Cancer Care Experiences and the Use of Complementary and Alternative Medicine (CAM) and Home Remedies in Nova Scotia's Black Community: A Pilot Study

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Cancer Care Experiences and the Use of
Complementary and Alternative Medicine (CAM) and
Home Remedies in Nova Scotia's Black Community A
Pilot Study

• June 6, 2006
• Victor Maddalena, PhD
• This research was funded by a CIHR - NET Grant
  "Palliative Care in a Cross Cultural Context A
  New and Emerging Team (NET) for equitable and
  quality cancer care for culturally diverse
  populations.  

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Research Team

• Principal Investigator
• Victor Maddalena, Post Doctoral Fellow,
• NET-CIHR Palliative Care in a Cross Cultural
  Context
• Co Investigators
• Sharon Davis-Murdoch, NS Department of Health
• Dr.Josephine Etowa, Dalhousie University School
  of Nursing
• Phyllis Marsh-Jarvis, Health Association of
  African Canadians
• Donna Smith, Cancer Care Nova Scotia
• Dr.Wanda Thomas-Bernard, School of Social Work,
  Dalhousie University

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Research Question

• 1. What is the experience of African Canadians
  with cancer at end-of-life?

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Research Question

• 2. What role, if any, do complementary and
  alternative medicine and home remedies play
  during terminal illness from cancer and
  end-of-life care in the Black community?

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Why is this topic of Interest?
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Nova Scotia's Black Population

• African Canadians account for more than half
  (52) of Nova Scotia's Visible Minorities
  (19,670)
• 66 live in metropolitan Halifax (13,100)
  representing approximately 2 of all Blacks
  living in Canada.
• Metro Halifax has the highest proportion of
  Canadian-born Blacks among major urban areas in
  Canada
• Nova Scotia has the largest population of
  indigenous Blacks in Canada (Statistics Canada
  2001).
• Source (Statistics Canada, 2003).

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African Canadians

• Some of the earliest settlers in Nova Scotia
• Three main groupings
• Indigenous African Nova Scotians (Refugee Blacks,
  Loyalist Blacks, Maroons)
• Immigrants from Africa
• Immigrants from Caribbean and other part of the
  world

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Past and Present

• Evidence of hardship, injustice, and systemic
  racism
• Black Learners Advisory Committee Report (1994)
• Royal Commission on the Donald Marshall Jr.
  Prosecution (Head 1989)
• Expropriation/ Forced Relocation of Residents of
  Africville 1964-1970

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Health Status

• Limited research on health status of ANS
• Reliance on American Research
• Reduced access to health services
• poorer health status
• higher rates of disease
• Racism is endemic

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• Rationale for the Research
• Limited research on end-of-life and cancer
  experiences of African Canadians
• institutional or cultural barriers to accessing
  cancer care services
• From diagnosis to death.
• No research on use of CAM and home remedies
• Anecdotal knowledge of use of home remedies is
  extensive

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Research Methods

• Qualitative Research (Participatory model)
• Case Study Approach
• Four Case studies (Families)
• 1 Rural 1 urban (both indigenous African Nova
  Scotians)
• One Immigrant family from Africa
• One Immigrant Family from Caribbean

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Research Methods

• Each case study will focus on the Primary
  Caregiver of the decedent
• Primary Caregivers will identify other
  significant caregivers
• (Family, neighbours, health professionals,
  spiritual community, etc.)

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Framework for Data Collection and Analysis

• Feminist Ethics, as the normative framework
  guiding this research, demands that policies and
  practices in society be examined to determine
  whether the practice in question maintains,
  exacerbates, or lessens existing patterns of
  oppression (Sherwin, 1992, 1996).
• Thematic and discourse analysis of interviews

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Outcome of Pilot Project

• The findings from this research will inform, and
  provide a foundation upon which, further studies
  can be developed to support the development of
  culturally appropriate cancer care to serve the
  needs of Nova Scotia's Black community.

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Questions?