Date of Award

Fall 2012

Degree Type

Thesis

Degree Name

Master of Science (MSc)

Department

Health Research Methodology

Supervisor

Kevin Brazil

Co-Supervisor

Harriet MacMillan

Language

English

Committee Member

Lynne Lohfeld

Abstract

Introduction: Palliative care in Canada is an under-funded service for all Canadians, but for Aboriginal people in Canada, the level of access to such care is significantly lower. This study examined the system of palliative care delivery at Six Nations of the Grand River. The overall aim of the project was to identify ways on how the system of care could be improved.

Methods: A qualitative case study approach was used. Interviews were held with Elders and family caregivers to identify the priorities in care delivery from their perspective. Focus groups were held with representatives from palliative care service provider agencies in an effort to identify the strengths and challenges within the system and to determine how palliative care services provided to the members of Six Nations could be improved.

Findings: Themes identified in the interviews included: personable, caring care; culturally-competent care; open two-way communication; support for family caregivers; palliative home care should be available; meeting comfort needs of the person; and the need for a hospice in the community. The main theme identified in the focus groups with care providers included: relationship/rapport issues between provider organizations; within-program strengths and challenges; cultural considerations in care; and broader system factors that influence care.

Discussion: Relationship/rapport issues were identified as a challenge, and it appeared that the focus groups provided an opportunity for communication between the organizations to improve. Identification of within-program challenges – and ways to address these challenges - may provide opportunities for each organization to improve how palliative care services are delivered at Six Nations. Identification of broader system factors that influence care may also benefit patients in need of palliative care.

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