Nurses as agents of disruption: Operationalizing a framework to redress inequities in healthcare access among Indigenous Peoples

Horrill, Tara; Martin, Donna; Lavoie, Josée G.; Schultz, Annette

doi:10.1111/nin.12394

Cited by 10 publications

(17 citation statements)

References 61 publications

(162 reference statements)

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“…Inuit communication was discussed as extending beyond simply words that are spoken to include different forms that should be understood by healthcare providers working with Inuit. Clear communication between patients and their healthcare providers is an essential aspect of cultural safety; clear communication leads to services that are free of racism and discrimination and helps build trust and support providers [ 38 ]. To ensure cultural safety, the importance of considering the social, cultural and emotional needs of Inuit patients was affirmed to allow them to draw strengths from their identity, culture and community.…”

Section: Culturally Safe Cancer Survivorship Carementioning

confidence: 99%

Understanding culturally safe cancer survivorship care with inuit in an urban community

Enuaraq

Gifford

Ashton

et al. 2021

International Journal of Circumpolar Health

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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.

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Section: Culturally Safe Cancer Survivorship Carementioning

confidence: 99%

Understanding culturally safe cancer survivorship care with inuit in an urban community

Enuaraq

Gifford

Ashton

et al. 2021

International Journal of Circumpolar Health

View full text Add to dashboard Cite

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“…Alternatively, this view may suggest a poor understanding of the impact of trusting patient‐provider relationships on access to healthcare and oncology care. Incorporating principles of cultural safety and trauma‐ and violence‐informed care into nursing education and practice would highlight the importance of relational care (Horrill et al, 2020b ). Cultural safety has been noted to be a key element of providing high‐quality, accessible healthcare for Indigenous Peoples (Browne et al, 2016 ; Horrill et al, 2020b ).…”

Section: Discussionmentioning

confidence: 99%

“…Incorporating principles of cultural safety and trauma‐ and violence‐informed care into nursing education and practice would highlight the importance of relational care (Horrill et al, 2020b ). Cultural safety has been noted to be a key element of providing high‐quality, accessible healthcare for Indigenous Peoples (Browne et al, 2016 ; Horrill et al, 2020b ). Integrating cultural safety into practice requires us as nurses to engage in reflexive processes and get uncomfortable with our own biases and attitudes, our shared history of colonialism in Canada, and how we may have been complicit in perpetuating structural inequities (Papps, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

A critical exploration of nurses' perceptions of access to oncology care among Indigenous peoples: Results of a national survey

Horrill¹,

Martin

Lavoie

et al. 2021

Nursing Inquiry

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Inequities in access to oncology care among Indigenous peoples in Canada are well documented. Access to oncology care is mediated by a range of factors; however, emerging evidence suggests that healthcare providers, including nurses, play a significant role in shaping healthcare access. The purpose of this study was to critically examine access to oncology care among Indigenous peoples in Canada from the perspective of oncology nurses. Guided by postcolonial theoretical perspectives, interpretive descriptive and critical discourse analysis methodologies informed study design and data analysis. Oncology nurses were recruited from across Canada to complete an online survey (n = 78). Nurses identified a range of barriers experienced by Indigenous peoples when accessing oncology care, yet located these barriers primarily at the individual and systems levels. Nurses perceived themselves as mediators of access to oncology care; however, their efforts to facilitate access to care were constrained by the dominance of biomedicine within healthcare. Nurses' constructions of access to oncology care highlight the embedded narrative of individualism within nursing practice and the relative invisibility of racism as a determinant of equitable access to care among Indigenous peoples. This suggests a need for oncology nurses to better understand and incorporate structural determinants of health perspectives.cancer, determinants of health, health inequity, health services accessibility, healthcare access, Indigenous health, Indigenous peoples, nurse roles, nursing, qualitative research, racism, social determinants of healthThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…This research highlights key considerations in this process including delivery approach necessitating specific Aboriginal and Torres Strait Islander knowledge, expertise, experience, leadership, more time and more resources are required in comparison with the traditional ‘linear’ curriculum development and delivery approach used within a singular often western worldview. All these considerations highlight contrasts between an Aboriginal and Torres Strait Islander worldview and the prevailing domain of most tertiary settings (Horrill et al, 2021 ).…”

Section: Reflection On the Experience Of A Unique Approachmentioning

confidence: 99%

Evolving beyond antiracism: Reflections on the experience of developing a cultural safety curriculum in a tertiary education setting

et al. 2022

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There is an inextricable link between cultural and clinical safety. In Australia highprofile Aboriginal deaths in custody, publicised institutional racism in health services and the international Black Lives Matter movement have cemented momentum to ensure culturally safe care. However, racism within health professionals and health professional students remains a barrier to increasing the Nursing Inquiry. 2022;e12524.

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Nurses as agents of disruption: Operationalizing a framework to redress inequities in healthcare access among Indigenous Peoples

Cited by 10 publications

References 61 publications

Understanding culturally safe cancer survivorship care with inuit in an urban community

Understanding culturally safe cancer survivorship care with inuit in an urban community

A critical exploration of nurses' perceptions of access to oncology care among Indigenous peoples: Results of a national survey

Evolving beyond antiracism: Reflections on the experience of developing a cultural safety curriculum in a tertiary education setting

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