First Nations Peoples' perspectives and experiences with cancer
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First Nations People have recently become concerned about the rising incidence of cancer in their communities. However, knowledge about First Nations Peoples' experiences with cancer is fragmented and limited in scope. To date, it is understood statistically; the psycho-social aspect of the cancer experience is absent. The purpose of this descriptive, ethnographic study was to explore the experiences of First Nations People diagnosed with cancer and Elders' perceptions of cancer. The Medicine wheel was the conceptual guide for this study. Forty six informants living in four Anishinaabe communities were interviewed using semistructured interview schedules. Content analysis of First Nations experiences with cancer occurred at various levels using three data sets: the individual with cancer, her/his family and community. The cancer experience was metaphorically characterized by "the stranger." Some examples of the themes are presented. In "The Presence of a Stranger: The Elders Speak," the Elders provided a historical perspective of the development and prevention of cancer in First Nations communities. "Becoming Aware: The Stranger in the Body" describes the informants' experiences when they sensed they had cancer. In the theme "Making The Stranger Known: The Healing Journey," the informants identified traditional Indian medicine as one way to manage cancer in their communities. Some of the findings revealed that cancer is thought to be a new disease affecting Anishinaabe. Food is considered to be the primary cause of cancer and the loss of traditional values is at the core of cancer in First Nations communities. A range of metaphors reflected First Nations Peoples' understanding about cancer. The most common metaphor used by the Anishinaabe in this study was "manitoch" which, in the Ojibwa language, Saulteaux, means cancer-as-worm. Informants suggested that Western medicine is limited in its ability to cure cancer. First Nations People with cancer consulted one or more Indian medicine healers before, during, or after obtaining medical cancer treatment. Spiritual visions and dreams were important to First Nations People. Recommendations are provided for future nursing research, education and practice.