Horrill Tara, McMillan Diana E, Schultz Annette S H, Thompson Genevieve
Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.
Health Sciences Centre, Winnipeg, MB, Canada.
Nurs Inq. 2018 Jul;25(3):e12237. doi: 10.1111/nin.12237. Epub 2018 Mar 25.
As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically.
作为护理专业人员，我们认为获得医疗保健是健康的基础，也是健康的一个决定因素。因此，有证据表明许多原住民在获得医疗保健方面存在问题，这令人担忧。虽然生物医学观点是我们目前对获得医疗保健的理解的基础，但考虑其他观点可能会扩大我们对这一问题的认识以及解决这一问题的能力。在本文中，我们批判了如何通过生物医学视角来理解获得医疗保健的问题，后殖民理论视角如何能够扩展这种理解，以及这种替代观点对护理专业产生的后续影响。借鉴有关医疗保健可及性和原住民的同行评审发表文献和灰色文献来为这一批判提供信息，我们关注塑造我们目前对可及性理解的潜在理论视角。后殖民分析提供了一种将医疗保健理解为社会空间和社会关系的方式，为获得医疗保健提供了独特的视角。这一发现的新颖性对护理专业尤为重要，因为我们有能力影响这些社会层面，广泛改善医疗保健服务的可及性，特别是在原住民中。
