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Nats'eji (healing): Examining patient and provider experiences with hospital-based Indigenous wellness services in Northwest Territories, Canada
被引:0
|作者:
Roher, Sophie Isabelle Grace
[1
,2
]
Andrew, Paul
[2
]
Chatwood, Susan
[2
,3
]
Fairman, Kimberly
[4
]
Galloway, Tracey
[1
]
Mashford-Pringle, Angela
[5
]
Gibson, Jennifer L.
[5
,6
]
机构:
[1] Univ Toronto Mississauga, Dept Anthropol, Mississauga, ON, Canada
[2] Inst Circumpolar Hlth Res, Yellowknife, NT, Canada
[3] Univ Alberta, Sch Publ Hlth, Edmonton, AB, Canada
[4] Univ Victoria, Sch Publ Hlth & Social Policy, Victoria, BC, Canada
[5] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[6] Univ Toronto, Joint Ctr Bioeth, Toronto, ON, Canada
来源:
CANADIAN JOURNAL OF PUBLIC HEALTH-REVUE CANADIENNE DE SANTE PUBLIQUE
|
2024年
基金:
加拿大健康研究院;
关键词:
Indigenous population;
Indigenous medicine;
Traditional medicine;
Self-determination;
Holistic health;
Hospital care;
Quality of care;
Population indig & egrave;
ne;
M & eacute;
decine indig & egrave;
decine traditionnelle;
Autod & eacute;
termination;
Sant & eacute;
holistique;
Soins hospitaliers;
Qualit & eacute;
des soins de sant & eacute;
HEALTH;
PEOPLES;
D O I:
10.17269/s41997-024-00959-6
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
ObjectiveThis study aimed to examine how Indigenous patients and biomedical healthcare providers understand and experience the Indigenous wellness services at a hospital in the Northwest Territories.MethodsThe qualitative study (May 2018-June 2022) was overseen by a regional Indigenous Community Advisory Committee. Guided by Two-Eyed Seeing and post-colonial theory, the study employed a community-engaged research design, and included two strategies for data generation: (1) interviews with Indigenous Elders, patient advocates, biomedical healthcare providers, policy makers, and hospital administrators (n = 41), and (2) iterative sharing circles with Indigenous Elders (n = 4). Data from the interviews and first sharing circle were transcribed, thematically analyzed, and presented to the sharing circle Elders for validation.ResultsThe study revealed three overarching and related themes: (1) Elders and patient advocates emphasized that while the Indigenous wellness services at the hospital play a pivotal role connecting patients with cultural supports, the hospital was still not effectively bringing Indigenous healing practices into hospital care; (2) participants identified that structural factors (i.e., policy and governance decisions) shaped patients' experiences with the wellness services; and (3) participants underscored that deeply rooted forces (i.e., racism, colonialism, and biomedical dominance) inhibit the integration of Indigenous healing practices.ConclusionThe findings extend understandings of hospital-based Indigenous wellness services by surfacing relationships between deeply rooted forces, organizational structures, and Indigenous patients' experiences. Altogether, they suggest that to advance care for Indigenous patients and improve the integration of Indigenous healing practices, a system-wide transformation is necessary, which includes Indigenous governance at the hospital and a recognition of the value of Indigenous healing practices. ObjectifD & eacute;terminer comment les patients autochtones et les fournisseurs de soins de sant & eacute; biom & eacute;dicaux interpr & egrave;tent et vivent les services de bien-& ecirc;tre autochtone dans un h & ocirc;pital des Territoires du Nord-Ouest.M & eacute;thode Guid & eacute;e par la << vision & agrave; deux yeux >> et par la th & eacute;orie postcoloniale, une & eacute;tude qualitative (mai 2018-juin 2022) men & eacute;e sous la supervision d'un comit & eacute; consultatif communautaire autochtone r & eacute;gional a employ & eacute; un plan de recherche faisant appel aux communaut & eacute;s et incluant deux strat & eacute;gies de production de donn & eacute;es : 1) des entretiens avec des a & icirc;n & eacute;s autochtones, des d & eacute;fenseurs des patients, des fournisseurs de soins de sant & eacute; biom & eacute;dicaux, des responsables des politiques et des administrateurs de l'h & ocirc;pital (n = 41); et 2) des cercles de partage it & eacute;ratifs avec des a & icirc;n & eacute;s autochtones (n = 4). Les donn & eacute;es des entretiens et du premier cercle de partage ont & eacute;t & eacute; transcrites, analys & eacute;es par th & egrave;me, puis pr & eacute;sent & eacute;es aux a & icirc;n & eacute;s des cercles de partage, qui les ont valid & eacute;es.R & eacute;sultats L'& eacute;tude a mis au jour trois grands th & egrave;mes connexes : 1) selon les a & icirc;n & eacute;s et les d & eacute;fenseurs des patients, les services de bien-& ecirc;tre autochtone de l'h & ocirc;pital jouent un r & ocirc;le central en mettant les patients en contact avec des soutiens culturels, mais l'& eacute;tablissement n'int & egrave;gre pas encore bien les pratiques de gu & eacute;rison autochtones dans les soins hospitaliers; 2) selon les participants, des facteurs structurels (les d & eacute;cisions de principe et de gouvernance) structurent l'exp & eacute;rience des services de bien-& ecirc;tre v & eacute;cue par les patients; et 3) les participants ont soulign & eacute; que des forces profondes (racisme, colonialisme, domination du mod & egrave;le biom & eacute;dical) freinent l'int & eacute;gration des pratiques de gu & eacute;rison autochtones.ConclusionLes constatations de l'& eacute;tude am & eacute;liorent la compr & eacute;hension des services de bien-& ecirc;tre autochtone & agrave; l'h & ocirc;pital en amenant & agrave; la surface les relations entre les forces profondes, les structures organisationnelles et l'exp & eacute;rience des patients autochtones. Ensemble, ces constatations indiquent que pour am & eacute;liorer les soins aux patients autochtones et l'int & eacute;gration des pratiques de gu & eacute;rison autochtones, il faut op & eacute;rer une transformation de tout le syst & egrave;me, ce qui comprend la gouvernance autochtone & agrave; l'h & ocirc;pital et la reconnaissance de la valeur des pratiques de gu & eacute;rison autochtones.
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