Honouring Stories: Mi'kmaq Women's Experiences with Pap Screening in Eastern Canada

Abstract

Mi'kmaq women are reported to have lower rates of Papanicolaou (Pap) screening and higher rates of cervical cancer than non-Aboriginal women. This qualitative participatory study used postcolonial feminist perspectives and Indigenous principles to explore Mi'kmaq women's experiences with Pap screening within the contexts that shaped their experiences. Community facilitators assisted with the research process. Talking circles and individual in-depth interviews were conducted with 16 Mi'kmaq women. Also, health-care providers were interviewed in 2 Mi'kmaq communities. The findings indicate that historical and social contexts are shaping Mi'kmaq women's screening experiences and that these experiences are diverse, as are their understandings about screening. Some women were accessing regular screening despite challenging personal circumstances. The results highlight the need for nurses and other health-care providers to understand the uniqueness of each woman's experiences with Pap screening. Improvements in screening rates depend on multifaceted nursing approaches developed in partnership with Mi'kmaq women.

Health Care with Indigenous Women: Respectful Partnerships

“…Despite the many atrocities, Aboriginal cultural traditions and values have been preserved, and serve as testament to the resiliency of the people [43]. For example, in conducting research with Mi'kmaw women and Pap-smear screening [22] found that some women talked openly about Residential School's impact on their health. In some instances, women became angry and tearful.…”

“…Research has shown that a lack of cultural safety and sensitivity when Aboriginal women are forced to seek information about healthcare from Western sources such as pamphlets and other print materials, which are not always representative or reflective of the women's realities [22]. In some instances, women receive culturally unsafe care because of the devaluing of Aboriginal knowledge, traditions, and cultural ways.…”

“…Yet, some women communicated positive healthcare experiences and described receiving culturally safe healthcare by providers who explained information adequately. Several participants indicated that brochures and other educational materials that are reflective of Aboriginal women's lives positively influenced Aboriginal women to access Pap screening: "It would seem important for them to attend [screening], and they could relate to those women in the pamphlets" [22].…”

“…In a participatory action qualitative study, the authors reported that mainstream healthcare systems are poorly aligned to address the healthcare needs of Aboriginal people because mainstream systems tend to conceptualize health and illness as stemming from 'lifestyle' or cultural differences; often overlooking the contextual factors that shape health and illness [22]. Aboriginal women are resilient, and many are addressing their health "by taking action to address some of the determinants of health, even though they were confronted with considerable disadvantages and adversity" [22]. Some women communicated that they were "taking care of their health by becoming educated, being employed, and instituting early childhood learning".…”

Stigma dan Diskriminasi Terhadap Orang yang Hidup Dengan HIV/AIDS (ODHA): Satu Pendekatan Tindakan Penyertaan Dalam Kalangan Belia di Pulau Pinang (Stigma and Discrimination Against People Living With HIV/AIDS (ODHA): A Participatory Action Approach Among Youth Circle in Penang)

“…Di samping itu, pendekatan tindakan penyertaan juga digunakan bagi penyelidikan yang meneroka isu-isu sosial dengan populasi yang terpinggir seperti orang asli (MacDonald, 2013). Aplikasi pendekatan tindakan penyertaan ini banyak melibatkan golongan belia dalam komuniti, pembangunan kemahiran kepimpinan dan pembangunan ilmu pengetahuan.…”