Table 2.

Key themes and issues found in Indigenous peoples’ cancer care experiences.

(A) Communication
Sub-Themes	Specific Issues That Cause Difficulty (Reference)
Language and literacy	Unfamiliar medical terms and procedures [25] Reading location maps and signs [35,39] Confusing information about medications [28] Electronic communication [21] Complex discharge reports [28] Unfamiliar medical terminology [26] Missing appointments [23,28] Health professionals’ lack of interest in seeking family assistance [31]
Understanding of the hospital environment	Felt “Alienating” and “Isolated” in the hospital [36] Unfamiliar hospital environments such as healthcare staff or professionals, treatment facility, and visitor numbers [32,35] Feared and anxious about hospital facilities [24]
Understanding of cancer care pathways	Lack of understanding of the pathway from primary to tertiary care [21,27,35] Lack of explanation from GP [27]
Lack of information	Lack of understanding of treatment in tertiary care [21,27,35] Insufficient information in the discharge report regarding medication [31], follow-up appointment [32], disease condition [32] or access to support [19] Limited information for carer [19]
(B) Cultural safety
Sub-Themes	Specific Issues That Cause Difficulty (Reference)
Trust in the system	GPs’ lack of awareness of cancer diagnosis delayed subsequent treatment procedures [23,29,36,37] Seeing multiple GPs and delayed cancer treatment [29,34,37] Lack of confidence due to the alienating environment [23] High expectations from tertiary care, such as complete recovery [31]
Privacy	Lack of interest in ‘women’s business’ [24,31] Preference of examiner for health checks in primary and tertiary care [25,41] Reluctant to receive treatment due to privacy [23] Hospital staff visits [36]
Racism	Racism behaviour of hospital staff [21,27,30,36,37,40] Disrespectful due to lack of carer information [19] Lack of warm interaction in the hospital [39] Communication in a culturally unsafe way [18] Unsympathetic delivery of bad news [23] Not maintaining patients’ privacy [19,31] Absence of Indigenous culture or unable to practice cultural ceremonies [21] Cultural and family support in treatment and recovery [31,39] Removal of hair and body parts due to surgery [26,27]
(C) Access to services.
Sub-Themes	Specific Issues That Cause Difficulty (Reference)
Long waiting time	Long waiting times for specialist referrals from GPs [23,37,40] Poor communication from public hospitals [23,37,40] Long waiting time for visiting specialists [24,41]
Availability of services at follow-up	Treatment prognosis from tertiary to primary care [21] Ongoing needs for follow-up care such as follow-up appointments, medication access, side effects, and adverse effects [22,28,31,32] Lack of follow-up instruction on postoperative complications or side effects [23] Travelling precautions from hospital to home [23] Lack of coordination in rural areas [30,35] Community services in rural and remote areas [24] Maintenance of follow-up appointments in the hospitals [24]
Coordination between services	Coordination problem between tertiary to primary services (GP) [28,36] Unplanned appointment schedules from allied health services and hospital staff [23,36,38]