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Disparities in cancer care: Perspectives from the front line

Published online by Cambridge University Press:  10 May 2013

Patricia A. Miller ,
Christina Sinding ,
Patti McGillicuddy ,
Judy Gould ,
Donna Fitzpatrick-Lewis ,
Linda Learn ,
Jennifer Wiernikowski  and
Margaret I. Fitch
Patricia A. Miller*
Affiliation:
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Christina Sinding
Affiliation:
School of Social Work, McMaster University, Hamilton, Ontario, Canada Department of Health, Aging and Society, McMaster University, Hamilton, Ontario, Canada
Patti McGillicuddy
Affiliation:
University Health Network, Toronto, Ontario, Canada Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
Judy Gould
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Donna Fitzpatrick-Lewis
Affiliation:
School of Social Work, McMaster University, Hamilton, Ontario, Canada
Linda Learn
Affiliation:
Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Jennifer Wiernikowski
Affiliation:
Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada School of Nursing, McMaster University, Hamilton, Ontario, Canada
Margaret I. Fitch
Affiliation:
Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
*
Address correspondence and reprint requests to: Patricia A. Miller, 5 Undercliffe Avenue, Hamilton, Ontario, CanadaL8P 3G9. E-mail: [email protected]
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Abstract

Objective:

The purpose of this qualitative study was to investigate how frontline healthcare professionals witness and understand disparity in cancer care.

Method:

Six healthcare providers from a range of care settings, none with < 15 years of frontline experience, engaged with researchers in an iterative process of identifying and reflecting on equity and disparity in cancer care. This knowledge exchange began with formal interviews. Thematic analysis of the interviews form the basis of this article.

Results:

Participants drew attention to health systems issues, the meaning and experience of discontinuities in care for patients at personal and community levels, and the significance of social supports. Other concerns raised by participants were typical of the literature on healthcare disparities.

Significance of results:

Providers at the front lines of care offer a rich source of insight into the operation of disparities, pointing to mechanisms rarely identified in traditional quantitative studies. They are also well positioned to advocate for more equitable care at the local level.

Keywords

CancerHealth disparitiesHealthcare providersQualitative researchCoordination of care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 3 , June 2014 , pp. 175 - 181
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Armstrong, P. & Armstrong, H. (1999). Women, Privatization and Health Care Reform: The Ontario Scan. Toronto: National Network on Environments and Women's Health, York University.Google Scholar
Beagan, B.L. (2003). Teaching social and cultural awareness to medical students: “It's all very nice to talk about it in theory, but ultimately it makes no difference.” Academic Medicine, 78, 605–614.Google Scholar
Berkman, L.F., Glass, T., Brissette, I., et al. (2000). From social integration to health: Durkheim in the new millennium. Social Science and Medicine, 51, 843–857.Google Scholar
Best, A., Hiatt, R.A. & Norman, C.D. (2008). Knowledge integration: Conceptualizing communication in cancer control systems. Patient Education and Counseling, 71, 319–327.Google Scholar
Braveman, P. (2006). Health disparities and health equity: Concepts and measurement. Annual Review of Public Health, 27, 167–94.Google Scholar
Cancer Action Team. (2008). Cancer Action: A Newsletter from the Cancer Action Team, Edition 26. Action for London 2007–2012: A Nursing Vision for Cancer Care in the Capitol. http://www.improvement.nhs.uk/cancer/documents/CANCER%20ACTION%20EDITION%2026.pdf.Google Scholar
Cresswell, J.W. (1998). Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks, CA: Sage.Google Scholar
Goss, E., Lopes, A.M., Brown, C.L., et al. (2009). American Society of Clinical Oncology Policy Statement: Disparities in Cancer Care. Journal of Clinical Oncology, 27, 2881–2885.Google Scholar
Graham, H. (1991). The informal sector of welfare: A crisis in caring? Social Science and Medicine, 32, 507–515.Google Scholar
Graham, I.D., Logan, J., Harrison, M.B., et al. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26, 13–24.CrossRefGoogle ScholarPubMed
Howell, D.M., Sussman, J., Weirnikowski, J., et al. (2008). A mixed methods evaluation of nurse-led community-based supportive care. Supportive Care in Cancer, 16, 1243–1352.Google Scholar
Huang, J., Groome, P., Tyldesley, S., et al. (2001). Factors affecting the use of palliative radiotherapy in Ontario. Journal of Clinical Oncology, 19, 137–144.Google Scholar
Kagawa-Singer, M., Dadia, A.V., Yu, M.C., et al. (2010). Cancer, culture, and health disparities: A time to chart a new course? CA: A Cancer Journal for Clinicians, 60, 12–39.Google Scholar
Krieger, N. (2005). Defining and investigating social disparities in cancer: Critical issues. Cancer Causes Control, 16, 5–14.Google Scholar
Maddison, A.R., Asada, Y. & Urquhart, R. (2011). Inequity in access to cancer care: A review of Canadian literature. Cancer Causes Control, 22, 359–366.Google Scholar
Marks, L. (2006). An evidence base for tackling inequalities in health: Distraction or necessity? Critical Public Health, 16, 61–71.CrossRefGoogle Scholar
McKeever, P. (1996). The family: Long-term care research and policy formulation. Nursing Inquiry, 3, 200–206.Google Scholar
Reblin, M. & Uchino, B.N. (2008). Social and emotional support and its implication for health. Current Opinion in Psychiatry, 21, 210–205.Google Scholar
Siminoff, L.A. & Ross, L. (2005). Access and equity to cancer care in the USA: A review and assessment. Postgraduate Medicine, 81, 674–679.Google Scholar
Sinding, C. (2004). Informal care – Two-tiered care? The work of family members and friends in hospitals and cancer centres. Journal of Sociology and Social Welfare, 31, 69–86.Google Scholar
Sinding, C. (2010). Using institutional ethnography to understand the production of health care disparities. Qualitative Health Research, 20, 1656–1663.Google Scholar
Sinding, C., Hudak, P., Wiernikowski, J., et al. (2010). “I like to be an informed person but…” Negotiating responsibility for treatment decisions in cancer care. Social Science and Medicine, 71, 1094–1101.Google Scholar
Sinding, C., Miller, P., Hudak, P., et al. (2012). Of time and troubles: Patient involvement and the production of health care disparities. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 16, 400–417.Google Scholar
Steinberg, M.L. (2008). Inequity in cancer care: Explanations and solution for disparity. Seminars in Radiation Oncology, 18, 161–167.CrossRefGoogle ScholarPubMed
Stienstra, D., D'Aubin, A. & Derksen, J. (2012). Heightened vulnerabilities and better care for all: Disability and end-of-life care. Palliative and Supportive Care, 10, 17–26.Google Scholar
Surbone, A. (2010). Cultural competence in oncology: Where do we stand? Annals of Oncology, 21, 3–5.Google Scholar
Uchino, B.N. (2009). Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science, 4, 236–255.Google Scholar
Wilkinson, S. (2004). Focus group research. In Qualitative Research: Theory, Method and Practice, 2 ndEd. Silverman, D. (ed.), Thousand Oaks, CA: Sage.Google Scholar