225386 Palliative Care for Cancer Patients in American Samoa. Development of a Culturally-Grounded Resource-Appropriate Training Curriculum

Monday, November 8, 2010 : 9:15 AM - 9:30 AM

Lana Ka'Opua, PhD, DCSW, LSW , Myron B. Thompson School of Social Work & Cancer Research, University of Hawaii, Manoa, Honolulu, HI
Jennifer Tofaeono, MBA , American Samoa Community Cancer Coalition, Pago Pago, American Samoa
PURPOSE. Prior research in American Samoa (AS)documents the presentation of late stage cancers at diagnosis, unavailability of advanced treatments, insufficient funding for offshore treatment, absence of comfort care resources, and patients intermittent use of indigenous Samoan and Western medicine. A palliative program is beneficial in American Samoa. > METHODS. Research questions were to identify necessary groups, organizations for development of palliative program. Identify community knowledge, attitudes and practices regarding palliative care. An ad hoc committee (through Cancer Coalition), identified participants for group or individual interviews. Snowball sampling was used to identify additional participants. Interviews were taped, transcribed verbatim, and examined using Content Analysis. > RESULTS. Diverse stakeholder groups (healthcare and social services personnel, indigenous healers, religious and village leaders) and organizations (health department, hospital, ministers association) were identified for inclusion in establishing a culturally-grounded, resource-appropriate palliative care program. Suggested units for training included: indigenous health beliefs and medicine, communication about end-of-life issues, pain and symptom management at home, and role of volunteers and families. Also suggested were opportunities for discussion between diverse stakeholder groups and separate sessions for clinicians. > CONCLUSIONS. AS lacks treatment options across the cancer care continuum. The status of palliative care could be improved by a program integrating available resources and establishing inter-disciplinary teams of those trained in bio-medical and social science, as well as indigenous healers and volunteers. Training tailored to diverse groups is essential to program success and ultimately, offers hope of enhanced quality of life for those affected by cancer.

Learning Areas:
Administration, management, leadership
Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture
Ethics, professional and legal requirements
Social and behavioral sciences

Learning Objectives:
Participants will understand the limited access to resources for cancer care in American Samoa. That these disparities, due to socioeconomic crisis, limited healthcare access, isolation have resulted in a need to address palliative care in a territory that continues to see patients in advanced stages of cancer. Participants will discuss how in a world where cancer care continues to improve, how this is not the case for American Samoa. Participants will learn how the territory views palliative care, and transitioning from curative care to comfort measures. How palliative care will need to be addressed culturally, and the importance of a inter-disciplinary team to support end of life needs. The author will share knowledge on the restricted cancer care continuum in American Samoa, as we must refer our patients off island, and with limited financial support, many patients remain home to die. Our community must deal with this by developing palliative care that can support the cultural needs of our community.

Keywords: Accountability, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author because I am the co-PI on this project, and led the development work groups in American Samoa.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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