Mary J Isaacson1, Tinka Duran2, Gina Johnson2, Alexander Soltoff3, Sean Jackson2, Daniel Petereit4, Katrina Armstrong5, Bethany-Rose Daubman6. 1. South Dakota State University, College of Nursing (M.J.I.), Rapid City, South Dakota, USA. Electronic address: Mary.isaacson@sdstate.edu. 2. Great Plains Tribal Leaders Health Board (T.D., G.J., S.J.), Rapid City, South Dakota, USA. 3. Department of Medicine (A.S.), Massachusetts General Hospital, Boston, Massachusetts, USA. 4. Department of Radiation Oncology (D.P.), Monument Health Cancer Care Institute, Walking Forward, Avera Research Institute, Avera Health, Rapid City, South Dakota, USA. 5. Dean, Vagelos College of Physicians and Surgeons, Columbia University, New York. 6. Division of Palliative Care and Geriatric Medicine (B.-R. D.), Massachusetts General Hospital, Boston, Massachusetts, USA.
Abstract
CONTEXT: American Indians (AIs) are disproportionately affected by serious illness such as cancer. Colonization, cultural genocide, and trauma have adversely affected AIs' ability to attain health and well-being, and in many cases led to the loss of the right to practice traditional ceremonies and rituals. Still many AIs describe well-being as being rooted in spirituality. OBJECTIVES: The purpose of this project was to learn about the perspectives of AI cancer survivors, caregivers, and Tribal leaders and healers specific to spirituality while on the cancer journey. METHODS: Qualitative interviews and Indigenous talking circle methodologies were used to explore AIs cancer survivors, caregivers, and Tribal leaders and healers' perspectives on spirituality while on the cancer journey. A data analysis team consisting of AI and non-AI members analyzed the narrative data. RESULTS: Qualitative analysis of interviews and talking circles revealed 4 major themes related to spirituality: the chasm of colonialism, coexistence of Traditional and Christian religions, calling the Spirit back, and prayer as sacred energy. CONCLUSION: It is critical that clinicians caring for AIs with serious illness seek to understand their patients' spiritual beliefs about disease treatment and death and work with them and their families to support quality of life throughout their illness journey. In addition, clinicians must recognize the systemic racism inherent in our healthcare systems, and dismantle cultural clashes and bias for all patients, particularly AIs, who have long suffered from poorer health outcomes.
CONTEXT: American Indians (AIs) are disproportionately affected by serious illness such as cancer. Colonization, cultural genocide, and trauma have adversely affected AIs' ability to attain health and well-being, and in many cases led to the loss of the right to practice traditional ceremonies and rituals. Still many AIs describe well-being as being rooted in spirituality. OBJECTIVES: The purpose of this project was to learn about the perspectives of AI cancer survivors, caregivers, and Tribal leaders and healers specific to spirituality while on the cancer journey. METHODS: Qualitative interviews and Indigenous talking circle methodologies were used to explore AIs cancer survivors, caregivers, and Tribal leaders and healers' perspectives on spirituality while on the cancer journey. A data analysis team consisting of AI and non-AI members analyzed the narrative data. RESULTS: Qualitative analysis of interviews and talking circles revealed 4 major themes related to spirituality: the chasm of colonialism, coexistence of Traditional and Christian religions, calling the Spirit back, and prayer as sacred energy. CONCLUSION: It is critical that clinicians caring for AIs with serious illness seek to understand their patients' spiritual beliefs about disease treatment and death and work with them and their families to support quality of life throughout their illness journey. In addition, clinicians must recognize the systemic racism inherent in our healthcare systems, and dismantle cultural clashes and bias for all patients, particularly AIs, who have long suffered from poorer health outcomes.
Authors: David K Espey; Melissa A Jim; Nathaniel Cobb; Michael Bartholomew; Tom Becker; Don Haverkamp; Marcus Plescia Journal: Am J Public Health Date: 2014-04-22 Impact factor: 9.308
Authors: Shaouli Shahid; Emma V Taylor; Shelley Cheetham; John A Woods; Samar M Aoun; Sandra C Thompson Journal: BMC Palliat Care Date: 2018-05-08 Impact factor: 3.234