A qualitative study of Samoan cancer patients' experiences.

Alice Every, Beatriz Cuesta-Briand, Dyxon Hansell, Shelley Burich, Fuamatala Tofilua, Gregory B Crawford, Aileen Collier
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Abstract

Methods: This qualitative interview study was part of a larger study that interviewed19 participants recruited among patients with cancer registered with Samoa Cancer Society, or patients recently discharged from the main tertiary hospital in Samoa. Interview transcripts were reviewed, and the research team identified the key palliative-care-related themes.

Results: Analysis led to the generation of the following key themes: living with pain; resource constraints; support from family and faith; and interactions with healthcare professionals. Most participants were experiencing unresolved pain as a result of poor health knowledge, lack of access to medications and practical issues, such as financial limitations and lack of transport. Participants also reported a lack of resources, including financial constraints, as a significant barrier to effective healthcare. Sources of support for patients with cancer were most commonly strong family relationships and religious faith. Although it was difficult for the participants to access care from healthcare professionals, they found that honest communication about their condition was comforting. However, they were frustrated if they felt communication was unsatisfactory.

Conclusion: This study provides much needed evidence on the issues that affect the quality of life patients with cancer receiving palliative care and their families in Samoa. It also highlights the intersectionality of these issues and how this compounds the patient experience. Practical recommendations for improving palliative care lie in a few key areas, including a need for improved access to opioids and support for family caregivers. However, from a systemic perspective, the way forward should lie in harnessing the strengths of Samoan culture, including the strong sense of family and the role of religion, to provide support and care for palliative patients.

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萨摩亚癌症患者经历的定性研究。
研究方法:这项定性访谈研究是一项大型研究的一部分,该研究从萨摩亚癌症协会登记的癌症患者或最近从萨摩亚主要三级医院出院的患者中招募了19名参与者进行访谈。研究小组对访谈记录进行了审查,并确定了与姑息关怀相关的关键主题:分析得出以下关键主题:带着疼痛生活;资源限制;来自家庭和信仰的支持;与医护人员的互动。大多数参与者由于健康知识匮乏、无法获得药物以及经济限制和交通不便等实际问题而经历着无法解决的疼痛。参与者还表示,资源匮乏(包括经济拮据)也是有效医疗保健的一大障碍。癌症患者的支持来源通常是牢固的家庭关系和宗教信仰。虽然参与者很难从医护人员那里获得治疗,但他们发现,就自己的病情进行坦诚交流会让他们感到欣慰。然而,如果他们觉得沟通不令人满意,就会感到沮丧:这项研究为萨摩亚接受姑息关怀的癌症患者及其家属提供了亟需的证据,说明影响他们生活质量的问题。它还强调了这些问题的交叉性,以及这如何加剧了病人的体验。改善姑息关怀的实用建议主要集中在几个关键领域,包括需要改善阿片类药物的获取和对家庭照护者的支持。然而,从系统的角度来看,前进的道路应在于利用萨摩亚文化的优势,包括强烈的家庭意识和宗教的作用,为姑息治疗患者提供支持和关怀。
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