Satisfaction with cancer care among American Indian and Alaska Natives in Oregon and Washington State: a qualitative study of survivor and caregiver perspectives

• Published in: Supportive care in cancer Vol. 24; no. 6; pp. 2437 - 2444
• Main Authors: Hohl, Sarah, Molina, Yamile, Koepl, Lisel, Lopez, Kerri, Vinson, Eric, Linden, Hannah, Ramsey, Scott
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2016; Springer; Springer Nature B.V
• Subjects: Alaska; Alaska Natives - psychology; Analysis; Cancer; Caregivers; Caregivers - standards; Content analysis; Empathy; Female; Humans; Indians, North American - psychology; Medicine; Medicine & Public Health; Native Americans; Native North Americans; Neoplasms - ethnology; Neoplasms - psychology; Neoplasms - therapy; Nursing; Nursing Research; Oncology; Oregon; Original Article; Pain Medicine; Patient satisfaction; Patient Satisfaction - ethnology; Physician patient relationships; Qualitative Research; Rehabilitation Medicine; Survivors; United States; Washington; Oregon; Alaska; United States; Washington; Cultural competence; Cancer health disparities; Patient-provider relationship; Satisfaction with care; Survivorship; Race/ethnicity
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-015-3041-x

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.