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Belaid L, Budgell R, Sauvé C, Andersson N. Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2021-008311. [DOI: 10.1136/bmjgh-2021-008311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BackgroundThe National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods.MethodsThis scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis.Results356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods.ConclusionsThe last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.
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Lie Ken Jie C, Finn YF, Bish M, Carlson E, Kumlien C, Chan EA, Leung DY. Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence: An Integrated Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1707-1721. [PMID: 35476677 PMCID: PMC9592147 DOI: 10.1097/acm.0000000000004714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The COVID-19 pandemic revealed a global urgency to address health care provision disparities, which have largely been influenced by systematic racism in federal and state policies. The World Health Organization recommends educational institutions train clinicians in cultural competence (CC); however, the mechanisms and interacting social structures that influence individuals to achieve CC have received little attention. This review investigates how postgraduate health and social science education approaches CC and how it accomplishes (or not) its goals. METHOD The authors used critical realism and Whittemore and Knafl's methods to conduct a systematic integrated review. Seven databases (MEDLINE, CINAHL, PsycINFO, Scopus, PubMed, Web of Science, and ERIC) were searched from 2000 to 2020 for original research studies. Inclusion criteria were: the use of the term "cultural competence" and/or any one of Campinha-Bacote's 5 CC factors, being about postgraduate health and/or social science students, and being about a postgraduate curriculum or a component of it. Thematic analysis was used to reveal the mechanisms and interacting social structures underlying CC. RESULTS Thirty-two studies were included and 2 approaches to CC (themes) were identified. The first theme was professionalized pedagogy, which had 2 subthemes: othering and labeling. The second theme was becoming culturally competent, which had 2 subthemes: a safe CC teaching environment and social interactions that cultivate reflexivity. CONCLUSIONS CC conceptualizations in postgraduate health and social science education tend to view cultural differences as a problem and CC skills as a way to mitigate differences to enhance patient care. However, this generates a focus on the other, rather than a focus on the self. Future research should explore the extent to which insight, cognitive flexibility, and reflexivity, taught in safe teaching environments, are associated with increasing students' cultural safety, cultural humility, and CC.
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Affiliation(s)
- Christopher Lie Ken Jie
- C. Lie Ken Jie is a medical student, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Yvonne F. Finn
- Y.F. Finn is a lecturer, clinical skills and clinical methods, School of Medicine, and vice dean for internationalization, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland; ORCID: https://orcid.org/0000-0002-9935-8453
| | - Melanie Bish
- M. Bish is associate professor, associate head, and director of academic partnerships, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia; ORCID: https://orcid.org/0000-0003-4305-6760
| | - Elisabeth Carlson
- E. Carlson is professor, Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden; ORCID: https://orcid.org/0000-0003-0077-9061
| | - Christine Kumlien
- C. Kumlien is professor and vice dean, Department of Care Science, Faculty of Health and Society, Malmö University, and Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden; ORCID: https://orcid.org/0000-0002-1437-5060
| | - E. Angela Chan
- E.A. Chan is associate professor and associate head of undergraduate education, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong; ORCID: https://orcid.org/0000-0003-4411-6200
| | - Doris Y.L. Leung
- D.Y.L. Leung is adjunct assistant professor, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong; ORCID: https://orcid.org/0000-0002-9636-3118
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Francis-Cracknell A, Truong M, Adams K. 'Maybe what I do know is wrong…': Reframing educator roles and professional development for teaching Indigenous health. Nurs Inq 2022; 30:e12531. [PMID: 36222233 DOI: 10.1111/nin.12531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Abstract
Settler colonisation continues to cause much damage across the globe. It has particularly impacted negatively on Indigenous peoples' health and wellbeing causing great inequity. Health professional education is a critical vehicle to assist in addressing this; however, non-Indigenous educators often feel unprepared and lack skill in this regard. In this qualitative study, 20 non-Indigenous nursing, physiotherapy and occupational therapy educators in Australia were interviewed about their experiences and perspectives of teaching Indigenous health. Findings from the inductive thematic analysis suggest educators require skill development to: identify their discomfort in teaching cultural safety; contextualise the sources of this discomfort and; reflect on how this understanding can improve their teaching. Additionally, educators require professional training to become practitioners of cultural humility and to be facilitators and colearners (rather than experts) of the Aboriginal-led curriculum. Of relevance to this is educator training in how to decentre non-Indigenous needs and perspectives. Educators can also renew their teaching practices by understanding what a dominant settler paradigm is, identifying if this is problematically present in their teaching and knowing how to remedy this. Crucial to improved cultural safety teaching is institutional support, which includes Indigenous leadership, institutional commitment, relevant policies, and well-designed professional development.
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Affiliation(s)
- Alison Francis-Cracknell
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Mandy Truong
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Karen Adams
- Gukwonderuk Indigenous Engagement Unit, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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204
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Daniel John M, Taylor EJ. Beyond Turmeric and Yoga: Advance Care Planning and End-of-Life Considerations Among Asian Indian American Hindus. J Hosp Palliat Nurs 2022; 24:258-264. [PMID: 35560304 DOI: 10.1097/njh.0000000000000880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Hinduism is the fourth largest religion in the United States; an understanding of Hindu beliefs and practices will help health care providers deliver culturally sensitive care while discussing advance care planning and end-of-life care for adult patients. For many Westerners, the practice of yoga, Ayurveda, and vegetarianism is used by people striving to live healthfully. However, what might be unfamiliar to Westerners is how for Hindus, these practices reflect their millennia-old spirituality and religiosity. Knowing the Hindu beliefs of atman, Brahman, karma, and moksha will help nurses connect to Hindus' various end-of-life wishes. In addition, getting familiar with interrelating factors such as lack of knowledge on palliative care and advance care planning, family dynamics, acculturation, and personal preferences will allow nurses to provide culturally competent care. By facilitating end-of-life conversations at an early stage, nurses can promote confidence and self-efficacy for patients who may fear that their religiosity and personal priorities are trivialized by acculturated family members or disregarded by their adopted homeland. This clinical article provides nurses with information about Asian Indian American Hindus' beliefs and practices, clinical implications for assessment, and suggestions to support patients' and families' end-of-life wishes.
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205
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Tee S, Üzar-Özçetin YS, Trenoweth S. Achieving culturally competent mental health care: A mixed-methods study drawing on the perspectives of UK nursing students. Perspect Psychiatr Care 2022; 58:1267-1280. [PMID: 34378792 DOI: 10.1111/ppc.12926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to examine the degree of cross-cultural competency among UK mental health student nurses, and the care delivery challenges arising from their internalized cultural assumptions. DESIGN AND METHODS This study adopted a mixed-methods design. Participants were final-year nursing students in the United Kingdom. FINDINGS The results revealed participants had a moderate level of cultural awareness and competency but highlighted many challenges to providing cross-cultural care arising from the meanings, enablers, and values they attributed to culturally competent mental health care. PRACTICE IMPLICATIONS As cultural competency is considered an essential characteristic of effective nursing care, greater attention should be paid to how student nurses assimilate cultural awareness to develop confidence in their day-to-day practice.
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Affiliation(s)
- Stephen Tee
- The Business School, Faculty of Health and Social Sciences, Bournemouth University, Dorset, UK
| | | | - Steve Trenoweth
- BU iWell Research Centre, Faculty of Health and Social Sciences, Bournemouth University, Dorset, UK
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206
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Ibrahim A, Came H, Cairncross C, Khalifa M. Learnings on Doing Health Research with Muslim Communities in Aotearoa New Zealand from a Study on Health and Ramadan. JOURNAL OF RELIGION AND HEALTH 2022; 61:3795-3805. [PMID: 35226294 DOI: 10.1007/s10943-022-01524-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
The Muslim community is a vibrant part of New Zealand society. As this community grows, researchers will need to strengthen engagement and collaboration to tailor the delivery of services. Given the paucity of the literature, this conceptual paper drawing on a study on health and Ramadan presents an exemplar for doing research with Muslim communities. This paper proposes several key elements (i) the importance of relationships, (ii) engagement with imams (mosque leaders), (iii) cultural and religious safety, (iv) a gendered approach and (v) utilizing religious festivals. These findings will be of interest to policy makers, practitioners and scholars wishing to engage with this community.
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Affiliation(s)
- Abduraouf Ibrahim
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand.
| | - Heather Came
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand
| | - Carolyn Cairncross
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand
| | - Marwa Khalifa
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand
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207
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Lee RS, Brown HK, Salih S, Benoit AC. Systematic review of Indigenous involvement and content in mental health interventions and their effectiveness for Indigenous populations. Aust N Z J Psychiatry 2022; 56:1230-1251. [PMID: 35379008 PMCID: PMC9513504 DOI: 10.1177/00048674221089837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the effects of psychological, psychosocial, educational and alternative interventions on mental health outcomes of Indigenous adult populations in Australia, Canada, New Zealand and the United States and the Indigenous involvement and content in each study. METHODS We systematically searched databases, key journals and gray literature, for records until June 2020. Eligible studies were in English or French and examined the impact of interventions on mental health outcomes including anxiety disorders, posttraumatic stress disorder, depression, psychological distress or stress for Indigenous adults (⩾16 years). Data were extracted using a modified Cochrane Data Extraction Form and the Template for Intervention Description and Replication. Quality was evaluated using the Effective Public Health Practice Project quality assessment form. RESULTS In total, 21 studies were eligible, comprising 8 randomized controlled trials, 10 single-group pre-post studies and 3 pre-post studies with comparison groups. Twenty studies had Indigenous individuals or organizations involved in some decision-making capacity, though extent of involvement varied widely. In total, 9 studies were rated moderate and 12 weak in the Effective Public Health Practice Project quality assessment. Eight studies measuring depression, three measuring posttraumatic stress disorder, three measuring psychological distress and two measuring stress showed statistically significant improvements following the intervention. CONCLUSION A wide range of interventions demonstrated mental health improvements. However, it is difficult to draw generalizable conclusions on intervention effectiveness, given heterogeneity among studies. Studies should employ a thorough assessment of the Indigenous involvement and content of their interventions for reporting and for critical consideration of the implications of their research and whether they address Indigenous determinants of mental health.
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Affiliation(s)
- Rachel Seungyun Lee
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Health and Society, University of Toronto Scarborough, Scarborough, ON, Canada,Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
| | - Sarah Salih
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anita C Benoit
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Health and Society, University of Toronto Scarborough, Scarborough, ON, Canada,Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada,Anita C Benoit, Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C 1A4, Canada.
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208
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Macniven R, Simon A, Wilson R, Howie A, Stewart G, Ma T, Turner NJ, Cairnduff S, Coombes J. Ironbark: Developing a healthy community program for older Aboriginal people. Health Promot J Austr 2022; 33 Suppl 1:128-133. [PMID: 35148452 PMCID: PMC9790301 DOI: 10.1002/hpja.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Programs by, with and for Aboriginal older people must be culturally safe and relevant. Successful elements include being Aboriginal specific and group based. Co-design with Aboriginal people and stakeholders is essential. We describe the co-design process of developing the Ironbark: Healthy Community program. METHODS Aboriginal ways of knowing, being and doing and yarning conversational methods guided the development process, during 2018. A desktop review provided details of current group characteristics and key community stakeholders. Stakeholder engagement regarding views about group operations, participants and benefits also occurred. Aboriginal Elders views of their groups were gathered through yarning circles in New South Wales (NSW). Grounded theory approach was used to ascertain key themes. RESULTS Initial engagement occurred with 13 different community stakeholders and organisations in three Australian states (NSW, South Australia (SA), Western Australia (WA)). Three yarning circles occurred with Elders from urban (N = 10), regional coastal (N = 10) and regional country (N = 4) groups. Six key themes were organised in three groups according to an Aboriginal ontology. 1. Knowing: groups provide opportunities to share knowledge and connect socially. Adequate program resourcing and sustainability are valued. 2. Being: groups strengthen culture, providing important social, emotional and other forms of support to age well. 3. Doing: previous program experiences inform perceptions for new program operations. Group venues and operational aspects should be culturally safe, acknowledging diversity among Elders, their preferences and community control. Themes were used to develop the program and its resource manual that were finalised with stakeholders, including steering committee approval. CONCLUSIONS Stakeholder feedback at multiple stages and Aboriginal Elders' perspectives resulted in a new co-designed community program involving weekly yarning circles and social activities. So what?: Co-design, guided by Aboriginal ways of knowing, being and doing, can develop programs relevant for Aboriginal people.
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Affiliation(s)
- Rona Macniven
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,Faculty of Health, Medicine and Human SciencesMacquarie UniversityNew South WalesAustralia
| | | | - Roland Wilson
- Southgate Institute for Health, Society, and EquityFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Adam Howie
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Georgia Stewart
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research InstituteThe University of WollongongWollongongNew South WalesAustralia
| | - Tracey Ma
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Norma Jean Turner
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Sallie Cairnduff
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Julieann Coombes
- The George Institute for Global HealthSydneyNew South WalesAustralia
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209
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Robinson A, O'Brien N, Sile L, Guraya HK, Govind T, Harris V, Pilkington G, Todd A, Husband A. Recommendations for community pharmacy to improve access to medication advice for people from ethnic minority communities: A qualitative person-centred codesign study. Health Expect 2022; 25:3040-3052. [PMID: 36161966 DOI: 10.1111/hex.13611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Medicines-centred consultations are vital to support medicine effectiveness and optimize health outcomes for patients. However, inequalities negatively impact ethnic minority populations when accessing medicines advice. It is important to identify opportunities to improve access for these communities however, knowledge of how best to achieve this is lacking; this study will generate recommendations to improve access to medicines advice from community pharmacies for people from ethnic minority communities. METHODS A series of codesign workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call (adhering to COVID-19 restrictions). Existing evidence-based perceptions affecting access to medicines advice were critiqued and recommendations were generated, by use of reflexive thematic analysis, to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim. QSR NVivo (Version 12) facilitated data analysis. RESULTS Twelve participants were recruited using purposive sampling; including eight UK citizens, two asylum seekers and two participants in receipt of residency visas. In total, four different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and cocreate recommendations to improve access to medicines advice in community pharmacies. Three recommendations were developed and centred on: (i) delivering and providing culturally competent medicines advice; (ii) building awareness of accessing medicines advice from community pharmacies; and (iii) enabling better discussions with patients from ethnic minority communities. CONCLUSIONS These recommendations have the potential to support community pharmacy services to overcome ethnic inequalities affecting medicines advice; service commissioners should consider these findings to best meet the needs of ethnic minority patients. Cultural competence training for community pharmacy staff could support the creation of pharmacies as inclusive healthcare settings. Collaborative working with ethnic minority communities could enable specific tailoring of medicines-centred services to best meet their needs. PATIENT OR PUBLIC CONTRIBUTION The National Institute for Health Research (NIHR) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualization. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and findings were reported, with cultural competence. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Laura Sile
- Alumni, School of Pharmacy, Liverpool John Moores University, Liverpool, UK
| | | | - Thorrun Govind
- Chair of the English Pharmacy Board, Royal Pharmaceutical Society, London, UK
| | - Vicki Harris
- Connected Voice Haref, Higham House, Newcastle upon Tyne, UK
| | - Guy Pilkington
- West End Family Health Primary Care Network, Cruddas Park Surgery, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Coombes J, Holland AJA, Hunter K, Bennett-Brook K, Ryder C, Finlay SM, Orcher P, Scarcella M, Briscoe K, Forbes D, Jacques M, Wilson R, Bourke E, Kairuz C. Discharge Interventions for First Nations People with Injury or Chronic Conditions: A Protocol for a Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811301. [PMID: 36141576 PMCID: PMC9517407 DOI: 10.3390/ijerph191811301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/12/2023]
Abstract
Severe injury and chronic conditions require long-term management by multidisciplinary teams. Appropriate discharge planning ensures ongoing care to mitigate the long-term impact of injuries and chronic conditions. However, First Nations peoples in Australia face ongoing barriers to aftercare. This systematic review will locate and analyse global evidence of discharge interventions that have been implemented to improve aftercare and enhance health outcomes among First Nations people with an injury or chronic condition. A systematic search will be conducted using five databases, Google, and Google scholar. Global studies published in English will be included. We will analyse aftercare interventions implemented and the health outcomes associated. Two independent reviewers will screen and select studies and then extract and analyse the data. Quality appraisal of the included studies will be conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement. The proposed study will analyse global evidence on discharge interventions that have been implemented for First Nations people with an injury or chronic conditions and their associated health outcomes. Our findings will guide healthcare quality improvement to ensure Aboriginal and Torres Strait Islander peoples have ongoing access to culturally safe aftercare services.
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Affiliation(s)
- Julieann Coombes
- The George Institute for Global Health, Sydney, NSW 2042, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Andrew J. A. Holland
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Paediatric Surgery, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kate Hunter
- The George Institute for Global Health, Sydney, NSW 2042, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Courtney Ryder
- The George Institute for Global Health, Sydney, NSW 2042, Australia
- Indigenous Health College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
- School of Population Health, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Summer M. Finlay
- School of Health and Society, Wollongong University, Wollongong, NSW 2522, Australia
| | - Phillip Orcher
- Agency for Clinical Innovation, Sydney, NSW 2065, Australia
| | - Mick Scarcella
- The Sydney Children’s Hospital Network (SCHN), Sydney, NSW 2145, Australia
| | - Karl Briscoe
- National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP), Canberra, ACT 2606, Australia
| | - Dale Forbes
- Department of Community and Justice, Sydney, NSW 2012, Australia
| | - Madeleine Jacques
- The Sydney Children’s Hospital Network (SCHN), Sydney, NSW 2145, Australia
| | - Roland Wilson
- Indigenous Health College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Elizabeth Bourke
- The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Camila Kairuz
- The George Institute for Global Health, Sydney, NSW 2042, Australia
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211
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Fraser C, Honeyfield J, White M, Qiu W, Sims D, Proverbs A. Using Cultural Lens Theory to Investigate the Impact of a Nursing Education Practicum in Aged Healthcare: Aotearoa New Zealand's Bi-cultural Framework. J Cross Cult Gerontol 2022; 37:237-256. [PMID: 36074216 PMCID: PMC9453732 DOI: 10.1007/s10823-022-09458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 11/27/2022]
Abstract
Aim The aim of this paper is to apply Cultural Lens Approach theory to data collected from third year nursing students related to an assignment undertaken during their month-long practicum placement in an aged residential care facility. We explore the extent to which a national vision of bi-culturalism and inclusivity is evident in students’ quality improvement project topic selection and practice. Background Aotearoa New Zealand is a nation of dual heritage, informed by the cultures of Māori as the indigenous tangata whenua (people of the land), and Pākehā, (European) settlers. All public sectors, including all higher education providers and the curricula they deliver, are required to incorporate and promote a contemporary, bi-cultural world-view. Methods Stage one of the research reported in this paper involved a) document analysis of 93 students’ quality improvement project reports; b) focus groups with 18 students; and c) an online questionnaire for 16 key stakeholders including aged care managers, clinical nurse leaders and student nurse educators. Stage two reviewed the above data through a five-step Cultural Lens Approach process to identify cultural biases and assumptions. Results Qualitative analysis revealed students’ increased professional confidence, improving communication and critical thinking skills. Responses as to development of cultural competence and cultural safety were mixed: a key barrier identified was that staff in the placement setting received minimal professional development to ensure appropriate tikanga (customary protocols and practice) for Māori residents was in place. Conclusion Viewed through a cultural lens, a westernized concept of aged healthcare provision continues to prevail in most settings. Nursing students noted gaps between cultural learning and practice.
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Affiliation(s)
- Cath Fraser
- Research Office, Toi Ohomai Institute of Technology, PB 12001, Tauranga, 3143, New Zealand.
| | - Judith Honeyfield
- Department of Nursing, Toi Ohomai Institute of Technology, PB 12001, Tauranga, New Zealand
| | - Mary White
- Department of Nursing, Toi Ohomai Institute of Technology, PB 12001, Tauranga, New Zealand
| | - Walley Qiu
- Access New Zealand, Hamilton, New Zealand
| | - Deb Sims
- Department of Nursing, Toi Ohomai Institute of Technology, PB 12001, Tauranga, New Zealand
| | - Adam Proverbs
- Department of Nursing, Toi Ohomai Institute of Technology, PB 12001, Tauranga, New Zealand
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Hikaka J, Ihimaera L, Kool B, Kerse N, Parsons J, Maxwell-Crawford K, Vercoe H, Merito P, Cavadino A, Te Ao B, Aramoana-Arlidge B. Feasibility and acceptability of a paeārahi (Indigenous Whānau Ora navigator) intervention for unintentional injury prevention for older Māori: non-randomised, non-comparator trial study protocol. Inj Prev 2022; 28:570-579. [DOI: 10.1136/ip-2022-044641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/06/2022] [Indexed: 11/05/2022]
Abstract
BackgroundMāori (the Indigenous population of Aotearoa New Zealand) experience increased burden of unintentional injury and reduced access to publicly funded injury prevention and rehabilitation services, compared with non-Māori. Māori-led models of care have been shown to improve outcomes for Māori. Paeārahi navigate across sectors (including health, education, housing and employment) to advocate for the best possible outcomes for individuals and families. This study aims to (1) test the acceptability and feasibility and (2) undertake exploratory efficacy analysis of a paeārahi injury intervention for Māori older adults.MethodsA prospective non-randomised, non-comparator study with preintervention and postintervention measurements of predefined outcomes. Eligible participants who consented to participate (Māori, 55+ years, community-dwelling and enrolled in one of three study general practices) will undergo a multivisit paeārahi intervention. The intervention includes home-hazard assessment, basic health screening, teaching of strength and balance exercises, education relating to injury prevention and access to injury-related, referral and connection to other health and social services) and participants can choose to have whānau (family) involved in the intervention.OutcomesThe primary outcome of interest is participant, whānau and paeārahi acceptability of the intervention. Secondary outcomes include intervention feasibility, cost-effectiveness and exploratory efficacy (including preintervention and postintervention unintentional injury-related hospitalisation, primary care access and public injury-related claims).DiscussionThe findings of this intervention research will be used to inform injury care models for older Māori and process for Māori-led health intervention development more generally.Trial registration numberACTRN12621001691831p.
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Abstract
BACKGROUND Diversity, equity, and inclusion (DEI) are increasingly recognized as core values for nursing education and practice. PURPOSE The purpose of this article is to offer teaching tools and strategies to integrate cultural humility within the nursing curriculum and create a more inclusive learning environment. APPROACH Various teaching tools, methods, and strategies are presented. OUTCOMES Use of ground rules, an environmental assessment, examination of the curriculum landscape and teaching materials, bias awareness activity, modified privilege walk, Modified Monopoly, simulation, low-income community experiences, study abroad, debriefing, and evaluation with valid and reliable tools are suggested. CONCLUSIONS By threading cultural humility concepts throughout the curriculum, nurse educators have the potential to shape learner perspectives to better appreciate and value diversity.
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Affiliation(s)
- Cynthia Foronda
- Professor of Clinical (Dr Foronda) and Assistant Professor of Clinical (Dr Prather), University of Miami School of Nursing and Health Studies, Coral Gables, Florida; Assistant Professor of Nursing (Dr Baptiste), Johns Hopkins University School of Nursing, Baltimore, Maryland; and Associate Professor (Dr Luctkar-Flude), Queen's University, Kingston, Ontario, Canada
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Ng L, Datt A, Moir F, Hakiaha H, O'Callaghan A, Lampshire D, Tennant G, Henry J, Wearn A. Medical students' evaluation of a suicide prevention multimedia resource: A focus group study. Int J Soc Psychiatry 2022; 68:1238-1247. [PMID: 35892140 DOI: 10.1177/00207640221113751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS A series of podcasts and videos was created to assist medical students with learning about suicide prevention. The aim of this research was to explore medical students experiences of using a suicide prevention learning resource. METHODS A multimedia repository of learning resources for suicide prevention was designed and created for use across all years of the medical programme at The University of Auckland. Emphasis was placed on ensuring that the resource was culturally safe. The impact of the learning resource was evaluated with a qualitative approach using focus group methodology. Two focus groups were audio-recorded, transcribed and a thematic analysis was conducted employing three cycles of coding. RESULTS Three themes were identified: perceiving that suicide is complex and sensitive; tailoring knowledge to match students' developmental stage and context; and elements that facilitated interaction with the resource. CONCLUSIONS Suicide is unsurprisingly a challenging topic for medical students. The students in this study actively engaged with this resource on suicide prevention, which supplemented their core learning of the topic. Early access to resources developed in a culturally safe way within a spiral curriculum empowers students to understand that they have an important contribution to make in preventing suicide. This may prepare them for encountering suicide with peers, family members and in clinical practice.
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Affiliation(s)
- Lillian Ng
- The University of Auckland, New Zealand.,Counties Manukau Health, Auckland, New Zealand
| | | | | | | | - Anne O'Callaghan
- The University of Auckland, New Zealand.,Auckland District Health Board, New Zealand
| | - Debra Lampshire
- The University of Auckland, New Zealand.,Auckland District Health Board, New Zealand
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215
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Truong M, Lazarus M, Ochoa GG, Brand G. Resisting and unlearning dehumanising language in nursing and healthcare practice, education and research: A call to action. NURSE EDUCATION TODAY 2022; 116:105458. [PMID: 35803047 DOI: 10.1016/j.nedt.2022.105458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/22/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Mandy Truong
- Monash Nursing & Midwifery, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Menzies School of Health Research, Darwin, Northern Territory, Australia.
| | - Michelle Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; Monash Centre for Scholarship in Health Education, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
| | - Gabriel García Ochoa
- School of Languages, Literatures, Cultures and Linguistics, Faculty of Arts, Monash University, Melbourne, Victoria, Australia.
| | - Gabrielle Brand
- Monash Centre for Scholarship in Health Education, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; Monash Nursing & Midwifery, Faculty of Medicine Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia.
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216
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Anishinabek sources of strength: Learning from First Nations people who have experienced mental health and substance use challenges. Soc Sci Med 2022; 309:115197. [DOI: 10.1016/j.socscimed.2022.115197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/09/2022] [Accepted: 07/03/2022] [Indexed: 11/23/2022]
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217
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Developing a Theory of Norm-Criticism in Nursing Education. ANS Adv Nurs Sci 2022; 46:E66-E79. [PMID: 36044350 DOI: 10.1097/ans.0000000000000440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this article, we explore the core concepts of norm-critical pedagogy developed in Sweden and only recently applied to nursing education praxis. These concepts, norms, power , and othering , are defined and demonstrated with exemplars from recent nursing education research. The theoretical model illustrates the ways in which these elements articulate in relationship to each other in nursing education praxis in ways that are dynamic, interlocking-like the gears of a clock-and resistant to interruption. We discuss the potential of a structurally oriented critical reflexivity-an equal and opposite force to the motion of the gears-to interrupt their motion.
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218
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Sehgal A, Barnabe C, Crowshoe L(L. Patient complexity assessment tools containing inquiry domains important for Indigenous patient care: A scoping review. PLoS One 2022; 17:e0273841. [PMID: 36044532 PMCID: PMC9432764 DOI: 10.1371/journal.pone.0273841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/16/2022] [Indexed: 11/21/2022] Open
Abstract
Patient complexity assessment tools (PCATs) are utilized to collect vital information to effectively deliver care to patients with complexity. Indigenous patients are viewed in the clinical setting as having complex health needs, but there is no existing PCAT developed for use with Indigenous patients, although general population PCATs may contain relevant content. Our objective was to identify PCATs that include the inquiry of domains relevant in the care of Indigenous patients with complexity. A scoping review was performed on articles published between 2016 and 2021 to extend a previous scoping review of PCATs. Data extraction from existing frameworks focused on domains of social realities relevant to the care of Indigenous patients. The search resulted in 1078 articles, 82 underwent full-text review, and 9 new tools were identified. Combined with previously known and identified PCATs, only 6 items from 5 tools tangentially addressed the domains of social realities relevant to Indigenous patients. This scoping review identifies a major gap in the utility and capacity of PCATs to address the realities of Indigenous patients. Future research should focus on developing tools to address the needs of Indigenous patients and improve health outcomes.
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Affiliation(s)
- Anika Sehgal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Cheryl Barnabe
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lynden (Lindsay) Crowshoe
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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219
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Falade E, Cornely RM, Ezekwesili C, Musabeyezu J, Amutah-Onukagha N, Ferguson T, Gebel C, Peprah-Wilson S, Larson E. Perspectives on cultural competency and race concordance from perinatal patients and community-based doulas. Birth 2022; 50:319-328. [PMID: 36017646 DOI: 10.1111/birt.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 07/24/2022] [Accepted: 07/30/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND As awareness of perinatal health disparities grows, many birthing people of color are seeking racially and/or culturally concordant providers. We described preferences for, and perceptions of, racial and/or cultural concordance and cultural competence in the context of the doula-client relationship. METHODS Seven focus group discussions (FGDs) with a total of 27 participants were conducted to investigate the perspectives of patients and doulas across Massachusetts, United States. An interdisciplinary stakeholder group informed the data collection instrument content and design. Two coders achieved 0.89 Kappa for inter-rater reliability prior to coding the remaining transcripts. We used a modified grounded theory approach and Dedoose software for coding. RESULTS Two major themes emerged. First, cultural competency in doula care is a learning process, with definitions consistent with terms such as "cultural humility" and "structural competency." Doulas discussed listening to clients' needs rather than making assumptions, the importance of understanding privilege and power dynamics, and self-initiating relevant education beyond formal doula training. Second, trust was most frequently cited as an indicator of successful doula-patient relationships. CONCLUSIONS Most study participants specified the importance of cultural humility in doula-client relationships. Doulas approaching the relationship humbly with a willingness to learn and challenge their own assumptions-regardless of the level of concordance-can make a meaningful impact on the perinatal experience.
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Affiliation(s)
- Ebunoluwa Falade
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ronald M Cornely
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Juliet Musabeyezu
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Tajh Ferguson
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Christina Gebel
- Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Elysia Larson
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
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220
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Červený M, Kratochvílová I, Hellerová V, Tóthová V. Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011–2021. Front Psychol 2022; 13:936181. [PMID: 36092120 PMCID: PMC9449514 DOI: 10.3389/fpsyg.2022.936181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Aim Training for the development of cultural competence is often not part of the professional training of nurses within the European Economic Area. Demographic changes in society and the cultural diversity of patients require nurses and other medical staff to provide the highest quality healthcare to patients from different cultural backgrounds. Therefore, nurses must acquire the necessary cultural knowledge, skills, and attitudes as part of their training and professional development to provide culturally competent care to achieve this objective. Objective This review aims to summarize existing methods of developing cultural competence in nurses working in clinical practice. Design A scoping review of the literature. Method The following databases were used: PubMed, ScienceDirect, ERIH Plus, and Web of Science using keywords; study dates were from 2011 to 2021. Results The analysis included six studies that met the selection criteria. The studies were categorized as face-to-face, simulations, and online education learning methods. Conclusion Educational training for cultural competence is necessary for today’s nursing. The training content should include real examples from practice, additional time for self-study using modules, and an assessment of personal attitudes toward cultural differences.
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Richardson L, Minh A, McCormack D, Laing A, Barbic S, Hayashi K, Milloy MJ, Huyser KR, Leahy K, Li J. Cohort Profile: The Assessing Economic Transitions (ASSET) Study-A Community-Based Mixed-Methods Study of Economic Engagement among Inner-City Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610456. [PMID: 36012091 PMCID: PMC9408769 DOI: 10.3390/ijerph191610456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 05/07/2023]
Abstract
The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an open prospective cohort which aims to provide data on opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada. Participants complete interviewer-administered surveys quarterly. A subset of participants complete nested semi-structured qualitative interviews semi-annually. Between April 2019 and May 2022, the study enrolled 257 participants ages 19 years or older (median age: 51; 40% Indigenous, 11.6% non-Indigenous people of colour; 39% cis-gender women, 3.9% transgender, genderqueer, or two-spirit) and 41 qualitative participants. At baseline, all participants reported past daily drug use, with 27% currently using opioids daily, and 20% currently using stimulants daily. In the three months prior to baseline, more participants undertook informal income generation (75%) than formal employment (50%). Employed participants largely had casual jobs (42%) or jobs with part-time/varied hours (35%). Nested qualitative studies will focus on how inner-city populations experience economic engagement. The resulting evidence will inform policy and programmatic initiatives to address socioeconomic drivers of health and well-being.
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Affiliation(s)
- Lindsey Richardson
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Correspondence:
| | - Anita Minh
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Deb McCormack
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
| | - Allison Laing
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
| | - Skye Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Providence Research, 1190 Hornby, Vancouver, BC V6Z 2K5, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - M.-J. Milloy
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Kimberly R. Huyser
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Kathleen Leahy
- UBC Learning Exchange, University of British Columbia, 612 Main St., Vancouver, BC V6A 2V3, Canada
| | - Johanna Li
- EMBERS Eastside Works, 57 E Hastings St., Vancouver, BC V6A 0A7, Canada
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Coombes J, Hunter K, Bennett-Brook K, Porykali B, Ryder C, Banks M, Egana N, Mackean T, Sazali S, Bourke E, Kairuz C. Leave events among Aboriginal and Torres Strait Islander people: a systematic review. BMC Public Health 2022; 22:1488. [PMID: 35927686 PMCID: PMC9354286 DOI: 10.1186/s12889-022-13896-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leave events are a public health concern resulting in poorer health outcomes. In Australia, leave events disproportionally impact Aboriginal and Torres Strait Islander people. A systematic review was conducted to explore the causes of leave events among Aboriginal and Torres Strait Islander people and strategies to reduce them. METHODS A systematic review was conducted using Medline, Web of Science, Embase and Informit, a database with a strong focus on relevant Australian content. Additionally, we examined the references of the records included, and performed a manual search using Google, Google scholar and the Australia's National Institute for Aboriginal and Torres Strait Islander Health Research. Two independent reviewers screened the records. One author extracted the data and a second author reviewed it. To appraise the quality of the studies the Mixed Methods Appraisal Tool was used as well as the Aboriginal and Torres Strait Islander Quality Appraisal Tool. A narrative synthesis was used to report quantitative findings and an inductive thematic analysis for qualitative studies and reports. RESULTS We located 421 records. Ten records met eligibility criteria and were included in the systematic review. From those, four were quantitative studies, three were qualitative studies and three reports. Five records studied data from the Northern Territory, two from Western Australia, two from New South Whales and one from Queensland. The quantitative studies focused on the characteristics of the patients and found associations between leave events and male gender, age younger than 45 years and town camp residency. Qualitative findings yielded more in depth causes of leave events evidencing that they are associated with health care quality gaps. There were multiple strategies suggested to reduce leave events through adapting health care service delivery. Aboriginal and Torres Strait Islander representation is needed in a variety of roles within health care provision and during decision-making. CONCLUSION This systematic review found that multiple gaps within Australian health care delivery are associated with leave events among Aboriginal and Torres Strait Islander people. The findings suggest that reducing leave events requires better representation of Aboriginal and Torres Strait Islander people within the health workforce. In addition, partnership with Aboriginal and Torres Strait Islander people is needed during the decision-making process in providing health services that meet Aboriginal and Torres Strait Islander cultural needs.
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Affiliation(s)
- J Coombes
- The George Institute for Global Health, Newtown, Australia.
| | - K Hunter
- The George Institute for Global Health, Newtown, Australia.,The University of New South Wales, Sydney, Australia
| | | | - B Porykali
- The George Institute for Global Health, Newtown, Australia
| | - C Ryder
- The George Institute for Global Health, Newtown, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - M Banks
- Australian Commission On Safety and Quality in Health Care, Sydney, Australia
| | - N Egana
- Australian Commission On Safety and Quality in Health Care, Sydney, Australia
| | - T Mackean
- The George Institute for Global Health, Newtown, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - S Sazali
- The George Institute for Global Health, Newtown, Australia
| | - E Bourke
- The George Institute for Global Health, Newtown, Australia
| | - C Kairuz
- The George Institute for Global Health, Newtown, Australia
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Lightfoot N, Manitowabi D, Arrandale V, Barnett N, Wabegijig-Nootchtai C, Odjig ML, Moulton J, Fongemy J, Larivière M, Kerekes Z, Holness L, MacEwan L, Eger T, Warry W. Workers’ compensation experience in some Indigenous Northern Ontario communities. Work 2022; 73:707-717. [DOI: 10.3233/wor-210895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: There is a dearth of research about occupational health and safety experience in Indigenous communities and compensation applications from Indigenous workers appear limited. OBJECTIVE: This qualitative descriptive study was designed to explore workers’ compensation experiences in some Canadian Indigenous communities. METHODS: A community-based participatory research approach was used to conduct focus groups (n = 25 participants) in three Northeastern Ontario (NEO) Indigenous communities and at one NEO Indigenous employment centre. Semi-structured focus group questions addressed community experience with workers’ compensation, the compensation process, and discussion of a training session about the process. Reflexive thematic analysis followed Braun and Clarke procedures. RESULTS: Discussion with study participants resulted in these themes: 1) both lack of knowledge, and knowledge, about compensation demonstrated, 2) impact of lack of compensation coverage and need for universal coverage on reserve, 3) need for community training sessions about workers’ compensation, 4) workload and financial impact of workers’ compensation on reserve, and 5) requirement for cultural competence training in the compensation board. CONCLUSIONS: This qualitative descriptive study revealed the: need for more information about applying for workers’ compensation and navigating the process, need for universal workplace insurance coverage in Indigenous communities, demand for community-based compensation process training, community costs of compensation, and the requirement for cultural safety and competence training for compensation organization employees. More education about the workers’ compensation process would be of benefit to leadership, health care providers, administrative personnel, employers, and employees on reserves. Nurses in community health centres are well situated to provide further guidance.
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Affiliation(s)
- Nancy Lightfoot
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON, Canada
| | - Darrel Manitowabi
- Human Sciences Division, Northern Ontario School of Medicine, Sudbury, ON, Canada
| | - Victoria Arrandale
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Nathaniel Barnett
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON, Canada
| | | | - Mary Lynn Odjig
- Economic Development, Wiikwemkoong Development Commission, Wiikwemkoong, ON, Canada
| | - Jeff Moulton
- Human Resources and Shared Services, Sagamok Anishnawbek, Massey, ON, Canada
| | - Julie Fongemy
- Office of the Worker Adviser, Ontario Ministry of Labour, Sault Ste. Marie, ON, Canada
| | - Michel Larivière
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON, Canada
| | - Zsuzsanna Kerekes
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON, Canada
| | - Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Leigh MacEwan
- School of Social Work, Laurentian University, Sudbury, ON, Canada
| | - Tammy Eger
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON, Canada
| | - Wayne Warry
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
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Singh H, Sangrar R, Wijekoon S, Nekolaichuk E, Kokorelias KM, Nelson MLA, Mirzazada S, Nguyen T, Assaf H, Colquhoun H. Applying 'cultural humility' to occupational therapy practice: a scoping review protocol. BMJ Open 2022; 12:e063655. [PMID: 35906054 PMCID: PMC9345050 DOI: 10.1136/bmjopen-2022-063655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Cultural humility is becoming increasingly important in healthcare delivery. Recognition of power imbalances between clients and healthcare providers is critical to enhancing cross-cultural interactions in healthcare delivery. While cultural humility has been broadly examined in healthcare, knowledge gaps exist regarding its application in occupational therapy (OT) practice. This scoping review protocol aims to: (1) describe the extent and nature of the published health literature on cultural humility, including concepts, descriptions and definitions and practice recommendations, (2) map the findings from objective one to OT practice using the Canadian Practice Process Framework (CPPF), and (3) conduct a consultation exercise to confirm the CPPF mapping and generate recommendations for the practice of cultural humility in OT. METHODS AND ANALYSIS We will search Ovid Medline, Ovid Embase, Ovid PsycINFO, Ebsco CINAHL Plus, ProQuest ASSIA, ProQuest Sociological Abstracts, ProQuest ERIC, WHO Global Index Medicus, and Web of Science databases. Published health-related literature on cultural humility will be included. There will be no restrictions on population or article type. Following deduplication on Endnote, the search results will undergo title, abstract, and full-text review by two reviewers working independently on Covidence. Extracted data will include descriptors of the article, context, population, and cultural humility. After descriptive extraction, data describing cultural humility-related content will be descriptively and interpretively analysed using an inductive thematic synthesis approach. The data will also be mapped to OT practice through deductive coding using the CPPF. Occupational therapists and clients will be consulted to further critique, interpret and validate the mapping and generate practice recommendations. ETHICS AND DISSEMINATION Ethics approval was not required for this scoping review protocol. We will disseminate the findings, which can enhance understanding of cultural humility in OT, facilitate cross-cultural encounters between occupational therapists and clients and improve care outcomes through publications and presentations.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ruheena Sangrar
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sachindri Wijekoon
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Erica Nekolaichuk
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Kristina Marie Kokorelias
- Department of Medicine, Geriatrics Program, Sinai Health and University Health Network, Toronto, Ontario, Canada
| | - Michelle L A Nelson
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sofia Mirzazada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Tram Nguyen
- March of Dimes Canada, Toronto, Ontario, Canada
| | - Holly Assaf
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Cultural Safety for LGBTQIA+ People: A Narrative Review and Implications for Health Care in Malaysia. SEXES 2022. [DOI: 10.3390/sexes3030029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
LGBTQIA+ people in Malaysia constitute a marginalised population as they are subjected to cisheterosexism that permeates every layer of society. Cisheterosexist ideologies in Malaysia find their eligibility on secular and religious laws that criminalise LGBTQIA+ identities, which have detrimental consequences on LGBTQIA+ people’s mental health and their ability to access equitable health care. Existing literature has revealed limitations for healthcare providers to employ a blinded approach (i.e., treat everyone the same) and practise culturally competency when seeing LGBTQIA+ patients. In this narrative review, we compiled international evidence of culturally safe care for LGBTQIA+ people and outlined its relevance to interrogating power relationships within healthcare practices and structures. Our reviewed findings brought together five components of culturally safe care for LGBTQIA+ people: power-enhancing care; inclusive healthcare institutions; continuous education and research; promotion of visibility; and individualised care. These components set crucial milestones for healthcare providers to reflect on ways to equalise power dynamics in a provider–patient relationship. The applicability and implication of culturally safe healthcare in Malaysia are succinctly discussed.
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226
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Wilson L, Wilkinson A, Tikao K. Health professional perspectives on translation of cultural safety concepts into practice: A scoping study. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:891571. [PMID: 36189045 PMCID: PMC9397926 DOI: 10.3389/fresc.2022.891571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022]
Abstract
People from unique and diverse populations, (i.e., social groupings excluded by the dominant majority by, for example, ethnicity, gender, age, sexual orientation, disability or even rurality), experience dissimilar health outcomes. Members of such populations who have long-term health conditions experience further health disparities through inefficient management and treatment. This remains a significant hindrance to achieving equity in health outcomes. Being responsive and acting upon the cultural needs of unique and diverse populations within health services is pivotal in addressing health disparities. Despite provision of professional training to health professionals, cultural competency remains an elusive goal. This scoping study summarized available literature about what helped health professionals translate cultural safety concepts into practice. We searched electronic databases using MeSH terms and keywords for English language articles and reference lists of potentially included studies. Quality appraisal was undertaken using Joanna Briggs Institute critical appraisal tools. Data were charted, with a descriptive numerical summary and thematic analysis of study findings undertaken. Twelve qualitative studies with n = 206 participants were included. Learning through and from direct experience, and the individual qualities of professionals (i.e., individual capacity for relational skills and intentionality of engagement with one's own values and biases) facilitated translation of cultural safety concepts into practice. Also important was the need for cultural training interventions to address both issues of content and process within course design. Doing this would take into consideration the benefits that can come from learning as a part of a collective. In each of these themes was evidence of how health professionals needed the ability to manage emotional discomfort as part of the process of learning. A dearth of information exists exploring professionals' perspectives on translating cultural safety concepts into practice. There may be merit in designing educational interventions that look beyond the classroom. We also suggest that nurturing people's relational skills likely holds benefits to growing culturally safe practice as does increasing health professional's capacity to sit with the discomfort that occurs when paying attention to one's own and others values and biases.
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227
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Healey SJR, Ghafournia N, Massey PD, Andrich K, Harrison J, Taylor K, Bolsewicz K. Factors contributing to the sharing of COVID-19 health information amongst refugee communities in a regional area of Australia: a qualitative study. BMC Public Health 2022; 22:1434. [PMID: 35897090 PMCID: PMC9331021 DOI: 10.1186/s12889-022-13850-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic has had a disproportionate impact on culturally and linguistically diverse (CALD) groups worldwide. Newly emerging CALD populations formed by recently arrived refugees are predisposed to even greater health disadvantages due to complexities of the refugee experience. The aim of this study was to explore how culture, refugee experiences and existing relationships shaped what COVID-19 messages were listened to and shared during the early-mid phases of the pandemic. The work focused on three newly emerging refugee groups in the Hunter New England region, Australia: Afghan, Congolese and Syrian communities. Methods Qualitative, semi-structured interviews were conducted to explore the experiences and stories of 15 adult community members, nine influential members and six service providers. All community members arrived in Australia on or after January 2014. Interpreter-assisted interviews were conducted with small groups or individuals, audio-recorded and transcribed verbatim in English. Three levels of thematic data analysis were employed to uncover the important issues and experiences of the participants. Results Three key themes and several subthemes were identified. The themes were: 1) Experience as a refugee uniquely influences COVID-19 message communication; 2) Refugee groups use diverse practices when accessing and sharing COVID-19 messages; and 3) Official government messages could be improved by listening and tailoring to community needs. Conclusions Effective health messaging relies on reaching communities in a culturally acceptable and meaningful way. Official COVID-19 messages can be tailored to engage newly emerging communities by improving the quality of the content, delivery and format whilst working collaboratively with communities and trusted service providers. Further mutual research is needed to understand emerging communities’ viewpoints. The use of culturally informed approaches is recommended.
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Affiliation(s)
- Sunita Joann Rebecca Healey
- Multicultural and Refugee Health Services, HNE Health, Harker Building, Wallsend Health Services, Longworth Ave, Wallsend NSW, Newcastle, 2287, Australia.
| | - Nafiseh Ghafournia
- Multicultural and Refugee Health Services, HNE Health, Harker Building, Wallsend Health Services, Longworth Ave, Wallsend NSW, Newcastle, 2287, Australia
| | - Peter D Massey
- College of Medicine & Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Karinne Andrich
- Multicultural and Refugee Health Services, HNE Health, Harker Building, Wallsend Health Services, Longworth Ave, Wallsend NSW, Newcastle, 2287, Australia
| | - Joy Harrison
- Multicultural and Refugee Health Services, HNE Health, Armidale Community Health Centre, 226 Rusden St, Armidale, NSW, 2350, Australia
| | - Kathryn Taylor
- Central Coast Population Health Unit, Level 1, 4 Watt St, Gosford, NSW, 2250, Australia
| | - Katarzyna Bolsewicz
- The University of Newcastle, University Drive, Callaghan NSW, Newcastle, 2308, Australia
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228
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Mitchell A, Wade V, Haynes E, Katzenellenbogen J, Bessarab D. “The world is so white”: improving cultural safety in healthcare systems for Australian Indigenous people with rheumatic heart disease. Aust N Z J Public Health 2022; 46:588-594. [DOI: 10.1111/1753-6405.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/01/2021] [Accepted: 01/01/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Alice Mitchell
- School of Population & Global Health University of Western Australia
| | - Vicki Wade
- Menzies School of Health Research Charles Darwin University Northern Territory
| | - Emma Haynes
- School of Population & Global Health University of Western Australia
| | | | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health University of Western Australia
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Smylie J, Harris R, Paine SJ, Velásquez IA, Lovett R. Beyond shame, sorrow, and apologies-action to address indigenous health inequities. BMJ 2022; 378:o1688. [PMID: 35803599 DOI: 10.1136/bmj.o1688] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Ricci Harris
- Te Rōpū Rangahau Hauora a Eru Pōmare, Department of Public Health, University of Otago, Wellington, New Zealand
| | | | | | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Australia
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230
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Russell J, Grant CC, Morton S, Denny S, Paine (Tūhoe) SJ. Prevalence and predictors of developmental health difficulties within New Zealand preschool-aged children: a latent profile analysis. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2083188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jin Russell
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Developmental Paediatrics, Neuroservices, Starship Children’s Health, Auckland, New Zealand
| | - Cameron C. Grant
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand
- General Paediatrics, Starship Children’s Health, Auckland, New Zealand
| | - Susan Morton
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Simon Denny
- Mater Research, Health Services Research Group, South Brisbane, Australia
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Pirhofer J, Bükki J, Vaismoradi M, Glarcher M, Paal P. A qualitative exploration of cultural safety in nursing from the perspectives of Advanced Practice Nurses: meaning, barriers, and prospects. BMC Nurs 2022; 21:178. [PMID: 35787799 PMCID: PMC9251927 DOI: 10.1186/s12912-022-00960-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background Cultural safety requires healthcare professionals and organisations to improve healthcare, facilitate patient access to healthcare, and achieve equity within the workforce. Methods This ethnomethodological study, which consisted of two phases, explored the concept of cultural safety from the perspective of Advanced Practice Nurses. Semi-structured interviews and the nominal group technique were used to prioritise challenges related to cultural safety, identify barriers to clinical practise and assess educational needs. The data collected was subjected to thematic analysis. Results Nurses working in Austria, Germany and Switzerland were recruited (N = 29). Accordingly, the phenomenon of cultural safety in health care is not generally known and there is little prior knowledge about it. The most frequently discussed themes were communication difficulties, lack of knowledge, the treatment of people with insufficient language skills and expectations of treatment goals and outcomes, which can lead to conflicts and accusations of unequal treatment due to diverse cultural backgrounds. Conclusion Diverse cultures are encountered in German-speaking healthcare settings. Cultural safety is also about healthcare staff, as nurses with different socialisations encounter prejudice, discrimination and racism. Although the issue of power was not discussed, academic nurses were willing to make an effort to change. Only a minority were aware that lasting change requires challenging one’s own cultural structures and adapted behaviours, rather than pushing for the mere acquisition of cultural competence. Organisations were encouraged to introduce self-reflection sessions and provide better access to translation services to improve equity and support nurses.
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Affiliation(s)
- Jacqueline Pirhofer
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Johannes Bükki
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.,Diakonie-Klinikum Stuttgart, Rosenbergstrasse 38, 70176, Stuttgart, Germany
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049, Bodø, Norway
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Piret Paal
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
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Kaphle S, Hungerford C, Blanchard D, Doyle K, Ryan C, Cleary M. Cultural Safety or Cultural Competence: How Can We Address Inequities in Culturally Diverse Groups? Issues Ment Health Nurs 2022; 43:698-702. [PMID: 34807792 DOI: 10.1080/01612840.2021.1998849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sabitra Kaphle
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | | | - Denise Blanchard
- School of Nursing and Midwifery, University of Newcastle, Central Coast Clinical School, New South Wales, Australia
| | - Kerrie Doyle
- Indigenous Health, School of Medicine, Western Sydney University, Sydney, Australia
| | - Colleen Ryan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Sydney, New South Wales, Australia
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233
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Kerrigan V, McGrath SY, Herdman RM, Puruntatameri P, Lee B, Cass A, Ralph AP, Hefler M. Evaluation of 'Ask the Specialist': a cultural education podcast to inspire improved healthcare for Aboriginal peoples in Northern Australia. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:139-157. [PMID: 35373706 DOI: 10.1080/14461242.2022.2055484] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
In Australia's Northern Territory (NT) most people who access health services are Aboriginal and most healthcare providers are non-Indigenous; many providers struggle to deliver culturally competent care. Cultural awareness training is offered however, dissatisfaction exists with the limited scope of training and the face-to-face or online delivery format. Therefore, we developed and evaluated Ask the Specialist: Larrakia, Tiwi and Yolŋu stories to inspire better healthcare, a cultural education podcast in which Aboriginal leaders of Larrakia, Tiwi and Yolŋu nations, known as the Specialists, answer doctors' questions about working with Aboriginal patients. The Specialists offer 'counterstories' which encourage the development of critical consciousness thereby challenging racist narratives in healthcare. After listening to the podcast, doctors reported attitudinal and behavioural changes which led to stereotypes being overturned and more culturally competent care delivery. While the podcast was purposefully local, issues raised had applicability beyond the NT and outside of healthcare. Our approach was shaped by cultural safety, critical race theory and Freirean pedagogy. This pilot is embedded in a Participatory Action Research study which explores strategies to improve culturally safe communication at the main NT hospital Royal Darwin Hospital.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | | | | | | | - Bilawara Lee
- Indigenous leadership, Charles Darwin University, Darwin, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Royal Darwin Hospital, Darwin, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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234
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Kaholokula JK, AuYoung M, Chau M, Sambamoorthi U, Carson S, Thao C, Nguyen M, Alo A, Riklon S, Lepule T, Ma GX. Unified in Our Diversity to Address Health Disparities Among Asian Americans, Native Hawaiians, and Pacific Islanders. Health Equity 2022; 6:540-545. [PMID: 36186617 PMCID: PMC9518805 DOI: 10.1089/heq.2022.0034] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic disproportionately impacted Asian Americans, Native Hawaiians, and Pacific Islanders (AA/NHPIs) in the United States. AA/NHPIs have historically been subjected to discrimination, which was exacerbated by the pandemic. To bring attention to their unique concerns, an AA/NHPI Interest Group of the National Institutes of Health Community Engagement Alliance Against COVID-19 Disparities (CEAL) was formed. This article highlights major concerns raised by the Interest Group: The pervasive and arbitrary practice of data aggregation by public health agencies and health-related researchers, the lack of culturally responsive services in the context of cultural safety, and leadership underrepresentation.
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Affiliation(s)
- Joseph Keawe‘aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, Hawai'i, USA
| | - Mona AuYoung
- Department of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA
| | - Michelle Chau
- Department of Population Health, Grossman School of Medicine, New York University, New York City, New York, USA
| | - Usha Sambamoorthi
- Department of Pharmacotherapy, College of Pharmacy and Texas Center for Health Disparities, University of North Texas Health Sciences Center, Fort Worth, Texas, USA
| | - Savanna Carson
- Department of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA
| | - Chia Thao
- Department of Public Health, University of California, Merced, California, USA
| | - May Nguyen
- Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston College of Medicine, Houston, Texas, USA
| | - Audrey Alo
- Pacific Islander Health Partnership, Garden Grove, California, USA
| | - Sheldon Riklon
- Department of Family and Preventive Medicine and Center for Pacific Islander Health, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
| | - Tana Lepule
- Pacific Islander Collective of San Diego, San Diego, California, USA
| | - Grace X. Ma
- Department of Urban Health and Population Science, Center for Asian Health and Fox Chase Cancer Center, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
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235
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Wallington SF, Noel A. Communicating with Community: Health Disparities and Health Equity Considerations. Med Clin North Am 2022; 106:715-726. [PMID: 35725236 DOI: 10.1016/j.mcna.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This article explores why communicating with communities is important to the health of individuals as well as public health, and best practices of how. We outline the use of relevant theoretic frameworks, understanding the role of technological contextual changes, trust despite misinformation, health and digital literacy skills, and working with the community for effective reciprocal communication. Strategies for developing community communication are also enumerated and applied to addressing health disparities.
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Affiliation(s)
- Sherrie Flynt Wallington
- George Washington University, School of Nursing, 1919 Pennsylvania Avenue, Suite 500, Washington, DC 20048, USA.
| | - Annecie Noel
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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236
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Embedding Diversity, Equity, and Inclusion into a Kinesiology Curriculum: A Detailed Report of a Curriculum Redesign. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11070271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Students need to be properly prepared by their education to work respectfully and effectively with diverse populations and in diverse environments. Our purpose is twofold: (i) to provide a thorough description of the curriculum redesign process for an undergraduate kinesiology and health promotion (KHP) program, and (ii) to use our experience to provide more general recommendations to other departments and universities undergoing curricular redesign. The catalyst for this redesign was the conversion from a quarter-system to a semester-system and the opportunities for improvement identified through that process. The redesign was guided by a newly created departmental strategic plan, faculty professional development trainings, student feedback, faculty hirings and their areas of expertise, and industry demands. Diversity, equity, and inclusion (DEI) was mindfully embedded into the curriculum to reflect the department-, college-, and university-level core value of inclusivity. The redesign allows prospective KHP students to complete several courses that address DEI themes, in addition to the courses that build their technical competencies. Providing foundational exposure to DEI concepts through the undergraduate curriculum can better prepare students to work in diverse settings. As such, this report provides other programs with a framework to follow to make curriculum more DEI centric for their students.
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237
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McLane P, Mackey L, Holroyd BR, Fitzpatrick K, Healy C, Rittenbach K, Plume TB, Bill L, Bird A, Healy B, Janvier K, Louis E, Barnabe C. Impacts of racism on First Nations patients' emergency care: results of a thematic analysis of healthcare provider interviews in Alberta, Canada. BMC Health Serv Res 2022; 22:804. [PMID: 35729530 PMCID: PMC9210059 DOI: 10.1186/s12913-022-08129-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background First Nations people experience racism in society and in the healthcare system. This study aimed to document emergency care providers’ perspectives on care of First Nations patients. First Nations research partner organizations co-led all aspects of the research. Methods Sixteen semi-structured interviews were conducted with Alberta emergency department (ED) physicians and nurses between November 2019 and March 2020. Results ED providers reported that First Nations patients are exposed to disrespect through tone and body language, experience overt racism, and may be neglected or not taken seriously. They described impacts of racist stereotypes on patient care, and strategies they took as individuals to address patient barriers to care. Recognized barriers to care included communication, resources, access to primary care and the ED environment itself. Conclusions Results may inform the content of anti-racist and anti-colonial pedagogy that is contextually tailored to ED providers, and inform wider systems efforts to counter racism against First Nations members and settler colonialism within healthcare. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08129-5.
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Affiliation(s)
- Patrick McLane
- Alberta Health Services, Strategic Clinical Networks, Alberta Health Services Corporate Office, Seventh Street Plaza, 14th Floor, North Tower, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada. .,Department of Emergency Medicine, University of Alberta, 790 University Terrace Building, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada.
| | - Leslee Mackey
- Department of Emergency Medicine, University of Alberta, 790 University Terrace Building, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Brian R Holroyd
- Alberta Health Services, Strategic Clinical Networks, Alberta Health Services Corporate Office, Seventh Street Plaza, 14th Floor, North Tower, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada.,Department of Emergency Medicine, University of Alberta, 790 University Terrace Building, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Kayla Fitzpatrick
- University of Alberta, School of Public Health, Edmonton Clinic Health Academy, 3-341, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Chyloe Healy
- Blackfoot Confederacy Tribal Council, P.O. Box 916, Standoff, AB, T0L 1Y0, Canada
| | - Katherine Rittenbach
- Alberta Health Services, Strategic Clinical Networks, Alberta Health Services Corporate Office, Seventh Street Plaza, 14th Floor, North Tower, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada.,University of Calgary, Department of Psychiatry, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.,University of Alberta, Department of Psychiatry, 1E1 Walter Mackenzie Health Sciences Centre, 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Tessy Big Plume
- Stoney Nakoda Tsuut'ina Tribal Council, PO Box 350, 9911 Chiila Boulevard S.W., Tsuut'ina, AB, T2W 6H6, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Suite 101, 535 8 Ave SE, Calgary, AB, T2G 5S9, Canada
| | - Anne Bird
- Paul First Nation Health Services, Box 89, Duffield, AB, TOE 0N0, Canada
| | - Bonnie Healy
- Blackfoot Confederacy Tribal Council, P.O. Box 916, Standoff, AB, T0L 1Y0, Canada
| | - Kristopher Janvier
- Kee Tas Kee Now Health Services, KTC Sub Office, 17015 - 105 Avenue NW, Edmonton, AB, T5S 1M5, Canada
| | - Eunice Louis
- Maskwacis Health Services, Box 100, 14 Ermineskin Ave, Maskwacis, AB, Canada
| | - Cheryl Barnabe
- University of Calgary, Departments of Medicine and Community Health Sciences, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
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238
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Edmonds LK, Cram F, Bennett M, Lambert C, Adcock A, Stevenson K, Geller S, MacDonald EJ, Bennett T, Storey F, Gibson-Helm M, Ropitini S, Taylor B, Bell V, Hoskin C, Lawton B. Hapū Ora (pregnancy wellness): Māori research responses from conception, through pregnancy and ‘the first 1000 days’ – a call to action for us all. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2075401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Liza K. Edmonds
- Kōhatu Centre for Hauora Māori, Division of Health Sciences, University of Otago, Dunedin, Aotearoa New Zealand
- Department of Women’s and Children’s, Otago School of Medicine, University of Otago, Dunedin, Aotearoa New Zealand
| | - Fiona Cram
- Katoa Limited, Auckland, Aotearoa New Zealand
| | - Matthew Bennett
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Charlie Lambert
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Anna Adcock
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Kendall Stevenson
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Stacie Geller
- Department of Obstetrics and Gynaecology, University of Illinois, Chicago, IL, USA
| | - Evelyn Jane MacDonald
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Tina Bennett
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Francesca Storey
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Melanie Gibson-Helm
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Sidney Ropitini
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Brittany Taylor
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Victoria Bell
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Caitlin Hoskin
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
| | - Beverly Lawton
- Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Aotearoa New Zealand
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Hantke S, St Denis V, Graham H. Racism and antiracism in nursing education: confronting the problem of whiteness. BMC Nurs 2022; 21:146. [PMID: 35689222 PMCID: PMC9185919 DOI: 10.1186/s12912-022-00929-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Systemic racism in Canadian healthcare may be observed through racially inequitable outcomes, particularly for Indigenous people. Nursing approaches intending to respond to racism often focus on culture without critically addressing the roots of racist inequity directly. In contrast, the critical race theory approach used in this study identifies whiteness as the underlying problem; a system of racial hierarchy that accords value to white people while it devalues everyone else. Methods This qualitative study seeks to add depth to the understanding of how whiteness gets performed by nursing faculty and poses antiracism education as a necessary tool in addressing the systemic racism within Canadian healthcare. The methodology of poststructural discourse analysis is used to explore the research question: how do white nursing faculty draw on common discourses to produce themselves following introductory antiracism education? Results Analysis of data reveals common patterns of innocent and superior white identity constructions including benevolence, neutrality, Knowing, and exceptionalism. While these patterns are established in other academic fields, the approaches and results of this study are not yet common in nursing literature. Conclusions The findings highlight the need for antiracism education at personal and policy levels beginning in nursing programs.
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Affiliation(s)
| | | | - Holly Graham
- University of Saskatchewan, Saskatoon, SK, Canada
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240
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Brewer KM, Grey C, Paynter J, Winter-Smith J, Hanchard S, Selak V, Ameratunga S, Harwood M. What are the gaps in cardiovascular risk assessment and management in primary care for Māori and Pacific people in Aotearoa New Zealand? Protocol for a systematic review. BMJ Open 2022; 12:e060145. [PMID: 35676004 PMCID: PMC9185566 DOI: 10.1136/bmjopen-2021-060145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION In New Zealand, significant inequities exist between Māori and Pacific peoples compared with non-Māori, non-Pacific peoples in cardiovascular disease (CVD) risk factors, hospitalisations and management rates. This review will quantify and qualify already-reported gaps in CVD risk assessment and management in primary care for Māori and Pacific peoples compared with non-Māori/non-Pacific peoples in New Zealand. METHODS AND ANALYSIS We will conduct a systematic search of the following electronic databases and websites from 1 January 2000 to 31 December 2021: MEDLINE (OVID), EMBASE, Scopus, CINAHL Plus, NZresearch.org, National Library Catalogue (Te Puna), Index New Zealand (INNZ), Australia/New Zealand Reference Centre. In addition, we will search relevant websites such as the Ministry of Health and research organisations. Data sources will include published peer reviewed articles, reports and theses employing qualitative, quantitative and mixed methods.Two reviewers will independently screen the titles and abstracts of the citations and grade each as eligible, not eligible or might be eligible. Two reviewers will read each full report, with one medically qualified reviewer reading all reports and two other reviewers reading half each. The final list of included citations will be compiled from the results of the full report reading and agreed on by three reviewers. Data abstracted will include authors, title, year, study characteristics and participant characteristics. Data analysis and interpretation will involve critical inquiry and a strength-based approach that is inclusive of Māori and Pacific values. This means that critical appraisal includes an assessment of quality from an Indigenous perspective. ETHICS AND DISSEMINATION Ethical approval is not required. The findings will be published in a peer-reviewed journal and shared with stakeholders. This review contributes to a larger project which creates a Quality-Improvement Equity Roadmap to reduce barriers to Māori and Pacific peoples accessing evidence-based CVD care.
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Affiliation(s)
- Karen Marie Brewer
- Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Corina Grey
- Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Janine Paynter
- Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Julie Winter-Smith
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sandra Hanchard
- Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Vanessa Selak
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Population Health Directorate, Counties Manukau Health, Auckland, New Zealand
| | - Matire Harwood
- Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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241
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‘We Want to Help but We Don’t Know What to Do’: Service Providers Working with Indigenous LGBTIQ+ Youth in Australia. SEXES 2022. [DOI: 10.3390/sexes3020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Access to adequate and appropriate service provision has a direct positive impact on health and wellbeing. Experiences of inaccessible, discriminatory, and culturally unsafe services and/or service providers are considered a root cause for the health inequalities that exist among Indigenous queer youth. Experiences of discrimination and cultural inappropriateness are commonplace, with Indigenous queer youth noting issues related to access to services and treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This paper examines the perspectives of Indigenous LGBTIQ+ youth and health service providers to identify what challenges, obstacles and opportunities are currently being faced and what could be implemented to improve the health and wellbeing outcomes for Indigenous LGBTIQ+ youth in the future.
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242
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Dickson T, Wilkinson T, Hegedus EJ, Gisselman AS. Transforming the Patient Experience: Moving Beyond Cultural Competence to Cultural Safety. Phys Ther 2022; 102:6556166. [PMID: 35358317 DOI: 10.1093/ptj/pzac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/01/2021] [Accepted: 02/06/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Tara Dickson
- Tufts DPT-Phoenix, Tufts University School of Medicine, Phoenix, Arizona, USA
| | - Tawna Wilkinson
- Tufts DPT-Phoenix, Tufts University School of Medicine, Phoenix, Arizona, USA
| | - Eric J Hegedus
- Tufts DPT-Phoenix, Tufts University School of Medicine, Phoenix, Arizona, USA
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243
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de Diego-Cordero R, Tarriño-Concejero L, Vargas-Martínez AM, Muñoz MÁGC. Effects of an educational intervention on nursing students' attitudes towards gypsy women: A non-randomized controlled trial. NURSE EDUCATION TODAY 2022; 113:105383. [PMID: 35508084 DOI: 10.1016/j.nedt.2022.105383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 03/01/2022] [Accepted: 04/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The cultural differences between health professionals and patients, together with the ethnocentric opinions that some health professionals sometimes hold, generate prejudice and negatively influence the experiences of these groups, for example, the Gypsy population. METHODS We set up a quasi-experimental study to test the efficacy of an educational intervention among 40 nursing students in Spain based on the use of positive references in order to improve the students' attitude towards gypsy women receiving health care. Analysis of comparison of means and correlation analysis were carried out according to the type of variable compared. RESULTS The score in all the items that make up the Prejudicial Attitude Scale (PAT) decreased after the test, which demonstrated that their attitudes had become less prejudiced. The Stereotype Content Model (SCM), the perception of the outgroup and the stereotypes regarding the Roma population as "trustworthy" all improved showing a statistically significant difference between the periods (pre and post educational intervention). CONCLUSION Nursing educators have the opportunity, through theoretical and practical exposure to positive references, to explore the students' experience and perceptions, analyze interventions and change their perceptions of threat, thus contributing to a more inclusive group identity.
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Affiliation(s)
- Rocio de Diego-Cordero
- Research Group CTS 969 Innovation in HealthCare and Social Determinants of Health, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
| | - Lorena Tarriño-Concejero
- Research Group CTS-1050: Complex Care, Cronocity and Health Outcome, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
| | - Ana Magdalena Vargas-Martínez
- Research Group CTS 969 Innovation in HealthCare and Social Determinants of Health, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
| | - Mª Ángeles García-Carpintero Muñoz
- Research Group CTS-1050: Complex Care, Cronocity and Health Outcome, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
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244
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Reflexive Practice as an Approach to Improve Healthcare Delivery for Indigenous Peoples: A Systematic Critical Synthesis and Exploration of the Cultural Safety Education Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116691. [PMID: 35682275 PMCID: PMC9180854 DOI: 10.3390/ijerph19116691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/22/2022]
Abstract
Cultural safety is increasingly being taught in tertiary programmes of study for health professionals. Reflexivity is a key skill required to engage in culturally safe practice, however, there is currently limited literature examining how reflexivity is taught or assessed within cultural safety curricula. A systematic review of the literature up until November 2021 was conducted, examining educational interventions which aimed to produce culturally safe learners. Studies were limited to those with a focus on Indigenous health and delivered in Australia, Aotearoa New Zealand, Canada, and the United States. A total of 46 documents describing 43 different educational interventions were identified. We found that definitions and conceptualisations of reflexivity varied considerably, resulting in a lack of conceptual clarity. Reflexive catalysts were the primary pedagogical approaches used, where objects, people, or Indigenous pedagogies provided a counterpoint to learners’ knowledges and experiences. Information regarding assessment methods was limited but indicates that the focus of existing programmes has been on changes in learner knowledge and attitudes rather than the ability to engage in reflexivity. The results demonstrate a need for greater conceptual clarity regarding reflexivity as it relates to cultural safety, and to develop methods of assessment that focus on process rather than outcomes.
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245
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Ness TM, Munkejord MC. "All I expect is that they accept that I am a Sami" an analysis of experiences of healthcare encounters and expectations for future care services among older South Sami in Norway. Int J Circumpolar Health 2022; 81:2078472. [PMID: 35612317 DOI: 10.1080/22423982.2022.2078472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study first aims to forward our empirical knowledge of how older Sami experience healthcare encounters in Norway and what they expect in terms of future care services, and second, to forward our understanding of how more culturally safe services could be offered to the Sami population, 30 years after they were officially recognised as an Indigenous People. A qualitative interpretative and constructivist research design was used. 12 older South Sami were interviewed about their experiences with healthcare encounters, and their expectations for future care services. The results showed that the participants sometimes felt deprioritised and misunderstood by healthcare professionals. Moreover, they sometimes experienced that healthcare professionals had little or no knowledge about Sami history, culture and cosmology. They worried that they would not be accepted for being Sami if one day they would have to move into a nursing home. To conclude, the participants of this study are situated in a colonising context characterised by personal and collective experiences of accumulated discrimination that have taken place over many generations. The concepts of health equity and accumulated discrimination provide useful insights in the further development of culturally safe services for Indigenous Peoples in Norway and beyond.
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Affiliation(s)
- Tove Mentsen Ness
- Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway.,Department for Child Welfare and Social work, UiT the Arctic University of Norway, Norway
| | - Mai Camilla Munkejord
- Centre for Care Research, West, Western Norway University of Applied Sciences, Norway.,NORCE, Norwegian Research Centre, Bergen, Norway
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246
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Manton D, Williams M, Hayen A. The Bunya Project: Protocol to develop culturally informed curriculum (Preprint). JMIR Res Protoc 2022; 12:e39864. [PMID: 37200069 DOI: 10.2196/39864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/19/2023] [Accepted: 03/14/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Indigenous peoples live across all continents, representing approximately 90 nations and cultures and 476 million people. There have long been clear statements about the rights of Indigenous peoples to self-determine services, policies, and resource allocations that affect our lives, particularly via the United Nations Declaration on the Rights of Indigenous Peoples. An area for urgent improvement is curricula that train the predominantly non-Indigenous health workforce about their responsibilities and that offer practical strategies to use when engaging with Indigenous peoples and issues. OBJECTIVE The Bunya Project is designed to advance Indigenous community-led teaching and evaluation of the embeddedness of strategies to achieve an Indigenous Graduate Attribute in Australia. The project centers the relationships with Aboriginal community services to lead education design relating to Indigenous peoples. The project aims to articulate community recommendations for university education in allied health in the usable format of digital stories to create culturally informed andragogy, curriculum, and assessment measures for use in teaching. It also aims to understand the impact of this work on student attitudes and knowledge about Indigenous peoples' allied health needs. METHODS Multilayered project governance was established, along with a 2-stage process using mixed methods participatory action research and critical reflection, using the reflective cycle by Gibbs. The first stage, preparing the soil, used community engagement, drew on lived experience, encouraged critical self-reflection, embodied reciprocity, and demanded working collectively. The second stage, planting the seed, requires more critical self-reflection, the development of community data through interviews and focus group discussions, the development of resources with an academic working group and community participants, the implementation of those resources with student feedback, the analysis of the feedback from students and community members, and reflection. RESULTS The protocol for the first stage, preparing the soil, is complete. The results of the first stage are the relationships built and the trust earned and gained, and it has resulted in the development of the planting the seed protocol. As of February 2023, we have recruited 24 participants. We will analyze data shortly and expect to publish the results in 2024. CONCLUSIONS The readiness of non-Indigenous staff to engage with Indigenous communities has not been ascertained by Universities Australia, nor can it be assured. Staff preparation and skills to support the curriculum, create a safe learning environment, and develop teaching and learning strategies to guide academics to recognize that how students learn is as important as the content students learn. This learning has broad implications and benefits for staff and students within their professional practice and for lifelong learning. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39864.
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247
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Paine SJ, Neumann D, Langridge F, Peters A, Kingi TK. Kaitiakitanga – principles for protecting and promoting tamariki and rangatahi wellbeing in Growing Up in New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2066142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sarah-Jane Paine
- Te Kupenga Hauora Māori, Waipapa Taumata Rau University of Auckland, Auckland, New Zealand
| | - Denise Neumann
- Growing Up in New Zealand, Waipapa Taumata Rau University of Auckland, Auckland, New Zealand
| | - Fiona Langridge
- Growing Up in New Zealand, Waipapa Taumata Rau University of Auckland, Auckland, New Zealand
| | - Aysha Peters
- Growing Up in New Zealand, Waipapa Taumata Rau University of Auckland, Auckland, New Zealand
| | - Te Kani Kingi
- Te Whare Wananga o Awānuiarangi, Whakatane, New Zealand
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248
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Mullane T, Harwood M, Warbrick I, Tane T, Anderson A. Understanding the workforce that supports Māori and Pacific peoples with type 2 diabetes to achieve better health outcomes. BMC Health Serv Res 2022; 22:672. [PMID: 35585592 PMCID: PMC9118861 DOI: 10.1186/s12913-022-08057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Prevalence of Type 2 diabetes mellitus (T2DM) is high among Māori and other Pacific Island peoples in New Zealand. Current health services to address T2DM largely take place in primary healthcare settings and have, overall, failed to address the significant health inequities among Māori and Pacific people with T2DM. Culturally comprehensive T2DM management programmes, aimed at addressing inequities in Māori or Pacific diabetes management and workforce development, are not extensively available in New Zealand. Deliberate strategies to improve cultural safety, such as educating health professionals and fostering culturally safe practices must be priority when funding health services that deliver T2DM prevention programmes. There is a significant workforce of community-based, non-clinical workers in South Auckland delivering diabetes self-management education to Māori and Pacific peoples. There is little information on the perspectives, challenges, effectiveness, and success of dietitians, community health workers and kai manaaki (KM) in delivering these services. This study aimed to understand perspectives and characteristics of KM and other community-based, non-clinical health workers, with a focus on how they supported Māori and Pacific Peoples living with T2DM to achieve better outcomes. Methods This qualitative study undertaken was underpinned by the Tangata Hourua research framework. Focus groups with dietitians, community health workers (CHWs) and KM took place in South Auckland, New Zealand. Thematic analysis of the transcripts was used to identify important key themes. Results Analysis of focus group meetings identified three main themes common across the groups: whakawhanaungatanga (actively building relationships), cultural safety (mana enhancing) and cultural alignment to role, with a further two themes identified only by the KM and CHWs, who both strongly associated a multidisciplinary approach to experiences of feeling un/valued in their roles, when compared with dietitians. Generally, all three groups agreed that their roles required good relationships with the people they were working with and an understanding of the contexts in which Māori and Pacific Peoples with T2DM lived. Conclusions Supporting community based, non-clinical workers to build meaningful and culturally safe relationships with Māori and Pacific people has potential to improve diabetes outcomes.
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Affiliation(s)
- Tania Mullane
- Whitireia Institute, DX Box: SX33459, Porirua, Wellington, New Zealand.
| | - Matire Harwood
- Department of General Practice and Primary Care, Faculty of Medical and Health Sciences, University of Auckland Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
| | - Isaac Warbrick
- Faculty of Health and Environmental Sciences, Auckland University of Technology Private Bag 92006, Auckland, 1142, New Zealand
| | - Taria Tane
- Faculty of Medical and Health Sciences, Te Kupenga Hauora Māori, University of Auckland Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
| | - Anneka Anderson
- Faculty of Medical and Health Sciences, Te Kupenga Hauora Māori, University of Auckland Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
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249
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Boyd DH, Moffat SM, Foster Page LA, Lacey (Te Arawa iwi, Ngāti Whakaue hapū and Ngāruahine iwi, JK, Fuge KN, Natarajan AK, Misa (Tule fanakava Misa of Te'ekiu, Kanokupolu, Tonga Islan TF, Thomson WM. Oral health of children in Aotearoa New Zealand–time for change. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2069826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dorothy H. Boyd
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Susan M. Moffat
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lyndie A. Foster Page
- Defence Health Directorate, Te Ope Kātua o Aotearoa–New Zealand Defence Force, Wellington, New Zealand
| | | | - Kathryn N. Fuge
- Bee Healthy Regional Dental Service, Hutt Valley District Health Board, Wellington, New Zealand
| | - Arun K. Natarajan
- Specialist Paediatric Dentist, Canterbury District Health Board, Christchurch, New Zealand
| | | | - W. Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Vorobyova A, Marante A, Cardinal C, Magagula P, Lyndon S, Braley M, Inglis K, Parashar S. Finding the Balance: Embracing the Two-Eyed Seeing Approach to Understand what Cultural Safety in Care Means to Older Adults Living with HIV. J Appl Gerontol 2022; 41:2063-2073. [PMID: 35582747 DOI: 10.1177/07334648221100803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Older adults living with HIV (OALHIV) are a fast-growing demographic who rely on home and community care (HCC) services. Cultural safety (an environment free of racism that fosters feelings of safety and respect) is integral to HCC services. We conducted 27 semi-structured interviews with OALHIV in Vancouver, British Columbia about their HCC experiences. Excerpts about cultural safety were qualitatively analyzed using Two-Eyed Seeing. Our themes-Voices from across Turtle Island, Voices from the African continent, Western Perspectives, and Universal Principles-indicate that cultural safety is important yet lacking. While specific aspects of culturally safe HCC services varied between and within cultural groups, some aspects were shared by participants across groups (e.g., respect, compassion, and non-judgment).
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Affiliation(s)
- Anna Vorobyova
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Antonio Marante
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Claudette Cardinal
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Patience Magagula
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Sharyle Lyndon
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - McKenzie Braley
- Department of Psychology, Faculty of Arts and Social Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Kathleen Inglis
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Surita Parashar
- Division of Epidemiology and Population Health, 198129BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
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