Providing culturally safe care to Indigenous people living with diabetes: Identifying barriers and enablers from different perspectives

Health Expectations

Sandro Echaquan¹  Maman Joyce Dogba²  Maude Bradette‐Laplante²  Marie‐Claude Tremblay²  Jean‐Sébastien Paquette²  Holly O. Witteman²  Pascale Breault³  Emmanuelle Careau⁴ 

[1] Centre Mihawoso Centre de pédiatrie sociale Manawan QC USA;Département de médecine familiale et médecine d’urgence Faculté de médecine Université Laval Québec QC Canada;Groupe de Médecine de famille universitaire du Nord de Lanaudière Joliette QC Canada;Vice‐décanat à la responsabilité sociale Faculté de médecine Université Laval Québec QC Canada;

关键词: barriers and enablers;    community‐based participatory research;    cultural safety;    diabetes;    healthcare inequities;    indigenous peoples;   

DOI  :  10.1111/hex.13168

来源: DOAJ

【 摘 要 】

Abstract In recent years, cultural safety has been proposed as a transformative approach to health care allowing improved consideration of Indigenous patient needs, expectations, rights and identities. This community‐based participatory study aimed to identify potential barriers and enablers to cultural safety in health care provided to Atikamekw living with diabetes in Québec, Canada. Based on a qualitative descriptive design, the study uses talking circles as a data collection strategy. Three talking circles were conducted with Atikamekw living with diabetes and caregivers, as well as with health professionals of the family medicine teaching clinic providing services to the community. Two team members performed deductive thematic analysis based on key dimensions of cultural safety. Results highlight four categories of barriers and enablers to cultural safety for Atikamekw living with diabetes, related to social determinants of health (including colonialism), health services organization, language and communication, as well as Atikamekw traditional practices and cultural perspectives of health. This study is one of the few that provides concrete suggestions to address key aspects of diabetes care in a culturally respectful way. Our findings indicate that potential enablers of cultural safety reside at different (from individual to structural) levels of change. Solutions in this matter will require strong political will and policy support to ensure intervention sustainability. Patient or public contribution Partners and patients have been involved in identifying the need for this study, framing the research question, developing the data collection tools, recruiting participants and interpreting results.

【 授权许可】

Unknown