Ha ora: Improving access to early diagnosis of lung cancer for Maori and rural communities. Understanding patient experiences in General Practice

Abstract

There were two main objectives for this report. The first was to identify the barriers to early diagnosis of lung cancer experienced by Māori lung cancer patients and whānau. Second was to co-design a multi-pronged intervention alongside rural Māori communities to improve early diagnosis of lung cancer for whānau in their localities. The team worked in the Waikato, Lakes, Bay of Plenty and Tairāwhiti districts of the Midland Region. Semi-structured interviews were carried out with 23 Māori lung cancer patients and whānau recruited through respiratory or cancer nurse specialists (CNSs) based at the hospitals of each district. Nine community hui (focus groups) and nine primary healthcare provider hui were carried out in five rural localities: Te Kuiti, Opōtiki, Te Kaha, Rotorua and Gisborne. Community hui included cancer patients, whānau, and other community members. Healthcare provider hui comprised staff members at the local primary healthcare centre, including General Practitioners and nurses. Study data were thematically analysed. Findings of the study highlight: 1. Barriers in primary care, including symptom ambiguity, accumulating costs, barriers and enablers relating to GP – patient relationships 2. Barriers in secondary care, including a lack of access to diagnostic tests, long waiting times, barriers and enablers relating to communication between HCPs and patients. 3. The importance of whānau as carers and advocates for Māori patients on their lung cancer journey. The interventions co-designed with each community included a Hā Ora website, a series of lung cancer awareness videos (entitled ‘wharo wharo wharo’), a kaiawhina training programme and a ‘pou pupuru oranga’ (cancer navigator). We suggest strategies that aim to improve early diagnosis of lung cancer for rural Māori communities. We welcome your feedback to us regarding these recommendations.