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Cancer Journey for American Indians and Alaska Natives in the Pacific Northwest .

PURPOSE/OBJECTIVES
To describe the experiences of American Indian and Alaska Native cancer survivors to improve understanding of the trajectory of cancer treatment.  .


RESEARCH APPROACH
Qualitative focus group research. .


SETTING
Rural and geographically isolated American Indian and Alaska Native communities in the Pacific Northwest. .


PARTICIPANTS
30 American Indian and Alaska Native cancer survivors or caregivers.  .


METHODOLOGIC APPROACH
The authors analyzed data from two focus groups with cancer survivors by using thematic analysis informed by indigenous methodologies. .


FINDINGS
Based on focus group findings, the authors developed a conceptual model of the cancer experience called Rough Waters. Participants described their cancer experience as a collective journey involving family and friends and requiring resources to offset challenges along the way. Dominant themes were delays, isolation, communication, money, advocacy, spirituality, and family involvement. .


CONCLUSIONS
American Indians and Alaska Natives in the Pacific Northwest have special cultural needs during cancer care. The current study provides examples that can guide patient-provider interactions. .


INTERPRETATION
Using the metaphor of cancer as a journey, clinicians can begin a dialogue to identify what will impede or assist the cancer journey for their American Indian and Alaska Native patients.