"Are They Just Experimenting With All of Us?" Cultural Considerations for Clinicians Caring for Seriously Ill Great Plains American Indians.

Abstract

Context: Serious illnesses like cancer disproportionately affect American Indians and Alaska Native (AI/AN) Peoples. AI/AN patients deserve culturally responsive healthcare at all times, and especially when journeying through serious illness. Objectives: To learn about specific clinician-related factors that AI/AN cancer survivors, caregivers, Tribal leaders, and traditional healers want from their clinicians while experiencing cancer. Methods: We utilized qualitative interviews and Indigenous talking circles to explore perspectives on what type of clinician education, communication approaches, and clinical resources are desired so that clinicians may provide culturally responsive care to AI/AN peoples experiencing cancer. Analysis was completed via a team of Native and non-Native researchers analyzing narrative data from AI/AN cancer survivors, caregivers, Tribal leaders, and traditional healers. Results: Interviews and talking circle qualitative analysis revealed 3 major themes related to clinician needs: cultural considerations, psychosocial support, and trust. Conclusion: Any clinician caring for AI/AN peoples with serious illness such as cancer needs to understand clinician-related factors that AI/ANs say impact their care when experiencing serious illness. It is important for clinicians to engage in cultural education and work to improve systemic deficiencies such as a lack of psychosocial support. An overarching theme was also the need for clinicians to seek to develop trustworthiness and earn trust when caring for AI/AN patients experiencing serious illness.