Monica Green1, Joan Cunningham2, Kate Anderson2, Kalinda Griffiths2,3, Gail Garvey2. 1. Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia. monica.green@menzies.edu.au. 2. Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia. 3. Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND: Measurement of patients' healthcare experiences is increasingly used as an indicator of quality of care, but there are concerns that existing measures omit information that is meaningful to patients and that results may not be used systematically to inform service improvement. Further, current approaches may be inadequate for some population groups, such as Indigenous people in Australia, whose healthcare experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the Western biomedical health system. This study aimed to assess the extent to which existing patient experience measures used in Australia collect information about critical aspects of cancer care, as previously identified by Indigenous people affected by cancer and their health care providers. METHODS: A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures selected as suitable comparators; (2) comparators were examined in detail and mapped against topics identified in earlier research as important to Indigenous people with cancer. Gaps in topic coverage in comparators were identified. RESULTS: No comparators completely captured the critical aspects of cancer care identified by Indigenous people affected by cancer and their health care providers. The number of topics 'partially' captured by the four comparators ranged from 4 to 7 out of 9. While most topics were partially covered, the lack of questions around culture and cultural safety was notable. CONCLUSIONS: Existing tools are likely to miss key aspects of Indigenous peoples' experiences of cancer care in Australia. Failure to adequately assess care experiences related to cultural safety may compromise efforts to improve health outcomes. Addressing gaps requires development of experience measures that are strengths-based, reflect an Indigenous worldview and measure aspects of experience relevant to Indigenous people.
BACKGROUND: Measurement of patients' healthcare experiences is increasingly used as an indicator of quality of care, but there are concerns that existing measures omit information that is meaningful to patients and that results may not be used systematically to inform service improvement. Further, current approaches may be inadequate for some population groups, such as Indigenous people in Australia, whose healthcare experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the Western biomedical health system. This study aimed to assess the extent to which existing patient experience measures used in Australia collect information about critical aspects of cancer care, as previously identified by Indigenous people affected by cancer and their health care providers. METHODS: A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures selected as suitable comparators; (2) comparators were examined in detail and mapped against topics identified in earlier research as important to Indigenous people with cancer. Gaps in topic coverage in comparators were identified. RESULTS: No comparators completely captured the critical aspects of cancer care identified by Indigenous people affected by cancer and their health care providers. The number of topics 'partially' captured by the four comparators ranged from 4 to 7 out of 9. While most topics were partially covered, the lack of questions around culture and cultural safety was notable. CONCLUSIONS: Existing tools are likely to miss key aspects of Indigenous peoples' experiences of cancer care in Australia. Failure to adequately assess care experiences related to cultural safety may compromise efforts to improve health outcomes. Addressing gaps requires development of experience measures that are strengths-based, reflect an Indigenous worldview and measure aspects of experience relevant to Indigenous people.
Entities:
Keywords:
Aboriginal; Australia; Cancer; Indigenous; Measurement; Patient experience; Person-centred care
Authors: Tamara L Butler; Kate Anderson; Gail Garvey; Joan Cunningham; Julie Ratcliffe; Allison Tong; Lisa J Whop; Alan Cass; Michelle Dickson; Kirsten Howard Journal: Soc Sci Med Date: 2019-06-05 Impact factor: 4.634
Authors: Emma V Taylor; Marilyn Lyford; Michele Holloway; Lorraine Parsons; Toni Mason; Sabe Sabesan; Sandra C Thompson Journal: BMC Health Serv Res Date: 2021-05-24 Impact factor: 2.655