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A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care

BACKGROUND: In Canada, Indigenous Peoples continue to experience persistent health inequities, resulting in disproportionately poorer health outcomes compared with non-Indigenous Canadians. This study engaged Indigenous patients accessing health care in Vancouver, Canada, about their experiences of...

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Autores principales: Pilarinos, Andreas, Field, Shannon, Vasarhelyi, Krisztina, Hall, David, Fox, Elder Doris, Price, Elder Roberta, Bonshor, Leslie, Bingham, Brittany
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CMA Impact Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158754/
https://www.ncbi.nlm.nih.gov/pubmed/37130609
http://dx.doi.org/10.9778/cmajo.20220135
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author Pilarinos, Andreas
Field, Shannon
Vasarhelyi, Krisztina
Hall, David
Fox, Elder Doris
Price, Elder Roberta
Bonshor, Leslie
Bingham, Brittany
author_facet Pilarinos, Andreas
Field, Shannon
Vasarhelyi, Krisztina
Hall, David
Fox, Elder Doris
Price, Elder Roberta
Bonshor, Leslie
Bingham, Brittany
author_sort Pilarinos, Andreas
collection PubMed
description BACKGROUND: In Canada, Indigenous Peoples continue to experience persistent health inequities, resulting in disproportionately poorer health outcomes compared with non-Indigenous Canadians. This study engaged Indigenous patients accessing health care in Vancouver, Canada, about their experiences of racism and improving cultural safety within health care. METHODS: A research team consisting of Indigenous and non-Indigenous researchers committed to employing a Two-Eyed Seeing approach and conducting culturally safe research hosted 2 sharing circles in May 2019 with Indigenous people recruited from urban health care settings. Talking circles were led by Indigenous Elders, and thematic analysis was used to identify overarching themes. RESULTS: A total of 26 participants attended 2 sharing circles, which included 25 self-identifying women and 1 self-identifying man. Thematic analysis resulted in the identification of 2 major themes: negative experiences in health care and perspectives on promising health care practices. For the first major theme, subthemes included the following: experiences of racism lead to poorer care experiences and health outcomes, Indigenous-specific racism results in mistrust in the health care system, and participants experience discrediting of traditional medicine and Indigenous perspectives on health. For the second major theme, subthemes included the following: Indigenous-specific services and supports improve trust in health care, Indigenous cultural safety education is necessary for all health care–involved staff, and providing welcoming, Indigenized spaces for Indigenous patients encourages health care engagement. INTERPRETATION: Despite participants’ racist health care experiences, receiving culturally safe care was credited with improving trust in the health care system and well-being. The continued expansion of Indigenous cultural safety education, the creation of welcoming spaces, recruitment of Indigenous staff, and Indigenous self-determination over health care services can improve Indigenous patients’ health care experiences.
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spelling pubmed-101587542023-05-05 A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care Pilarinos, Andreas Field, Shannon Vasarhelyi, Krisztina Hall, David Fox, Elder Doris Price, Elder Roberta Bonshor, Leslie Bingham, Brittany CMAJ Open Research BACKGROUND: In Canada, Indigenous Peoples continue to experience persistent health inequities, resulting in disproportionately poorer health outcomes compared with non-Indigenous Canadians. This study engaged Indigenous patients accessing health care in Vancouver, Canada, about their experiences of racism and improving cultural safety within health care. METHODS: A research team consisting of Indigenous and non-Indigenous researchers committed to employing a Two-Eyed Seeing approach and conducting culturally safe research hosted 2 sharing circles in May 2019 with Indigenous people recruited from urban health care settings. Talking circles were led by Indigenous Elders, and thematic analysis was used to identify overarching themes. RESULTS: A total of 26 participants attended 2 sharing circles, which included 25 self-identifying women and 1 self-identifying man. Thematic analysis resulted in the identification of 2 major themes: negative experiences in health care and perspectives on promising health care practices. For the first major theme, subthemes included the following: experiences of racism lead to poorer care experiences and health outcomes, Indigenous-specific racism results in mistrust in the health care system, and participants experience discrediting of traditional medicine and Indigenous perspectives on health. For the second major theme, subthemes included the following: Indigenous-specific services and supports improve trust in health care, Indigenous cultural safety education is necessary for all health care–involved staff, and providing welcoming, Indigenized spaces for Indigenous patients encourages health care engagement. INTERPRETATION: Despite participants’ racist health care experiences, receiving culturally safe care was credited with improving trust in the health care system and well-being. The continued expansion of Indigenous cultural safety education, the creation of welcoming spaces, recruitment of Indigenous staff, and Indigenous self-determination over health care services can improve Indigenous patients’ health care experiences. CMA Impact Inc. 2023-05-02 /pmc/articles/PMC10158754/ /pubmed/37130609 http://dx.doi.org/10.9778/cmajo.20220135 Text en © 2023 CMA Impact Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Research
Pilarinos, Andreas
Field, Shannon
Vasarhelyi, Krisztina
Hall, David
Fox, Elder Doris
Price, Elder Roberta
Bonshor, Leslie
Bingham, Brittany
A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
title A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
title_full A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
title_fullStr A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
title_full_unstemmed A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
title_short A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
title_sort qualitative exploration of indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158754/
https://www.ncbi.nlm.nih.gov/pubmed/37130609
http://dx.doi.org/10.9778/cmajo.20220135
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