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• W142048026 abstract "This study aims to explore the meaning of cancer for rural Aboriginal women and the cultural context that influences their decision-making about cancer treatment and support services. The motive for this study is to understand why Aboriginal women participate in cancer screening programs but are either reluctant to return for follow-up of abnormal test results or hesitant to follow medical advice about treatment.  Cancer has been considered a lesser problem for Aboriginal women because they suffer morbidities from other systemic diseases and have a relatively short life expectancy, approximately twenty years less than non-Aboriginal women. But recent epidemiological observations demonstrate an increasing incidence of respiratory system cancers, particularly smoking related diseases, in the Aboriginal population generally and a growing incidence of cervical and breasts cancers in Aboriginal women, who also suffer a disproportionate cancer mortality rate compared to other Australian women. This thesis reports on interviews and fieldwork observations I undertook in two rural Aboriginal communities in Queensland. I used the broad approach of interpretive ethnography as the methodology for this study. The principal method is fieldwork, which involves my spending time living in the communities and experiencing first hand the context that is the everyday world of the participants. My fieldwork data collection occurred over two years, during which I have made numerous field visits of one to two weeks at a time. To facilitate my data collection, I engaged two local women to act as field mentors and mediators, and to escort me around their respective communities. Being with these 'insiders' enhanced my research position in developing the researcher-participant relationship necessary to generate rich data and unique opportunities to observe close-up the lives of many different participants. Data collection methods were face-to-face interviews, focus groups and participant observation. Other sources of data were medical records, historical documents and government reports. I used the conceptual frame of cultural identity, relationship and expectations and cultural empowerment from the PEN-3 model to highlight the cultural constructs that emerged from the data.  The findings are that many Aboriginal women blame the whiteman's invasion and colonisation of their traditional way of life and denigration of their culture for the increasing prevalence of cancer in their communities. Cancer is a dreaded disease in all societies, but, for Aboriginal women, it presents an additional threat of positioning them, as once again, vulnerable to what is perceived as the colonial mentality of Western biomedical institutions. A consequence of this tension is that the women avoid the risk of becoming entrapped in the biomedical system by, for example, denying their symptoms or ignoring medical advice about following-up abnormal cancer tests. Consequently the women are likely to present with late stage disease at the time of diagnosis, which means treatment options are palliative rather than curative. Even with palliative care holistic options for symptom management many of the women remain ambivalent about following medical advice. The women choose instead to go their own way, which usually means returning to their rural community where predominantly primary health services are available. Another important finding is that the cultural needs of Aboriginal women for family support and care are compromised in the biomedical institution of a city hospital. A concern of the women with cancer is that being in a city or regional hospital hinders access to traditional medicine and healers, which are considered vital in holistic care of the sick person and their families, and necessary in preparing for the transition from life to death.   I propose that public health strategies for reducing cancer morbidity and mortality rates of rural Aboriginal women should be focused on an agenda for promoting cultural empowerment which profiles Aboriginal culture in all stages of cancer related services or interventions for this population. This approach involves a program that increases understanding and respect for Aboriginal culture among non-Aboriginal health-care staff and means that culture is the central point from which services are developed. A key strategy for cultural empowerment is recognizing the cultural significance of the sick person's need to be with family and friends and in their community, particularly when in the palliative phase of the disease. I propose that a palliative care approach that promotes cultural empowerment builds on the 'cultural strength' of a community and is a service that works to complement or integrate traditional practice and healing processes rather than imposing Western methods as the dominant paradigm." @default.
• W142048026 created "2016-06-24" @default.
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• W142048026 date "2017-06-26" @default.
• W142048026 modified "2023-09-27" @default.
• W142048026 title "Cultural strengths and social needs of Aboriginal women with cancer : take away the cancer but leave me whole" @default.
• W142048026 doi "https://doi.org/10.14264/uql.2017.626" @default.
• W142048026 hasPublicationYear "2017" @default.
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