1
|
Meechan E, Geia L, Taylor M, Murray D, Stothers K, Gibson P, Devine S, Barker R. Culturally responsive occupational therapy practice with First Nations Peoples-A scoping review. Aust J Rural Health 2024; 32:617-671. [PMID: 38888234 DOI: 10.1111/ajr.13143] [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] [Received: 12/19/2023] [Revised: 05/16/2024] [Accepted: 05/19/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION First Nations Peoples consistently demonstrate strength and resilience in navigating systemic health care inequities. Acknowledging racism as a health determinant underscores the urgent need for a counterforce-cultural safety. Indigenous Allied Health Australia (IAHA) contends that with cultural responsiveness, the health workforce can take action to create a culturally safe environment. OBJECTIVE To explore features of culturally responsive occupational therapy (OT) practice when providing a service with First Nations People and examine alignment of those features with the IAHA Cultural Responsiveness in Action Framework. DESIGN A systematic scoping review was undertaken using CINAHL, Emcare, MEDLINE, PsychInfo and Scopus databases. Examples of culturally responsive OT practice with First Nations Peoples were mapped to the six IAHA Framework capabilities and confirmed by First Nations co-authors. FINDINGS OT practice with First Nations Peoples aligned with the six capabilities to varying degrees. The importance of OTs establishing relationships with First Nations People, applying self-reflection to uncover cultural biases, and addressing limitations of the profession's Western foundations was evident. DISCUSSION Recognising the interrelatedness of the six capabilities, the absence of some may result in a culturally unsafe experience for First Nations People. OTs must acknowledge the leadership of First Nations Peoples by privileging their voices and consider how established practices may reinforce oppressive systems. CONCLUSION To ensure a culturally safe environment for First Nations People, the OT profession must respect the leadership of First Nations Peoples and address the limitations of the profession's Western foundations to uphold the profession's core value of client-centred care.
Collapse
Affiliation(s)
| | - Lynore Geia
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Marayah Taylor
- Townsville University Hospital, Douglas, Queensland, Australia
| | - Donna Murray
- Indigenous Allied Health Australia, Deakin, Australian Capital Territory, Australia
| | - Kylie Stothers
- Indigenous Allied Health Australia, Deakin, Australian Capital Territory, Australia
| | - Paul Gibson
- Indigenous Allied Health Australia, Deakin, Australian Capital Territory, Australia
| | - Sue Devine
- James Cook University, Douglas, Queensland, Australia
| | - Ruth Barker
- James Cook University, Smithfield, Queensland, Australia
| |
Collapse
|
2
|
Tafur MM, de la Torre Montiel Y, Montiel M. Mexican American Intergenerational Research: Transformative Model of Occupational Therapy. Occup Ther Int 2024; 2024:6301510. [PMID: 39015426 PMCID: PMC11251786 DOI: 10.1155/2024/6301510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 04/17/2024] [Accepted: 06/14/2024] [Indexed: 07/18/2024] Open
Abstract
Thirty-seven interviews of Mexican American women who crossed the border into the United States during the era of the Mexican Revolution of 1910 were analyzed using constructivist grounded theory methods. The intent is to expand the occupational therapy profession's occupational consciousness and cultivate cultural humility. Four themes emerged from the data: suffering, work, yearning for an education, and compassion for others. The findings suggest that environmental barriers such as hierarchy (patriarchy and discrimination) and physical barriers (limited access to built environments, lack of nonexploitative work opportunities, and hostile educational institutions) prevented occupational participation. Small acts of resistance through everyday living (finding joy, playing, self-sufficiency, and community organizing) were identified as facilitators of occupational participation. The research findings challenge proposed assumptions found within the occupational therapy literature: (1) humans and occupations exist as separate from their environments, and (2) work, productivity, and leisure contribute positively to health. The Transformative Model of Occupational Therapy is introduced as a decolonized framework that inextricably links individual health to community and global health. The model centers play, social participation, work, and education as occupations that contribute to the common good. These occupations are kept in equilibrium within the Four Pillars of Culture (self-determination, compassion, sustainability, and language) or the cultural values identified and derived from the stories.
Collapse
|
3
|
Kiepek N. Occupation in the Anthropocene and Ethical Relationality. Can J Occup Ther 2024; 91:44-55. [PMID: 37072931 PMCID: PMC10903124 DOI: 10.1177/00084174231169390] [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: 04/20/2023]
Abstract
Purpose. Occupations have "implications for individuals, societies, and the earth". This article focusses on implications of occupation in relation to the earth and examines the potential to expand occupational justice beyond anthropocentric viewpoints to honour interspecies justice. Approach. A 'theory as method' approach is used to explore the literature. Transgressive decolonial hermeneutics informs analysis. Key issues. The discussion advances understandings about human occupation in relation to more-than-humans, intersections with human occupations and animals, and ethical relationality. Implications. Occupational justice includes honouring interdependence of species, engaging in occupations in ways that are sustainable, considering future generations, and refraining from occupations that have a destructive or detrimental impact on the earth and more-than-humans. The profession has a collective responsibility to honour Indigenous worldviews and Indigenous sovereignty, recognising and welcoming the potential for Western conceptualisations of occupation to be transformed.
Collapse
|
4
|
Jacek CC, Fritz KM, Lizon ME, Packham TL. Knowledge Gaps Regarding Indigenous Health in Occupational Therapy: A National Survey. Can J Occup Ther 2024; 91:65-77. [PMID: 37654201 PMCID: PMC10903141 DOI: 10.1177/00084174231197622] [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: 09/02/2023]
Abstract
Background. There is a need for the occupational therapy profession to respond to the Truth and Reconciliation Commission of Canada Calls to Action and work towards supporting the health and well-being of Indigenous Peoples. Purpose. (1) To determine the knowledge gaps of occupational therapists about Indigenous health and (2) to create recommendations to address identified gaps and inform responses from the profession. Method. A national needs survey was created and distributed to occupational therapists across Canada to determine the knowledge of occupational therapists about Indigenous health. Survey results were analyzed using thematic analysis and descriptive statistics. Findings. Data collected from 364 survey responses informed six distinct themes representing knowledge gaps of occupational therapists related to Indigenous health as follows: lack of foundational knowledge, power relations, lifelong learner, need for appropriate tools/approaches, respectful collaboration, and environmental influences. Implications. The project offers insight into the role of the occupational therapy profession in the process of reconciliation. Insights are focused on decolonizing occupational therapy practice, building trusting relationships with Indigenous Peoples, and the provision of appropriate training for occupational therapists to engage in culturally safer practices.
Collapse
|
5
|
Pomerville A, Wilbur RE, Pham TV, King CA, Gone JP. Behavioral health services in Urban American Indian Health Programs: Results from six site visits. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2618-2634. [PMID: 36976752 DOI: 10.1002/jcop.23035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
This study explores behavioral health services for American Indians and Alaska Natives (AIANs) at six Urban Indian Health Programs (UIHPs). Interviews and focus groups with clinicians and staff inquired about behavioral health treatment available, service needs, client population, and financial and staffing challenges. Resulting site profiles were created based on focused coding and integrative memoing of site visit field notes and respondent transcripts. These six UIHPs evidenced diversity across multiple facets of service delivery even as they were united in their missions to provide accessible and effective behavioral health treatment to urban AIAN clients. Primary challenges to service provision included heterogenous client populations, low insurance coverage, limited provider knowledge, lack of resources, and incorporation of traditional healing. Collaborative research with UIHPs harbors the potential to recognize challenges, identify solutions, and share best practices across this crucial network of health care sites for improving urban AIAN well-being.
Collapse
Affiliation(s)
- Andrew Pomerville
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachel E Wilbur
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Cheryl A King
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Joseph P Gone
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anthropology, Harvard University, Cambridge, Massachusetts, USA
| |
Collapse
|
6
|
So H, Mackenzie L, Chapparo C, Ranka J, McColl MA. Spirituality in Australian Health Professional Practice: A Scoping Review and Qualitative Synthesis of Findings. JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01840-5. [PMID: 37306862 PMCID: PMC10258742 DOI: 10.1007/s10943-023-01840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/13/2023]
Abstract
This study explores how spirituality is integrated into practice across the different Australian health professions. Utilising the Joanna Briggs Institute's (JBI) protocol, six databases were searched, and sixty-seven articles were finally included. To present the findings, a qualitative synthesis was used. 'Meaning' and 'purpose in life' were found to be key to many spirituality definitions. The most frequently reported approach for Australian health professionals (HPs) in asking about client spirituality was using one or two questions within a comprehensive assessment. Major facilitators included a holistic care approach and prior training, whereas a key barrier was a lack of time.
Collapse
Affiliation(s)
- Heather So
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Chris Chapparo
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Judy Ranka
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Mary Ann McColl
- The Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| |
Collapse
|
7
|
Josewski V, de Leeuw S, Greenwood M. Grounding Wellness: Coloniality, Placeism, Land, and a Critique of "Social" Determinants of Indigenous Mental Health in the Canadian Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4319. [PMID: 36901327 PMCID: PMC10002458 DOI: 10.3390/ijerph20054319] [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: 12/29/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Authored by a small team of settler and Indigenous researchers, all of whom are deeply involved in scholarship and activism interrogating ongoing processes of coloniality in lands now known to many as Canada, this paper critically examines "social" and grounded determinants of Indigenous mental health and wellness. After placing ourselves on the grounds from which we write, we begin by providing an overview of the social determinants of health (SDOH), a conceptual framework with deep roots in colonial Canada. Though important in pushing against biomedical framings of Indigenous health and wellness, we argue that the SDOH framework nevertheless risks re-entrenching deeply colonial ways of thinking about and providing health services for Indigenous people: SDOH, we suggest, do not ultimately reckon with ecological, environmental, place-based, or geographic determinants of health in colonial states that continue to occupy stolen land. These theoretical interrogations of SDOH provide an entry point to, first, an overview of Indigenous ways of understanding mental wellness as tethered to ecology and physical geography, and second, a collection of narrative articulations from across British Columbia: these sets of knowledge offer clear and unequivocal evidence, in the form of Indigenous voices and perspectives, about the direct link between land, place, and mental wellness (or a lack thereof). We conclude with suggestions for future research, policy, and health practice actions that move beyond the current SDOH model of Indigenous health to account for and address the grounded, land-based, and ecologically self-determining nature of Indigenous mental health and wellness.
Collapse
Affiliation(s)
- Viviane Josewski
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | - Sarah de Leeuw
- Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | - Margo Greenwood
- School of Education, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
| |
Collapse
|
8
|
Rides At The Door M, Shaw S. The Other Side of the ACEs Pyramid: A Healing Framework for Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4108. [PMID: 36901119 PMCID: PMC10001615 DOI: 10.3390/ijerph20054108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
For over two decades, extensive research has demonstrated significant associations between adverse childhood events (ACEs) and a wide range of negative health, mental health, and social outcomes. For Indigenous communities globally, colonization and historical trauma are commonly associated with ACEs, and these effects reverberate through generations. While the ACEs conceptual framework expanded pyramid is a useful model and a visual aid for understanding the historical and present-day dimensions of ACEs in Indigenous communities, a healing conceptual framework is needed to outline a path toward increased community well-being. In this article, we provide a holistic Indigenous Wellness Pyramid that represents the other side of the ACEs pyramid to guide pathways toward healing in Indigenous communities. In this article, the authors describe the Indigenous Wellness Pyramid according to each of the following contrasts with the ACEs pyramid: Historical Trauma-Intergenerational Healing/Indigenous Sovereignty; Social Conditions/Local Context-Thriving Economic and Safe Communities; ACEs-Positive Childhood, Family, and Community Experiences; Disrupted Neurodevelopment-Consistent Corrective Experiences/Cultural Identity Development; Adoption of Health Risk Behaviors-Cultural Values and Coping Skills; Disease Burden and Social Problems-Wellness and Balance; Early Death-Meaningful Life Longevity. We provide examples, supporting research, and implications for implementing the Indigenous Wellness Pyramid.
Collapse
Affiliation(s)
| | - Sidney Shaw
- School of Counseling, Walden University, Minneapolis, MN 55401, USA
| |
Collapse
|
9
|
Barrett NM, Burrows L, Atatoa-Carr P, Smith LT, Masters-Awatere B. Holistic antenatal education class interventions: a systematic review of the prioritisation and involvement of Indigenous Peoples' of Aotearoa New Zealand, Australia, Canada and the United States over a 10-year period 2008 to 2018. Arch Public Health 2022; 80:169. [PMID: 35836247 PMCID: PMC9281049 DOI: 10.1186/s13690-022-00927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research into the effectiveness of antenatal education classes is crucial for Indigenous Peoples from Aotearoa New Zealand, Australia, Canada and the United States who experience poorer maternal and infant health outcomes compared to non-Indigenous populations. Our systematic review questions were intended to determine the extent of Indigenous Peoples prioritisation and involvement in antenatal education classes, and to understand the experience of Indigenous Peoples from these countries in antenatal education classes. METHODS Using a standardised protocol, we systematically searched five electronic databases for primary research papers on antenatal education classes within the four countries noted and identified 17 papers that met the criteria. We undertook a qualitative meta-synthesis using a socio-critical lens. RESULTS Systematic review of the academic literature demonstrates that Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States are not prioritised in antenatal education classes with only two of 17 studies identifying Indigenous participants. Within these two studies, Indigenous Peoples were underrepresented. As a result of poor engagement and low participation numbers of Indigenous Peoples in these antenatal education classes, it was not possible to understand the experiences of Indigenous Peoples. CONCLUSION Given that Indigenous Peoples were absent from the majority of studies examined in this review, it is clear little consideration is afforded to the antenatal health needs and aspirations of Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States. To address the stark antenatal health inequities of Indigenous Peoples, targeted Indigenous interventions that consider culture, language, and wider aspects of holistic health must be privileged. TRIAL REGISTRATION PROSPERO Registration ID: CRD4202017658.
Collapse
Affiliation(s)
- Nikki M Barrett
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
| | - Lisette Burrows
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Polly Atatoa-Carr
- National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Linda T Smith
- Te Whare Wānanga o Awanuiārangi, Whakatane, New Zealand
| | | |
Collapse
|
10
|
Bauer HF, Neal EC, Lizon ME, Jacek CC, Fritz KM. Indigenous Peoples and occupational therapy in Canada: A scoping review. Can J Occup Ther 2022; 89:249-260. [PMID: 35603659 PMCID: PMC9511236 DOI: 10.1177/00084174221088410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background. Calls to Action outlined by the Truth and Reconciliation Commission (TRC) necessitate critical reflection and urgent action to improve occupational therapy with Indigenous Peoples in Canada. Purpose. This scoping review aims to synthesize the literature related to Indigenous Peoples and occupational therapy practice, research, and education in Canada, and appraise empirical research using adapted Indigenous Health Research criteria. Method. A scoping review was conducted across published academic and grey literature with additional appraisal of empirical studies. Findings. A total of 6 themes emerged from 47 articles spanning from 1970 to 2020: recognizing colonial history, responding to the TRC, participating in personal and professional reflection, identifying Western ideologies, engaging in partnership in practice, and recognizing social and systemic barriers. Empirical studies met appraisal criteria inconsistently. Implications. To meaningfully engage in reconciliation, the profession of occupational therapy must generate Indigenous-led and relevant research, critically transform curricula, and address tensions between themes in practice.
Collapse
Affiliation(s)
- Hannah F. Bauer
- Hannah F. Bauer, 144 Trout Lake Road, Lawrencetown, NS B0S 1M0, Canada.
| | - Ellen C. Neal
- Ellen C. Neal, 75-590 North Service Road, Stoney Creek, ON L8E 0K5, Canada.
| | | | | | | |
Collapse
|
11
|
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).
Collapse
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
| |
Collapse
|
12
|
Abstract
Unsustainable lifestyles contribute to global greenhouse gas emissions and climate change. The growing recognition of this negative impact on the earth's ecosystems and human health and well-being compels occupational therapy practitioners to address environmental sustainability issues. Western contextual factors present obstacles to the adoption of ecologically beneficial practices in occupational therapy. Resolving these ethical challenges through the use of multiple epistemologies may yield novel solutions and usher in the adoption of ecologically sustainable occupational therapy in the United States. In this column, I explore some of the contextual factors that influence occupational therapy theory and practice as they relate to ecological sustainability. I also briefly discuss some non-Western cultural perspectives, challenges to integrating ecological ethics into occupational therapy practice in the United States, and ways individual occupational therapy practitioners and state and national organizations can begin to address this issue.
Collapse
Affiliation(s)
- Lisa C Lieb
- Lisa C. Lieb, MOT, OTR/L, is Independent Scholar, Beaver, PA;
| |
Collapse
|
13
|
Marques B, Freeman C, Carter L. Adapting Traditional Healing Values and Beliefs into Therapeutic Cultural Environments for Health and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010426. [PMID: 35010690 PMCID: PMC8744804 DOI: 10.3390/ijerph19010426] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022]
Abstract
Although research has long established that interaction with the natural environment is associated with better overall health and well-being outcomes, the Western model mainly focuses on treating symptoms. In Aotearoa/New Zealand, the Indigenous Māori have long demonstrated significantly more negative health outcomes than non-Māori. Little research has examined the causes compared to Western populations or the role of the natural environment in health outcomes for Māori. An exploration of rongoā Māori (traditional healing system) was conducted to ascertain the importance of landscape in the process of healing. Eight rongoā healers or practitioners took part in semi-structured narrative interviews from June to November 2020. Transcribed interviews were analysed using an interpretative phenomenological analysis and Kaupapa Māori techniques. The findings show how rongoā is underpinned by a complex set of cultural values and beliefs, drawing from the connection to wairua (spirit), tinana (body), tikanga and whakaora (customs and healing), rākau (plants), whenua (landscape) and whānau (family). Incorporating such constructs into the landscape can foster our understanding of health and well-being and its implications for conceptualising therapeutic environments and a culturally appropriate model of care for Māori and non-Māori communities.
Collapse
Affiliation(s)
- Bruno Marques
- Wellington School of Architecture, Te Herenga Waka—Victoria University of Wellington, Wellington 6012, New Zealand
- School of Geography, University of Otago, Dunedin 9016, New Zealand;
- Correspondence: ; Tel.: +64-4-463-4718
| | - Claire Freeman
- School of Geography, University of Otago, Dunedin 9016, New Zealand;
| | - Lyn Carter
- Te Tumu School of Māori, Pacific Island and Indigenous Studies, University of Otago, Dunedin 9016, New Zealand;
| |
Collapse
|
14
|
Sâkipakâwin: Assessing Indigenous Cancer Supports in Saskatchewan Using a Strength-Based Approach. Curr Oncol 2021; 29:132-143. [PMID: 35049686 PMCID: PMC8775083 DOI: 10.3390/curroncol29010012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Given that the health care system for Indigenous people tends to be complex, fragmented, and multi-jurisdictional, their cancer experiences may be especially difficult. This needs assessment study examined system-level barriers and community strengths regarding cancer care experiences of Indigenous people in Saskatchewan. Guided by an advisory committee including Indigenous patient and family partners, we conducted key informant interviews with senior Saskatchewan health care administrators and Indigenous leaders to identify supports and barriers. A sharing circle with patients, survivors, and family members was used to gather cancer journey experiences from Indigenous communities from northern Saskatchewan. Analyses were presented to the committee for recommendations. Key informants identified cancer support barriers including access to care, coordination of care, a lack of culturally relevant health care provision, and education. Sharing circle participants discussed strengths and protective factors such as kinship, connection to culture, and spirituality. Indigenous patient navigation, inter-organization collaboration, and community relationship building were recommended to ameliorate barriers and bolster strengths. Recognizing barriers to access, coordination, culturally relevant health care provision, and education can further champion community strengths and protective factors and frame effective cancer care strategies and equitable cancer care for Indigenous people in Saskatchewan.
Collapse
|
15
|
Abstract
Background. Occupational therapy and occupational science literature include growing attention to issues of justice, marginalization, and rights. In contrast, the concept of oppression has scarcely been employed. Purpose. This paper investigates how adding the concept of oppression may enhance occupational therapy approaches to injustice, prioritizing a focus on structural causes, and facilitating conscientious action. Method. A critical interpretive synthesis explored insights from authors who name oppressions in occupational therapy and occupational science literature. In total, a sample of 28 papers addressing oppression, ableism, ageism, classism, colonialism, heterosexism, racism, and/or sexism was selected for inclusion. Findings. Four themes were identified: oppression and everyday doing; effects of structures and power; responding and resisting; and oppression within occupational therapy. Implications. Incorporating oppression within the plurality of social discourse may help occupational therapists to avoid individualistic explanations, attend to relationships between social structures and constrained occupations, frame intersectional analysis, and engage in praxis.
Collapse
Affiliation(s)
- Elizabeth A. Pooley
- Elizabeth A. Pooley, c/o School of Occupational Therapy, Dalhousie University, Room 324, Forrest Building, 5869 University Avenue PO Box 15000, Halifax, Nova Scotia, Canada B3H 4R2.
| | | |
Collapse
|
16
|
Enuaraq S, Gifford W, Ashton S, Al Awar Z, Larocque C, Rolfe D. Understanding culturally safe cancer survivorship care with inuit in an urban community. Int J Circumpolar Health 2021; 80:1949843. [PMID: 34219604 PMCID: PMC8259824 DOI: 10.1080/22423982.2021.1949843] [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] [Received: 02/02/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 11/03/2022] Open
Abstract
Cancer is a leading cause of death among Inuit. A legacy of colonialism, residential schools, and systemic racism has eroded trust among Inuit and many do not receive culturally safe care. This study aimed to explore the meaning of culturally safe cancer survivorship care for Inuit, and barriers and facilitators to receiving it in an urban setting in Ontario Canada. As Inuit and Western researchers, we conducted a descriptive qualitative study. We held two focus groups (n = 27) with cancer survivors and family members, and semi-structured interviews (n = 7) with health providers. Data were analysed using thematic content analysis.Three broad themes emerged as central to culturally safe care: access to traditional ways of life, communication, and family involvement. Family support, patient navigators, and designated spaces were facilitators; lack of support for traditional ways, like country food, was a barrier. Participants were clear what constituted culturally safe care, but major barriers exist. Lack of direction at institutional and governmental levels contributes to the complexity of issues that prevent Inuit from engaging in and receiving culturally safe cancer care. To understand how to transform healthcare to be culturally safe, studies underpinned by Inuit epistemology, values, and principles are required.
Collapse
Affiliation(s)
| | - Wendy Gifford
- School of Nursing, University of Ottawa, Ottawa, Canada
| | | | - Zeina Al Awar
- School of Nursing, University of Ottawa, Ottawa, Canada
| | | | | |
Collapse
|
17
|
Perilla VML, Magalhães L, Pérez DKC, Olivero MMA, Cortes BDM, Montero YR, Arias VSA, Arias DRA. “O bicho, aquele pirralho” nos territórios indígenas colombianos: tecendo diálogos com a comunidade Kankuama em tempos de pandemia. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2021. [DOI: 10.1590/2526-8910.ctoao2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Este artigo tem como objetivo refletir sobre as experiências de afirmação da vida e preparação para a morte da comunidade colombiana indígena Kankuama, diante da pandemia e dos efeitos físicos, socioculturais, ecológicos e espirituais que fundamentam e impactam sua identidade, visibilidade, consciência e participação ocupacional. Por meio de pesquisa étnico-nacional colaborativa com base no pensamento indígena, o “Yarning” ou tecido foi utilizado para recuperar as narrativas de três kankuamos por meio de duas entrevistas semiestruturadas presenciais e uma virtual, gravadas e transcritas entre abril e agosto de 2020. As narrativas permitiram tecer reflexões vinculadas à luta pela preservação da própria dinâmica intercultural da saúde, reconhecendo elementos vinculados à sua história, além da ressignificação do vírus como fenômeno de aprendizagem do ser humano na relação com a Mãe Terra e com o território. O artigo também aborda os processos ocupacionais vinculados à morte, enfatizando os aprendizados da perda e da consciência do legado espiritual dos mais velhos, decanos e sábios para a interpretação e orientação das práticas mortuárias da passagem ao “Chundwa”. Resgatam-se as percepções que os Kankuamos possuem sobre a situação atual de saúde, conceitos de saúde e bem-estar, com base na Lei de Sé e sua relação com as ocupações relacionadas à morte, ao equilíbrio social, cultural e natural, que devem ser consideradas dentro da terapia ocupacional e da ciência ocupacional na América Latina.
Collapse
|
18
|
Sense of Place and Belonging in Developing Culturally Appropriate Therapeutic Environments: A Review. SOCIETIES 2020. [DOI: 10.3390/soc10040083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The connection the Māori, the Indigenous people of Aotearoa-New Zealand, have to the land is threatened by the effects of colonisation, urbanisation and other factors. In particular, many Māori suffer significant health and wellbeing inequalities compared to the non-Māori population. In an effort to reduce such inequalities, there is a growing consciousness of the need to better understand the cultural and place-specific determinants that affect the health and wellbeing of population groups in different environments. This article explores how environmental and cultural connections to land enable the development of place-specific and culturally-driven principles that promote the health and wellbeing of Māori populations. It argues that concepts of place, belonging, landscape and wellbeing play an important role in linking environment and culture as well as in contributing to creating therapeutic spatial environments that promote both human health and ecosystems. A set of principles is developed that allows for the landscape design of such therapeutic environments while accommodating the socio-cultural and environmental values that promote health and wellbeing of both Māori and non-Māori people.
Collapse
|
19
|
Sokang YA, Westmaas AH, Kok G. From Physical to Spiritual: A Qualitative Study of Jakartans Health & Sickness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193564. [PMID: 31554179 PMCID: PMC6801871 DOI: 10.3390/ijerph16193564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 11/24/2022]
Abstract
Understanding the perceptions of health and sickness can help the government, health providers and health promoters encourage individuals to participate in healthy behaviors and to follow a healthy lifestyle. Jakarta, the capital city of Indonesia, is a culturally, socially and financially diverse city, with complex health care needs. As yet, there is no published data available about Jakartans’ (i.e., the citizens of Jakarta city) perceptions on health and sickness. This study aimed to describe what health and sickness mean to Jakartans. To this means, we collected data using an open-ended survey about the meanings of health and sickness from 640 Jakartans. Five main themes of health and sickness emerged. The five themes of health were health as a physical condition, a psychological condition, a spiritual condition, a capability to carry out daily activities, and a healthy lifestyle. The themes regarding sickness were sickness as a physical condition, a psychological condition, an abnormal circumstance or bad situations, a spiritual condition, and an inability to carry out daily activities. We discussed how the above-mentioned perceptions might influence the daily health-related behaviors of Jakartans. In contrast to the typical biomedical approach, we found that, in Jakarta, health was not merely seen as a causal effect of the physical world. Further details are discussed.
Collapse
Affiliation(s)
- Yasinta Astin Sokang
- Department of Work and Social Psychology, Maastricht University, 6229 ER Maastricht, The Netherlands.
- Faculty of Psychology, Krida Wacana Cristian University, Jakarta 11470, Indonesia.
| | - Alvin Henry Westmaas
- Department of Work and Social Psychology, Maastricht University, 6229 ER Maastricht, The Netherlands.
- Faculty of Health Sciences, University of Applied Sciences, 2333 CK Leiden, The Netherlands.
| | - Gerjo Kok
- Department of Work and Social Psychology, Maastricht University, 6229 ER Maastricht, The Netherlands.
| |
Collapse
|