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Culture-broker and medical decoder: contributions of caregivers in American Indian cancer trajectories
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Culture-broker and medical decoder: contributions of caregivers in American Indian cancer trajectories
Background Caregivers play a special role in the management and control of cancer-related pain. For American Indians with cancer, caregivers can contribute to patient education, medication compliance, and can facilitate communication between the patient and the provider and the patient and the family.
Objective To identify the role(s) of caregivers of American Indian cancer survivors.
Methods As a part of a large randomized intervention designed to improve barriers to cancer symptom management, 13 focus groups were held among American Indian cancer survivors and their caregivers at Southwest reservations and urban sites. Focus groups, audiotaped and transcribed, used constant comparative methods in the analysis of caregiver dialogues.
Results Caregivers are patient educators and provider culture-brokers and their communication strategies use a combination of cultural and conventional strategies in their care of American Indian cancer patients. Cultural communication styles include “talk stories” (storytelling), group (talking circles), and dialogue to manage cancer pain, educate the patient and community, and to protect the patient from stigma, reduce barriers to care, and provide support to patients and families. Active discussion with providers “re-packaged” the patient’s reporting/responses to specific clinical measures (pain measure scores) and identified the need for pain medication and compliance-related issues.
Limitations Findings are not generalizable to the American Indian population outside of the sites and focus groups from which data were collected.
Conclusions Caregivers are “cultural brokers” who inform providers of the cultural nuances associated with American Indian patient care. However, caregivers voiced that cultural restriction for not discussing illness openly was a sanction and an important barrier.
Funding National Cancer Institute, NIH, grant R01CA115358
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The Journal of Community and Supportive Oncology - 14(5)
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221-228
Legacy Keywords
American Indian, symptom management, barriers to care, caregivers
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Background Caregivers play a special role in the management and control of cancer-related pain. For American Indians with cancer, caregivers can contribute to patient education, medication compliance, and can facilitate communication between the patient and the provider and the patient and the family.
Objective To identify the role(s) of caregivers of American Indian cancer survivors.
Methods As a part of a large randomized intervention designed to improve barriers to cancer symptom management, 13 focus groups were held among American Indian cancer survivors and their caregivers at Southwest reservations and urban sites. Focus groups, audiotaped and transcribed, used constant comparative methods in the analysis of caregiver dialogues.
Results Caregivers are patient educators and provider culture-brokers and their communication strategies use a combination of cultural and conventional strategies in their care of American Indian cancer patients. Cultural communication styles include “talk stories” (storytelling), group (talking circles), and dialogue to manage cancer pain, educate the patient and community, and to protect the patient from stigma, reduce barriers to care, and provide support to patients and families. Active discussion with providers “re-packaged” the patient’s reporting/responses to specific clinical measures (pain measure scores) and identified the need for pain medication and compliance-related issues.
Limitations Findings are not generalizable to the American Indian population outside of the sites and focus groups from which data were collected.
Conclusions Caregivers are “cultural brokers” who inform providers of the cultural nuances associated with American Indian patient care. However, caregivers voiced that cultural restriction for not discussing illness openly was a sanction and an important barrier.
Funding National Cancer Institute, NIH, grant R01CA115358
Click on the PDF icon at the top of this introduction to read the full article.
Background Caregivers play a special role in the management and control of cancer-related pain. For American Indians with cancer, caregivers can contribute to patient education, medication compliance, and can facilitate communication between the patient and the provider and the patient and the family.
Objective To identify the role(s) of caregivers of American Indian cancer survivors.
Methods As a part of a large randomized intervention designed to improve barriers to cancer symptom management, 13 focus groups were held among American Indian cancer survivors and their caregivers at Southwest reservations and urban sites. Focus groups, audiotaped and transcribed, used constant comparative methods in the analysis of caregiver dialogues.
Results Caregivers are patient educators and provider culture-brokers and their communication strategies use a combination of cultural and conventional strategies in their care of American Indian cancer patients. Cultural communication styles include “talk stories” (storytelling), group (talking circles), and dialogue to manage cancer pain, educate the patient and community, and to protect the patient from stigma, reduce barriers to care, and provide support to patients and families. Active discussion with providers “re-packaged” the patient’s reporting/responses to specific clinical measures (pain measure scores) and identified the need for pain medication and compliance-related issues.
Limitations Findings are not generalizable to the American Indian population outside of the sites and focus groups from which data were collected.
Conclusions Caregivers are “cultural brokers” who inform providers of the cultural nuances associated with American Indian patient care. However, caregivers voiced that cultural restriction for not discussing illness openly was a sanction and an important barrier.
Funding National Cancer Institute, NIH, grant R01CA115358
Click on the PDF icon at the top of this introduction to read the full article.
Issue
The Journal of Community and Supportive Oncology - 14(5)
Issue
The Journal of Community and Supportive Oncology - 14(5)
Page Number
221-228
Page Number
221-228
Topics
Article Type
Display Headline
Culture-broker and medical decoder: contributions of caregivers in American Indian cancer trajectories
Display Headline
Culture-broker and medical decoder: contributions of caregivers in American Indian cancer trajectories
Legacy Keywords
American Indian, symptom management, barriers to care, caregivers
Legacy Keywords
American Indian, symptom management, barriers to care, caregivers
Sections
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JCSO 2016;14:221-22
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