Since most hospitals funded by the Indian Health Service are focused more on acute care treatment and services for chronically ill people, end-of-life services for patients on Indian reservations are sometimes lacking, said Yoshiko Colclough, an assistant professor of nursing at MSU.
"But the reality is people are dying, and palliative care is needed," Colclough said.
The LAF notes that cancer occurrence is significantly higher among American Indian populations compared to whites with respect to both incidence and mortality.
Colclough became involved with the Blackfeet Community Hospital in Browning, which has 27 beds, after its director of nursing participated in a workshop put on by the Montana Consortium for Community-Based Research in Health and contacted MSU with questions about providing end-of-life care.
"She wants to offer palliative care, because the hospital's focus is more acute care treatment," Colclough said. "She thought it was important to try to offer a better atmosphere for those who are at the end of their lives."
Colclough notes that palliative care involves caring for dying patients and looking after their emotional, physical, spiritual and financial needs.
To better understand exactly what those needs are, Colclough and a team of community members plan to interview four groups of people to learn about cultural values that could influence end-of-life issues in the community. Those groups will include the chronically ill and people who have lost family members to chronic illness. Groups also will consist of caregivers, both family members and professionals, who have provided end-of-life care. Colclough and her team hope to interview between 50 and 60 people on the Blackfeet Reservation.
Colclough plans to spend about one year conducting interviews and a second year analyzing them. Once the analysis is complete, she plans to provide a recommendation about how to improve palliative care on the reservation.
The qualitative study, called "End of Life Decision Making and Quality Care for American Indians," is different from many research studies in that Colclough does not have a hypothesis going into her research. But she said the interviews are an especially important part of her work because Colclough is interested in community members' values and beliefs. She said she is intent on honoring those values and beliefs.
"Whatever community people feel is good for them, that's what I want to do," Colclough said. "I hope my research will help people, but the community members will also have to stand up for themselves.
"I want to be a catalyst," she added.
Colclough's research interests center on generational and cultural differences in end-of-life decision making, particularly in Japanese-American and American Indian minority populations.
"My original interest is cultural differences in decision making," she said. "I come from a different culture where, in general, parents make decisions for their children. Then, when parents age, their children are supposed to make decisions for them."
Those cultural differences are noticeable when comparing Japan to United States, said Colclough, who is from Japan but has lived in the United States for nearly 20 years. In general, she thinks independence and individual decision-making is valued more highly in the United States than it is in Japan.
Colclough's sensitivity to people's cultures and their relationships will contribute to her success as a researcher, said Elizabeth Nichols, dean of the College of the Nursing.
"We anticipate that Yoshi's talent for 'hearing' the truths that others speak will contribute to nursing interventions for the Blackfeet that are meaningful, stand the test of time, and provide some relief for families who are faced with losing a loved one," Nichols said.
Colclough's grant is one of 11, totaling nearly $2 million, the LAF awarded to research institutions in December. Among the institutions receiving grants are Georgetown University, Columbia University and the University of California at Los Angeles. The Foundation, which has invested $21 million in research grants over 10 years, aims to fund research that meets the needs of underserved populations and encourages and supports the efforts of both established professionals in the field and young investigators in the early stages of their research careers.
Yoshiko Colclough, firstname.lastname@example.org