title: 'It's whanaungatanga and all that kind of stuff': Maori cancer patients' experiences of health services.
abstract: BACKGROUND
  There are unacceptable ethnic differences in cancer survival in Aotearoa/New Zealand. For people with cancer, quality of life and survival are shaped by access to care, but research on Maori access to, and through, cancer care is limited. Internationally, research has shown that primary care plays an important role in providing patient-centred, holistic care and information throughout the cancer care journey. Additionally, Maori health providers provide practical support and facilitate access to all levels of health care. Here we describe the cancer journeys of Maori patients and whanau and identify factors that may facilitate or inhibit access to and through cancer care services.
  
  
  METHODS
  Twelve Maori patients affected by cancer and their whanau (family) in the lower North Island took part in face-to-face semi-structured interviews exploring their experiences of cancer screening, diagnosis, treatment, survival and palliative care.
  
  
  RESULTS
  Three key areas were identified that impacted upon the cancer care journey: the experience of support; continuity of care; and the impact of financial and geographic determinants.
  
  
  CONCLUSIONS
  Primary care plays a key role in support and continuity of care across the cancer journey. Alongside interpersonal rapport, a long-term relationship with a primary health provider facilitated a more positive experience of the cancer care journey, suggesting that patients with a 'medical home' are happier with their care and report less problems with coordination between services. Positive, longstanding relationships with general practitioners and Maori health providers assisted patients and whanau with the provision and understanding of information, alongside practical support.
authors.affiliation: Centre for Public Health Research, Massey University, Wellington, PO Box 756, Wellington 6140, New Zealand. t.m.slater@massey.ac.nz.
authors.forename: Tania
authors.initials: T
authors.lastname: Slater
authors.forename: Anna
authors.initials: A
authors.lastname: Matheson
authors.forename: Cheryl
authors.initials: C
authors.lastname: Davies
authors.forename: Huia
authors.initials: H
authors.lastname: Tavite
authors.forename: Triny
authors.initials: T
authors.lastname: Ruhe
authors.forename: Maureen
authors.initials: M
authors.lastname: Holdaway
authors.forename: Lis
authors.initials: L
authors.lastname: Ellison-Loschmann
mesh_terms: D003266:Continuity of Patient Care; D005190:Family; D005260:Female; D006296:Health Services; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D009520:New Zealand / Q000208:ethnology; D010166:Palliative Care; D017060:Patient Satisfaction / Q000208:ethnology*; D036301:Qualitative Research; D012944:Social Support