Collegian
Volume 14, Issue 3 , Pages 21-26, 2007

Practical Problems for Aboriginal Palliative Care Service Provision in Rural and Remote Areas: Equipment, Power and Travel Issues

International Program for Psycho-Social Health Research, Central Queensland University, Queensland

Article Outline

With regards to end-of-life care, there is scant published research that looks specifically at the provision of palliative care services for Indigenous people. In addition, for Indigenous people in the rural and remote areas there is only limited literature that focuses on the problems associated with geography. To address the hiatus in the literature on Aboriginal, rural and remote palliative care, the following article provides findings from a two-year research project, funded by Australia's National Health and Medical Research Council (NH&MRC), which developed an innovative model for Indigenous palliative care. The data was collected through a qualitative methodology (descriptive phenomenology) which involved open-ended in-depth interviews, audio-recorded, transcribed verbatim and thematically analysed. The sub-set of findings from the study presented in this paper examine issues in relation to the many practical obstacles in relation to palliative care service provision to Indigenous people in the rural and remote areas. The findings are a testament to the ingenuity and dedication of those who provide end-of-life care for Aboriginal peoples in rural and remote locations. The information about the many obstacles associated with equipment, power, transport, distance and telephone access provide important insights to inform the development of health policy planning and funding. The topic is specifically relevant to nurses as further findings from the study indicate that clinic and community nurses are key health professionals providing care to Indigenous people in the rural and remote areas.

Key words:  Aboriginal , Indigenous , palliative care , obstacles , qualitative research

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References 

  1. Australia Parliament  . House of Representatives standing committee on Aboriginal affairs, Aboriginal health . Canberra: Australian Government Publishing Service.; 1979;
  2. Australian Bureau of Statistics. (2004). Population and housing. Urban Centres and Locations 2001 cat no.2016.7
  3. Australian Institute of Aboriginal and Torres Strait Islander Health Research. (2004). Ethical guidelines for research. Retrieved from the World Wide Web n.d: http://www.aiatsis.gov.au/research_program/publications
  4. Australian Institute of Health and Welfare (AIHW)  . Australia's health, 1996 . Canberra: Australian Government Publishing Service.; 1996;
  5. Baltic T , Whedon M , Ables T , Fanciullo G . Improving pain relief in a rural cancer centre . Cancer Practice . 2002;10(Suppl 1):S39–S44
  6. Clark D , Ingleton C , Hughes P , Yap T , Noble B . Evaluation of a scheme to enhance palliative cancer care in rural Wales . Supportive Care in Cancer . 2004;12(10):683–691
  7. Crawford G . Palliative care on Kangaroo Island . Australian Journal of Rural Health . 2000;8(1):35–40
  8. Crombie I . Research in Health Care . New York: John Wiley & Sons.; 1996;
  9. Elsey B , McIntyre J . Assessing a support and learning network for palliative care workers in a country area of South Australia . Australian Journal of Rural Health . 1996;4(3):159–164
  10. Evans R , Stone D , Elwyn G . Organising palliative care for rural populations: a systematic review of the evidence . Family Practice . 2003;20(3):304–310
  11. Greenhalgh T , Taylor R . Papers that go beyond numbers (qualitative research) . British Medical Journal . 1997;315:740–743
  12. Holloway I . Basic concepts for qualitative research . Oxford: Blackwell Science.; 1997;
  13. Humphreys J , Murray D . The national rural health strategy . Australian Journal of Rural Health . 1994;2:25–31
  14. Keleher H , Ellis J . Rural people utilizing city hospitals: Issues for service provision . Australian Journal Rural Health . 1996;4:144–150
  15. Kelley M , Habjan S , Aegard J . Building capacity to provide palliative care in rural and remote communities: Does education make a difference? . Journal of Palliative Care . 2004;20(4):308–315
  16. Kitzes J , Berger L . End-of-life issues for American Indians/Alaska Natives: Insights from one Indian health service area . Journal of Palliative Medicine . 2004;7(6):830–838
  17. McConigley R , Kristjanson L , Morgan A . Research study. Palliative care nursing in rural Western Australia . International Journal of Palliative Nursing . 2000;6(2):80–90
  18. McConigley R , Kristjanson L , Nikoletti S . Palliative care in Western Australia: An assessment of information and support needs . International Journal of Palliative Nursing . 2001;7(11):555–564
  19. McGrath P . Experience of relocation for specialist treatment for haematological malignancies . Cancer Strategy . 1999;1:157–163
  20. McGrath P . Exploring Aboriginal peoples' experience of relocation for treatment during end-of-life care . International Journal of Palliative Nursing . 2006;12(2):75–82
  21. McGrath P , Holewa H , Ogilvie K , Rayner R , Patton M . Insights on the Aboriginal view of cancer . Contemporary Nurse . 2006;22(2):240–254
  22. McGrath P , Ogilvie K , Rayner R , Holewa H , Patton M . The ‘right story’ to the ‘right person’: Communication issues in end-of-life care for Indigenous people . Australian Health Review . 2005;29(3):306–316
  23. McGrath P , Patton M . Relocation for specialist treatment for Indigenous people: escort issues . Journal of Rural and Tropical Public Health . 2006;5:16–26
  24. McGrath P , Patton M , Holewa H , Rayner R . The importance of the ‘family meeting’ in health care communication with Indigenous people: Findings from an Australian study . Australian Journal of Primary Health . 2006;12(1):56–64
  25. McGrath P , Patton M , McGrath Z , Ogilvie K , Rayner R , Holewa H . ‘It's very difficult to get respite out here at the moment’: Australian findings on end-of-life care for Indigenous people . Health and Social Care in the Community . 2006;14(2):147–155
  26. McGrath, P., Watson, J., Derschow, B., Murphy, S., & Rayner, R. (2004). Indigenous palliative care service delivery — a living model. Darwin: Uni Print, Charles Darwin University. www.opp-shr.cqu.edu.au
  27. McRae S , Caty S , Nelder M , Picard L . Palliative care on Manitoulin Island. Views of family caregivers in remote communities . Canadian family physician . 2000;46:1301–1307
  28. National Health and Medical Research Council. (2004). Values & ethics: Guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research. Retrieved from the World Wide Web n.d: http://www7.health.gov.au/nhmrc/publications/_files/e52.pdf
  29. O'Donoghue L . Towards a culture of improving Indigenous health in Australia . Australian Journal of Rural Health . 1999;7(1):64–70
  30. Polit D , Hungler B . Nursing research: Principles and methods . 5th ed.. Philadelphia: Lippincott; 1995;
  31. Sach J . Issues for palliative care in rural Australia . Collegian . 1997;4(3):22–27 41.
  32. Smith T, Desch C, Grasso M, McCue M, Buonaiuto D, Grasso K, et al. The rural cancer Australian Institute of Health and Welfare outreach program: Clinical and financial analysis of palliative and curative care for an underserved population . Cancer Treatment Reviews . 1996;22(Suppl A):97–101
  33. Streubert K , Carpenter D . Qualitative research in nursing: Advancing the humanistic imperative . Philadelphia: Lippincott.; 1995;
  34. Sullivan K, Johnston L, Colyer C, Beale J, Willis J, Harrison J, et al. National Indigenous palliative care needs study . The National Palliative Care Program, Australian Government-Department of Health and Ageing, ACT; 2003;
  35. Thomson N . Australian Aboriginal health and health care . Social Science and Medicine . 1984;18(11):939–948
  36. Trollor J . Rural general practitioners and palliative care in the north-west of New South Wales . Australian Family Physician . 1995;24(6):1106–1109 1112–1113.
  37. White K , Wall D , Kristjanson L . Out of sight out of mind: Reframing remoteness in providing palliative care in remote Australia . Collegian . 2004;11(3):29–33
  38. Wilkes L , White K . The family and nurse in partnership: Providing day-today care for rural cancer patients . Australian Journal of Rural Health . 2005;13(2):121–126

PII: S1322-7696(08)60561-2

doi:10.1016/S1322-7696(08)60561-2

Collegian
Volume 14, Issue 3 , Pages 21-26, 2007

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