Cultural safety and continuing competence

Vernon, Rachael; Papps, Elaine

doi:10.1017/cbo9781316151136.007

Cited by 6 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increasingly in Canada, the USA and Australia, cultural safety is featured as an essential element of health care involving Indigenous peoples [ 85 – 87 ]. In New Zealand, cultural safety is legislated as a basic requirement of nursing and medical professional education [ 88 ].…”

Section: Resultsmentioning

confidence: 99%

Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study

Browne

Varcoe

Lavoie

et al. 2016

BMC Health Serv Res

246

337

View full text Add to dashboard Cite

BackgroundStructural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery. In this paper, we discuss an evidence-based framework and specific strategies for promoting health care equity for Indigenous populations.MethodsUsing an ethnographic design and mixed methods, this study was conducted at two Urban Aboriginal Health Centres located in two inner cities in Canada, which serve a combined patient population of 5,500. Data collection included in-depth interviews with a total of 114 patients and staff (n = 73 patients; n = 41 staff), and over 900 h of participant observation focused on staff members’ interactions and patterns of relating with patients.ResultsFour key dimensions of equity-oriented health services are foundational to supporting the health and well-being of Indigenous peoples: inequity-responsive care, culturally safe care, trauma- and violence-informed care, and contextually tailored care. Partnerships with Indigenous leaders, agencies, and communities are required to operationalize and tailor these key dimensions to local contexts. We discuss 10 strategies that intersect to optimize effectiveness of health care services for Indigenous peoples, and provide examples of how they can be implemented in a variety of health care settings.ConclusionsWhile the key dimensions of equity-oriented care and 10 strategies may be most optimally operationalized in the context of interdisciplinary teamwork, they also serve as health equity guidelines for organizations and providers working in various settings, including individual primary care practices.These strategies provide a basis for organizational-level interventions to promote the provision of more equitable, responsive, and respectful PHC services for Indigenous populations. Given the similarities in colonizing processes and Indigenous peoples’ experiences of such processes in many countries, these strategies have international applicability.

show abstract

Section: Resultsmentioning

confidence: 99%

Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study

Browne

Varcoe

Lavoie

et al. 2016

BMC Health Serv Res

246

337

View full text Add to dashboard Cite

show abstract

“…The Calls to Action outlined in the Truth and Reconciliation Commission of Canada urge clinicians to provide culturally safe care for Indigenous people (The Truth & Reconciliation Commission of Canada, ). The concept of culturally safe care was developed by Maori nurses in New Zealand, who recognized a need for clinicians to acknowledge their own beliefs and values and how these may influence the care they provide to people with differing views (Vernon & Papps, ). An awareness of the differences between ourselves and others requires an understanding of the historical, social, political, and cultural contexts impacting infants and families.…”

Section: Discussionmentioning

confidence: 99%

“…Only with this understanding can nurses appreciate how our assumptions, unconscious biases, and position of authority may perpetuate further harm. Ultimately, it is the family receiving care who determines whether they feel truly safe (Vernon & Papps, ).…”

Section: Discussionmentioning

confidence: 99%

Caring for Indigenous families in the neonatal intensive care unit

2020

View full text Add to dashboard Cite

Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health outcomes by effectively meeting the needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families.

show abstract

“…Cultural safety has the potential to play a similar role in the healthcare sector; the analytical leverage of cultural safety lies in its potential to shift attention away from clients' presumed cultural ‘differences’ as the source of the problem onto the culture of healthcare as the site for transformation (Browne et al., ). In Canada, the United States and Australia, cultural safety is increasingly being integrated into healthcare organisational mandates, policies and practice guidelines, particularly in relation to care involving Indigenous peoples (Aboriginal Nurses Association of Canada, , Indigenous Physicians Association of Canada and The Royal College of Physicians and Surgeons of Canada, ), and in New Zealand, cultural safety is required as a basic component in nursing and medical professional education (Vernon & Papps, ).…”

Section: Discussionmentioning

confidence: 99%

Engaging Indigenous families in a community-based Indigenous early childhood programme in British Columbia, Canada: A cultural safety perspective

Gerlach

Browne

Greenwood

2017

Health Soc Care Community

View full text Add to dashboard Cite

This article is part of a larger study that explored how an Indigenous early intervention programme in British Columbia (BC), Canada, known as the 'Aboriginal Infant Development Program' (AIDP), influenced family and children's health and well-being and was responsive to child health inequities. Postcolonial feminist and Indigenous feminist perspectives provided a critical analytical lens to this qualitative inquiry. The study was undertaken with AIDPs based in diverse community organisations located in off-reserve urban municipalities throughout the province of BC. From September 2013 to March 2014, in-depth, semi-structured interviews were undertaken with: Indigenous primary caregivers (n = 10), Indigenous Elders (n = 4), AIDP workers (n = 18) and administrative leaders (n = 3). The purpose of this article is to examine and analyse the findings that focus on how AIDP workers supported family and children's health and well-being by transforming their routine policies and practices in ways that fostered caregivers' active engagement in their programmes. Findings centre on three main themes: (i) overcoming mistrust; (ii) 'being willing to move a step forward' and (iii) resisting what's taken-for-granted. These inter-related themes are examined and discussed in relation to the concept of cultural safety. The findings have international relevancy for social and healthcare community-based programmes that are questioning how to engage with parents who may be hard to reach as a result of multi-faceted social and structural factors.

show abstract

Cultural safety and continuing competence

Cited by 6 publications

References 0 publications

Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study

Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study

Caring for Indigenous families in the neonatal intensive care unit

Engaging Indigenous families in a community-based Indigenous early childhood programme in British Columbia, Canada: A cultural safety perspective

Contact Info

Product

Resources

About