Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Institute for Circumpolar Health Research, Yellowknife, Canada.
Int J Circumpolar Health. 2021 Dec;80(1):1886798. doi: 10.1080/22423982.2021.1886798.
The factors that influence patient healthcare experiences are complex and connected to place. In northern Canada, the socio-historical context and the inequitable distribution of health services are unique influences on patients. The objective of this study was to examine the characteristics of patient healthcare experiences as reported through news media in the Northwest Territories. We used a case series design to examine patient healthcare experiences reported in news media articles. We conducted a systematic search for articles published between 2008 and 2017 in the online database of a media outlet in the Northwest Territories. We used descriptive statistics to summarise the article characteristics and thematic analysis to understand patient experiences in 128 articles related to 71 cases. Most often, cases involved women, concerned mental health, suicidality, or chronic diseases, and were predominantly negative. Patient experiences included problems associated with medical travel, communication difficulties with providers, lack of cultural safety, and barriers in accessing care resulting in poor-quality care, particularly for Indigenous patients. Broadly, these experiences are rooted in the colonial history in the North. Understanding patient experiences and including Indigenous patients in health system decision-making can help focus policies and clinical care on cultural safety and equity.
影响患者医疗体验的因素是复杂的，并与地点有关。在加拿大北部，社会历史背景和卫生服务的不平等分配对患者有独特的影响。本研究的目的是研究通过西北地区新闻媒体报道的患者医疗体验的特征。我们使用病例系列设计来研究新闻媒体文章中报道的患者医疗体验。我们在西北地区媒体在线数据库中进行了系统搜索，以查找 2008 年至 2017 年间发表的文章。我们使用描述性统计来总结文章特征，并通过主题分析来理解与 71 例相关的 128 篇文章中的患者体验。大多数情况下，病例涉及女性，涉及心理健康、自杀倾向或慢性疾病，且主要为负面报道。患者体验包括与医疗旅行相关的问题、与提供者沟通困难、缺乏文化安全性，以及在获得医疗服务方面的障碍，导致医疗质量差，特别是对土著患者而言。总体而言，这些体验源于北方的殖民历史。了解患者体验并让土著患者参与卫生系统决策制定，可以帮助将政策和临床护理重点放在文化安全性和公平性上。
