivors. Native Patient Navigators helped Native cancer patients complete a 114-item QOL survey and access survivorship information available on the NACES website. The survey was modified from Ferrell et. al’s QOL measure and assessed the four domains of cancer survivorship: physical, psychological, social, and spiritual. Findings from Native survivors were compared to Ferrell’s findings. This is the first time that QOL outcomes have been compared between Native and Non-Native cancer survivors. Natives scored lower for physical and social QOL, the same for psychological QOL, and higher for spiritual QOL in comparison to non-Natives. Overall QOL scores were the same. Although this is the largest sample of Native cancer survivors reported in peer-reviewed manuscripts, these Native survivorship data are based on a self-selected group and it is unknown if the findings are generalizable to others.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation, 3022 South Nova Road, Pine, CO 80470-7830, USA,
| | - Mark Dignan
- Prevention Research Center, Department of Internal Medicine, Markey Cancer Center, Room CC444, 800 Rose Street, Lexington, KY 40536-0093, USA,
| | - Katherine L. Jones
- Southeastern Program Evaluation, 4623 Hallandale Drive, Batavia, OH 45103, USA,
| | - Linda U. Krebs
- University of Colorado Denver, Anschutz Medical Campus, College of Nursing, Box C288-18, ED2N Room 4209, 13120 East 19th Avenue, Aurora, CO 80045, USA,
| | - Paula Marchionda
- Native American Cancer Research Corporation (NACR), 3110 S. Wadsworth, #103, Lakewood, CO 80227, USA,
| | - Judith Salmon Kaur
- Native American Programs, Spirit of EAGLES, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA,
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Warson E. Healing pathways: art therapy for American Indian cancer survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:S47-S56. [PMID: 22311692 DOI: 10.1007/s13187-012-0324-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There is a paucity of research addressing quality of life factors for American Indian and Alaska Native cancer survivors. Complementary forms of therapy, such as art therapy, are beginning to address quality of life factors through the "healing" arts for cancer survivors. The purpose of this mixed methods pilot was to explore the effects of culturally relevant art interventions on stress reduction for American Indian cancer survivors and their family members. Forty-six adult participants attended one of three workshops held within two settlements of the Coharie tribe and one southeastern urban tribal center. The data collected consisted of a pretest and posttest State-Trait Personality Inventory (STPI) and artwork resulting from three directed interventions. The artwork was analyzed using qualitative coding methods; however, the scores from the STPI were inconclusive because the inventory was determined to be culturally biased. While statistical significance was not achieved, the findings from qualitative coding reinforced a native concept of wellness focusing on the complex interaction between mind, body, spirit, and context. This pilot study also demonstrated how a community-driven approach was instrumental in the development of the overall workshop format. An expansion of the pilot study is also presented with preliminary results available in 2012.
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Coreil J, Corvin JA, Nupp R, Dyer K, Noble C. Ethnicity and cultural models of recovery from breast cancer. ETHNICITY & HEALTH 2011; 17:291-307. [PMID: 22011254 DOI: 10.1080/13557858.2011.616188] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Recovery narratives describe the culturally shared understandings about the ideal or desirable way to recover from an illness experience. This paper examines ethnic differences in recovery narratives among women participating in breast cancer support groups in Central Florida, USA. It compares groups serving African-American, Latina, and European American women, with the objective of better understanding the appeal of ethnic-specific illness support groups for culturally diverse populations. DESIGN A mixed-method study design combined qualitative and quantitative measures, including in-depth interviews, participant observation at support group meetings, collection of printed documents, and a structured survey. RESULTS Core elements of the recovery narrative drew from the dominant societal cancer discourse of optimism and personal transformation through adversity; however, important ethnic differences were evident in the meaning assigned to these themes. Groups gave distinctive salience to themes of faith and spirituality, empowerment through the migration experience, and becoming a better person through the journey of recovery. CONCLUSION The findings suggest that ethnic cancer support groups draw upon dominant societal discourses about cancer, but they espouse distinctive recovery narratives that are consonant with the groups' cultural models of illness. Similarity between ethnic members' individual recovery narratives and that of the group may contribute to the appeal of ethnic illness support groups for culturally diverse populations.
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Affiliation(s)
- Jeannine Coreil
- Department of Community and Family Health, University of South Florida, Tampa, FL 33612, USA.
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Burhansstipanov L, Krebs LU, Seals BF, Bradley AA, Kaur JS, Iron P, Dignan MB, Thiel C, Gamito E. Native American breast cancer survivors' physical conditions and quality of life. Cancer 2010; 116:1560-71. [PMID: 20120031 PMCID: PMC2868581 DOI: 10.1002/cncr.24924] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Based on Survivors' Guidance, an interactive, Web-based, culturally relevant Native American cancer survivorship program, Native American Cancer Education for Survivors (NACES), was developed. The focus of the program is to improve quality of life (QOL) for Native American breast cancer survivors. METHODS NACES is a community-driven research and education project, based on the Social Cognitive Theoretical Model. Participants complete a QOL survey that includes physical, psychosocial, spiritual, and social components. This publication focuses on the physical component of the survey collected by trained Native American patient advocates, and compares physical conditions among Native American breast cancer survivors who were diagnosed within 1 year, those diagnosed between 1 and 4 years, and those who are long-term survivors (diagnosed > or = 5 years ago). RESULTS For the first time, survivorship issues are reported specifically for Native American breast cancer patients (n = 266). Selected access issues document situations that contribute to disparities. Comorbidities such as high blood pressure and arthritis are common in the survivors, with more than a third having diabetes, in addition to breast cancer. Numerous side effects from cancer treatments are experienced by these survivors. CONCLUSIONS These data describe what Native American breast cancer patients are experiencing based on self-reported information. Clearly there is need for much more work and long-term tracking of Native American patients to begin to document if or how the severity of physical symptoms lessens over time and if their experiences are significantly different from non-Native Americans.
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Shahid S, Thompson SC. An overview of cancer and beliefs about the disease in Indigenous people of Australia, Canada, New Zealand and the US. Aust N Z J Public Health 2009; 33:109-18. [PMID: 19413852 DOI: 10.1111/j.1753-6405.2009.00355.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Cancer among Indigenous populations in the developed world appears to have increased over past few decades. This article explores issues related to cancer among the Indigenous populations of Australia, Canada, New Zealand and the US and examines variations in the epidemiology, Indigenous peoples' perceptions about cancer and potential effects on care-seeking behaviour. METHODS A search of peer-reviewed journal articles, government reports, published and unpublished theses and other grey literature was undertaken using electronic databases and citation snowballing. Both epidemiological and qualitative studies were included. RESULTS Cancer in Indigenous populations in these four countries is characterised by high incidence and mortality rates for specific cancers and lower survival rates as a result of late diagnosis, lower participation and poorer compliance with treatment. A higher prevalence of many cancer risk factors occurs across these populations. Fear of death, fatalism, payback, shame and other spiritual and cultural issues are reported in the few qualitative studies examining Indigenous beliefs and understanding of cancer which undoubtedly influences participation in cancer screening and treatment. CONCLUSIONS AND IMPLICATIONS The holistic approach (physical, mental, emotional and spiritual) to healing and well-being, and the concept that individual, family and community are inseparable underpin Indigenous care-seeking behaviour. Further community-based research is needed to increase understanding of the needs of Indigenous people with cancer, and to guide policy and practice towards more supportive and effective care.
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Affiliation(s)
- Shaouli Shahid
- Centre for International Health, Curtin University of Technology, Perth WA, Australia.
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Nguyen TUN, Kagawa-Singer M. Overcoming barriers to cancer care through health navigation programs. Semin Oncol Nurs 2009; 24:270-8. [PMID: 19000601 DOI: 10.1016/j.soncn.2008.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To provide an overview of theoretical concepts in community-based, culturally tailored health navigation programs that have improved access to health care for ethnic minority populations, particularly for Asian Americans and Pacific Islanders. DATA SOURCES Published articles, reports, book chapters, government documents, research findings. CONCLUSION Community-based patient navigation interventions provide promising strategies for providing culturally tailored programs that are more likely to succeed in eliminating cancer disparities in screening and early detection of cancers for diverse cultural communities. IMPLICATIONS FOR NURSING PRACTICE Nurses need to be more involved in developing and delivering effective, culturally competent community-based cancer screening and treatment navigation programs through education, practice, research, and policy improvement.
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Hubbard G, Kidd L, Donaghy E. Involving people affected by cancer in research: a review of literature. Eur J Cancer Care (Engl) 2008; 17:233-44. [PMID: 18419626 DOI: 10.1111/j.1365-2354.2007.00842.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of the literature review was to find out why people affected by cancer have been involved in research; how they have been involved and the impact of their involvement. We used systematic methods to search for literature, applied inclusion and exclusion criteria, conducted a quality appraisal, selected relevant data from the included articles for analysis, and provided a narrative summary of these data. The literature shows that people affected by cancer, particularly women with breast cancer, have been involved in a range of research programmes, projects and initiatives especially in the USA, UK, Canada and Australia. Their involvement has impacted upon research design, accrual and response rates. There is increasing recognition of the need for an infrastructure, including formal recruitment procedures, training and mentoring, to support an agenda of involvement and a need to challenge the ethos of traditional research, which does not easily lend itself to this agenda. Further critique of the role of 'experiential knowledge' in research is required so that researchers and people affected by cancer can work in partnership.
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Affiliation(s)
- G Hubbard
- Cancer Care Research Centre, Department of Nursing & Midwifery, University of Stirling, Stirling, UK.
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Watson RA, Sidor M. Bladder Cancer in Native Americans and Alaskan Natives. Urology 2008; 72:10-4. [DOI: 10.1016/j.urology.2007.12.087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Revised: 12/20/2007] [Accepted: 12/21/2007] [Indexed: 11/15/2022]
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Mokuau N, Braun KL. Family support for Native Hawaiian women with breast cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2007; 22:191-6. [PMID: 17760528 DOI: 10.1007/bf03174336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND A cancer diagnosis affects not only the individual but the entire family. Despite the growing body of literature on family support as a resource in cancer care, there is very little research on how cancer affects families in non-Western cultures. A minority population that experiences a disproportionate burden from cancer is Native Hawaiian women. METHODS In this study, 8 Native Hawaiian women with breast cancer and 17 family members of other Native Hawaiian women with breast cancer participated in focus groups examining family support. Specifically, types of support provided by the family (eg, informational, emotional, and tangible), changing dynamics of family roles, and recommendations for health care providers, with attention paid to the influence of culture on family support, were topics that were examined. RESULTS Similarly to other populations, Native Hawaiians viewed the family as the most important source of emotional and tangible support for women with cancer, and identified a need for increased informational support for both patients and families in the face of cancer. However, their reference to specific cultural values and practices within the 'ohana (family) [eg, haku (family liaison) and ho'omana (spirituality)] reflects a uniqueness that has implications for clinical work with this population. CONCLUSIONS Consideration of cultural values and practices may enhance health care services for this population.
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Hubbard G, Kidd L, Donaghy E, McDonald C, Kearney N. A review of literature about involving people affected by cancer in research, policy and planning and practice. PATIENT EDUCATION AND COUNSELING 2007; 65:21-33. [PMID: 16860517 DOI: 10.1016/j.pec.2006.02.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Revised: 01/24/2006] [Accepted: 02/18/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To systematically review the literature on involving people affected by cancer in healthcare research, policy and planning and practice. METHODS Database searches, cited author, and grey literature searches were conducted. RESULTS 131 documents were included. Rationales for the agenda of involvement represent two polar characteristics of modernity: individualism and collectivism. In research, people acted as advocates, strategists, advisors, reviewers and as participatory researchers. In policy and planning, people were involved in one-off involvement exercises and in longer-term partnerships. Men, those with rare cancers, children, and people who are socially deprived have been rarely involved. There is little research evidence about the impact of involvement. Training and information, resources and a change in attitudes and roles are required to implement an agenda of involvement. CONCLUSION The USA, the UK, followed by Canada and Australia have promoted an agenda of involvement. PRACTICE IMPLICATIONS A dissemination strategy to share good practice; involvement of all types of people; an individualised and flexible approach; training, resources and a shift in thinking from paternalism towards partnership working are required. More research is needed about the impact of involvement and relationships between rationales for involvement and implementation.
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Affiliation(s)
- Gill Hubbard
- Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA, United Kingdom.
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Burhansstipanov L. Community-driven Native American cancer survivors' quality of life research priorities. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2005; 20:7-11. [PMID: 15916513 DOI: 10.1207/s15430154jce2001s_03] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND This commentary summarizes quality of life (QOL) research priorities gleaned from three sources: (1) Native survivors who are participating as working group members to develop QOL education modules, (2) enrolled members of the "National Native American Cancer Survivors' Support Network," and (3) participants of the "1st National Native American Cancer Survivors'/Thrivers' Conference." METHODS Criteria for including issues within this summary are that the issue was raised by 8 or more different survivors from at least 2 of the data collection sources. RESULTS The research priorities identified insufficient or lack of access to quality care and resources. CONCLUSIONS Nine research issues were prioritized by Native cancer survivors.
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Mitchell TL, Baker E. Community-building versus career-building research: the challenges, risks, and responsibilities of conducting research with Aboriginal and Native American communities. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2005; 20:41-6. [PMID: 15916520 DOI: 10.1207/s15430154jce2001s_10] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND The Aboriginal Women's Cancer Care Project used a participatory research model guided by an Aboriginal advisory group. METHODS The researchers attempted to conduct cancer research with 5 culturally and geographically different communities in North America. RESULTS We discuss the challenges of conducting ethical research in keeping with the emergent research principles of community ownership and control of the research process and products. CONCLUSIONS Although there are many perils for researchers and communities in conducting participatory research, clearer practice guidelines will ensure that research in Aboriginal communities will increasingly prioritize community- versus career-building outcomes.
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Boyle DA. Cultural Diversity Issues in Cancer Nursing. Oncol Nurs Forum 2004. [DOI: 10.1188/04.onf.686-688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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