| Summary: | Due to a shift in the pattern of health and disease in First Nations populations from infectious to more chronic diseases, there is a growing pattern in the use of large urban institutions. First Nations people with culturally different backgrounds from mainstream society, are routinely treated in contemporary health institutions by health care providers whose understanding and experience of illness may have little in common with their own. Hence, differences in medical and cultural orientations on illness have the potential to compromise the provision of effective care. The aims of this research were to: (1) describe and explain how cultural beliefs framed how Ojibway people, living on a reserve community, understood the illness experience of cancer and related pain and, (2) to describe differences and/or similarities between Ojibway respondents and health professionals' explanations and perceptions of cancer and related pain. This qualitative study used a grounded theory approach to collect and analyze data, using open-ended focused interviews. Eighteen Ojibway persons and thirteen health professionals participated. The data revealed that these Ojibway participants used culturally patterned knowledge to construct their understanding and perceptions about the biomedical disease called cancer and related pain and, that this differed remarkably from that of health professionals. The core concept of blocking, emerged as the central explanatory scheme for understanding how cancer and related pain were interwoven with and epitomized that which was most painful in life. he properties and dimensions of blocking were revealed as affording protection from exposure to threat and alienation from cultural and spiritual values. Blocking was triggered within well articulated contexts. Examination of these contexts provided valuable insights into issues of cultural safety in biomedical institutions.
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