Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Aboriginal and Torres Strait Islander peoples’ views and perceptions of pathways to pain management and early palliative care for people with pancreatic cancer   (#61)

Gail Garvey 1 , Isabel E Young 2 , Melanie Lovell 2 , Mei Krishnasamy 3 , Gregory Crawford 4 5 , Nicole Rankin 6 , Kara Burns 7 , Kylee Bellingham 8 , Georgia Christopolous 8 , Farwa Rizvi 8 , Jennifer Philip 8 9 10
  1. Indigenous Health Research, Univeristy of Queensland, Brisbane, Queensland, Australia
  2. Palliative Care, HammondCare, Greenwich , NSW, Australia
  3. School of Nursing, University of Melbourne, Parkville, Vic, Australia
  4. Medicine, University of Adelaide, Adelaide, South Australia, Australia
  5. Palliative Medicine, Lyell McEwin Hospital, Modbury, South Australia, Australia
  6. School of Population and Global Health, University of Melbourne, Parkville, Vic, Australia
  7. Centre for Digital Transformation of Health, University of Melbourne, Parkville, Vic, Australia
  8. Medicine, University of Melbourne , Parkville, Victoria, Australia
  9. Victorian Comprehensive Cancer Centre, University of Melbourne, Parkville, Vic, Australia
  10. St Vincent's Hospital, Fitzroy , VIC, Australia

Aims:  To develop pathways to timely pain management, including interventional pain management and palliative care, with supporting materials for people with pancreatic cancer. The need for this work was set out in the National Pancreatic Cancer Roadmap, developed by Cancer Australia.

Method: Themed working groups involving clinicians and community members were established to develop and review evidence-based summaries. Four online Yarning groups facilitated by a senior Aboriginal researcher were held with Aboriginal and Torres Strait Islander health workers from different Australian states and regional areas. Participants reviewed the relevance, applicability, and provided broad reflections of the pain assessment and management, palliative care, education and information, and implementation materials. Feedback was re-presented to working groups for consideration and adaptation. 

Results: A number of discussion points raised in the Yarning groups had resonance for, and resulted in modifications of, all components of the pathways, clinical guidance and education/information resources developed.

Key points highlighted across all Yarning groups were:

  • The person is the expert of their own experience.
  • The focus of care and language should be around ‘self-determination’.
  • Trust is imperative to and within health care professional interactions, with relationships being central to care.
  • Historical and current trauma will influence the experiences of symptoms and illness, and also the expression of pain.
  • The importance of acknowledging and using cultural strengths including truth telling and storytelling.
  • The importance of giving examples of other patients’ stories and outcomes.
  • The need for early involvement of Aboriginal and Torres Strait Islander Health Workers to support patients across the care pathway.

Conclusion: Yarning groups with Aboriginal and Torres Strait Islander health workers were enormously rich, and the outcomes of these discussions led to adjustments and improvements of the national pathways and supporting materials.