Wain Toni, Sim Moira, Bessarab Dawn, Mak Donna, Hayward Colleen, Rudd Cobie
Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
University of Western Australia, Centre for Aboriginal Medical and Dental Health, 35 Stirling Hwy, Crawley, WA, 6009, Australia.
BMC Med Educ. 2016 Jun 2;16:156. doi: 10.1186/s12909-016-0677-2.
Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients' experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of culturally appropriate methodologies. This paper presents a methodological account of collecting narratives which accurately and respectfully reflect Aboriginal Australians' experiences with health care in Western Australia. The purpose of these narratives is to provide health students and professionals with an opportunity to 'walk-in the shoes' of Aboriginal people where face-to-face interaction is not feasible.
With the incorporation of Indigenous peoples' voices being an important link in cultural safety, the project was led by an Indigenous Reference group, who encouraged active participation of Aboriginal people in all areas of the project. Using a phenomenological approach and guided by the Indigenous Reference group, yarning data collection was implemented to collect stories focusing on Aboriginal people's experiences with health care services. An open-access, on-line website was established to host education resources developed from these "yarns".
Yarning provided a rich source of information on personal experiences and encouraged the story provider to recognise their facilitative role in the research process. While the methodology used in this project was lengthy and labour-intensive it afforded a respectful manner for story collection and highlighted several innate flaws when Western methods are applied to an Indigenous context.
Engagement of an Indigenous Reference Group was pivotal to designing an appropriate methodology that incorporated the voices of Aboriginal people in a multimedia resource of Aboriginal narratives. However further research is warranted to understand how the resources are being used and integrated into curricula, and their impact on students and health care outcomes.
对少数群体的无意识偏见和消极态度会对向这些群体提供或不提供医疗保健的方式产生不利影响。认识到种族主义态度和行为以及了解客户的健康和医疗保健经历对于制定更好的医疗保健策略以积极影响向原住民提供的护理质量和安全至关重要。原住民研究需要包容性的研究过程和使用符合文化习惯的方法。本文介绍了一种收集叙述的方法,这些叙述准确且尊重地反映了澳大利亚原住民在西澳大利亚的医疗保健经历。这些叙述的目的是为健康专业的学生和从业人员提供一个机会,在无法进行面对面互动的情况下“设身处地”体验原住民的生活。
由于纳入原住民的声音是文化安全的重要环节,该项目由一个原住民参考小组牵头,该小组鼓励原住民积极参与项目的各个领域。采用现象学方法并在原住民参考小组的指导下,实施了“讲故事”数据收集,以收集侧重于原住民医疗保健服务经历的故事。建立了一个开放获取的在线网站,以托管从这些“故事”中开发的教育资源。
“讲故事”提供了丰富的个人经历信息,并鼓励故事提供者认识到他们在研究过程中的促进作用。虽然本项目中使用的方法冗长且耗费人力,但它为故事收集提供了一种尊重的方式,并突出了将西方方法应用于原住民背景时的一些固有缺陷。
原住民参考小组的参与对于设计一种合适的方法至关重要,该方法将原住民的声音纳入一个原住民叙述的多媒体资源中。然而,有必要进行进一步的研究,以了解这些资源是如何被使用和整合到课程中的,以及它们对学生和医疗保健结果的影响。