Berg Kelsey, McLane Patrick, Eshkakogan Nicole, Mantha Jennifer, Lee Tracy, Crowshoe Chelsea, Phillips Ann
Alberta Health Services, 10101 Southport Rd SW, Calgary, AB T2W 3N2, Canada; University of Lethbridge, 4401 University Drive West, Lethbridge, AB T1K 3M4, Canada.
Alberta Health Services, 10101 Southport Rd SW, Calgary, AB T2W 3N2, Canada; University of Alberta, 116 St. and 85 Ave., Edmonton, AB T6G 2R3, Canada.
Int Emerg Nurs. 2019 Mar;43:133-140. doi: 10.1016/j.ienj.2019.01.004. Epub 2019 Feb 4.
Emergency departments are primary health care entry points for Indigenous persons in Canada. They are also among the settings where Indigenous patients report access barriers and discriminatory treatment. Cultural competency and cultural safety have been proposed as approaches to improving emergency care.
To identify and elaborate upon barriers and facilitators of cultural competency and safety in Canadian Emergency Departments.
We conducted a scoping review to search published and grey literature to identify and extract data on definitions, measures, facilitators and barriers of cultural competency and safety.
Six articles met inclusion criteria. Studies presented perspectives from patients, care providers, health care organizations, and Indigenous knowledge holders. Key themes emerged across studies and stakeholders. These include: Interpersonal relationships between patients and care providers; cultural competency training; Emergency Department capacity; and racism and discrimination.
We recommend that Emergency Department cultural competency and safety initiatives i) be built upon post-colonial understanding and partnerships with local Indigenous communities ii) provide practitioners with competencies in relationship-building and self-awareness iii) orient ED resources and services to meet the needs of patients with limited access to non-emergency healthcare and iv) aim to prevent discrimination.
急诊科是加拿大原住民进入初级卫生保健的入口点。它们也是原住民患者报告存在就医障碍和遭受歧视性待遇的场所之一。文化能力和文化安全已被提议作为改善急诊护理的方法。
识别并详细阐述加拿大急诊科文化能力和安全的障碍与促进因素。
我们进行了一项范围综述，以检索已发表和灰色文献，识别并提取关于文化能力和安全的定义、措施、促进因素和障碍的数据。
六篇文章符合纳入标准。研究呈现了患者、护理人员、医疗保健组织和原住民知识持有者的观点。跨研究和利益相关者出现了关键主题。这些包括：患者与护理人员之间的人际关系；文化能力培训；急诊科能力；以及种族主义和歧视。
我们建议急诊科文化能力和安全举措：i）基于后殖民理解以及与当地原住民社区的伙伴关系；ii）为从业者提供建立人际关系和自我意识的能力；iii）调整急诊科资源和服务，以满足难以获得非急诊医疗保健的患者的需求；iv）旨在防止歧视。
