RESUMO
This paper explores the bioethical issues associated with the diagnosis and treatment of vulvar cancer for Indigenous women in East Arnhem Land, Northern Territory, Australia. Based on a qualitative study of a vulvar cancer cluster of Indigenous women, the article highlights four main topics of bioethical concern drawn from the findings: informed consent, removal of body parts, pain management, and issues at the interface of Indigenous and Western health care. The article seeks to make a contribution towards Indigenous health and bioethics and bring to light areas of further research.
Assuntos
Atenção à Saúde/ética , Ética Clínica , Serviços de Saúde do Indígena/ética , Havaiano Nativo ou Outro Ilhéu do Pacífico , Neoplasias Vulvares/terapia , Bioética , Competência Cultural , Feminino , Humanos , Consentimento Livre e Esclarecido/ética , Northern Territory , Manejo da Dor , Pesquisa Qualitativa , Neoplasias Vulvares/diagnósticoRESUMO
Vulvar cancer is a serious condition that requires a range of specialist treatments including surgery, chemotherapy, and radiation. In Australia, such treatments are only available in major metropolitan hospitals. Thus, women diagnosed with this condition in rural and remote areas must relocate to the metropolitan specialist centers for treatment. The focus of this article is on the experience of relocation for specialist care for Indigenous women diagnosed with vulvar cancer from East Arnhem Land, Northern Territory, Australia. The findings presented in this article explore a range of issues that affect the experience of relocation such as community concerns, cultural distress, loneliness, fear, worry, and physical concerns associated with the condition.
Assuntos
Atitude Frente a Saúde/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , População Rural , Serviços Urbanos de Saúde , Neoplasias Vulvares/etnologia , Neoplasias Vulvares/terapia , Ansiedade/etnologia , Ansiedade/psicologia , Características Culturais , Medo/psicologia , Feminino , Humanos , Solidão/psicologia , Northern Territory , Pesquisa Qualitativa , Características de Residência , Estresse Psicológico/etnologia , Neoplasias Vulvares/psicologiaRESUMO
PURPOSE: To date, there has been limited research on the topic of vulvar cancer. This paper provides findings from a qualitative study conducted with Indigenous women in East Arnhem Land, Northern Territory, Australia on the psychosocial impact of diagnosis and treatment for vulvar cancer. The insights from the study outlined in this paper not only make a contribution to deepening our understanding of the experience of vulvar cancer for Indigenous women, but provide practical recommendations to ensure effective and early engagement for diagnosis and treatment. METHODS: A qualitative research method was employed through in-depth, open-ended interviews. The participants of the study were a purposive sample of Indigenous women with the condition, health professionals, and Aboriginal health workers. There were a total of 40 participants; with twelve (n = 12) Indigenous women affected with the condition, fourteen (n = 14) Aboriginal Health Workers, ten (n = 10) nurses, three (n = 3) doctors, and one (n = 1) community member. RESULTS: This paper addresses three key issues highlighted by the participants which include the fact that the private nature of the disease makes the condition 'women's business', that there is a sense of shame associated with the condition, and that there is fear and worry generated by the seriousness of the condition. CONCLUSION: The private nature of the disease and the sense of shame associated with the condition impact upon the diagnosis and treatment for many Indigenous women. In addition, the limitation of resources for health service delivery for East Arnhem Land exacerbates the problems faced by these communities. This paper puts forward suggestions to facilitate early diagnosis and treatment for women affected with the condition.