Sara Filoche

‘I was able to make a better decision about my health.’ Wāhine experiences of colposcopy at a marae‐based health clinic: A qualitative study

BackgroundEquitable access to colposcopy services is required if we are to realise the benefit of the introduction of human papilloma virus (HPV) screening in Aotearoa New Zealand. We piloted a community colposcopy clinic, co‐located at an urban marae health clinic.AimTo describe the experiences of wāhine (women) attending the marae‐based colposcopy clinic.MethodsAn in‐depth reflexive thematic analysis from 34 people's accounts was undertaken.ResultsFive themes were identified from the experiences of wāhine attending the clinic. Three themes related to how having a local clinic supported access: everyone was welcoming and friendly, the environment was familiar and non‐clinical and the clinic was accessible. The fourth theme related to how this contributed to agency. A fifth theme relates to wāhine views about informing the ongoing provision of colposcopy services. The experiences reflected the principles and values practised at the marae health clinic. Wāhine described feeling cared for as soon as they entered the clinic. As the clinic was local, and for some based at their marae, it was a known space where they knew the experience would be safe. Whānau were welcome with spaces for children to play. Being local meant there were fewer logistics to manage, all of which supported access.DiscussionPrioritising wāhine through the provision of culturally safe and accessible colposcopy is feasible. It has the potential to contribute to the elimination of cervical cancer in Aotearoa, New Zealand.

‘It's not a solution to keep telling me to lose weight!’ Exploring endometrial cancer survivors’ experiences of nutrition and well‐being advice: A qualitative study

AimsThe aim was to explore Endometrial cancer (EC) survivors' experiences of being offered nutrition and well‐being advice.MethodsThis qualitative study was conducted at two tertiary centres in Aotearoa New Zealand. Semi‐structured conversations with people who had completed treatment for EC in the past 12 months were undertaken to explore how they were offered nutrition and well‐being advice as part of standard follow‐up care. Interviews were analysed using reflexive thematic analysis.ResultsFifteen people of Pacific, Māori and European ethnicity participated. Five themes were derived: (i) isolation and vulnerability, (ii) importance of language, (iii) inconsistent availability and relevance of nutrition and well‐being information, (iv) competing priorities and influences and (v) holistic and culturally responsive support. People often experienced judgement associated with their weight as part of their care, with limited understanding of their lived realities. Nutrition and well‐being advice was not widely available or accessible, and people had to explicitly ask for it. Social and environmental factors were barriers to making changes to health behaviours. A need for culturally safe holistic care was identified.ConclusionEnhancing survivorship after EC is ultimately premised on providing culturally safe and responsive care. Expanding workforce training in communication around high weight as well as education and self‐assessment of cultural safety could enable aspects of this. A holistic care program could facilitate wider access to nutrition and well‐being advice and better meet the needs of this population.

Increasing incidence of endometrial cancer in Aotearoa New Zealand: Health professionals' perspective

BackgroundThe incidence of endometrial cancer is globally increasing. Aotearoa New Zealand is no exception with a 59% increase in cases over that last ten years.AimsWe report a sub‐set of themes which pertain to provider reflections of rising endometrioid‐type endometrial cancer incidence in individuals with high weight.Materials and MethodsFifteen semi‐structured interviews with healthcare professionals experienced in providing care to women with endometrial cancer were audio‐recorded and transcribed. Interviews were analysed using reflexive thematic analysis.ResultsTwo main themes emerged: (1) concerns for the future; and (2) impact on fertility and treatment options. Healthcare professionals discussed rising incidence in younger people and a need for increased awareness about the association of excess weight as a risk factor for developing the disease. The concern extended to workforce and equipment shortfalls of meeting the needs of individuals with higher weight, which subsequently influenced treatment options, health outcomes and survivorship.ConclusionsRising incidence of endometrial cancer in individuals with high weight presents multiple chances for inequitable access and health outcomes over the care continuum for endometrial cancer. Action is required to address incidence, awareness, access to equitable and inclusive treatment, and survivorship.