Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Krembil Neuroscience Centre, University Health Network, Toronto, Ontario, Canada.
World Neurosurg. 2022 Nov;167:213-221.e2. doi: 10.1016/j.wneu.2022.07.108. Epub 2022 Aug 2.
Neurotrauma accounts for over 24,000 hospitalizations annually in Canada and has a significant impact in many developed countries. Among those affected, indigenous peoples are disproportionately impacted. The present scoping review explores the factors contributing to neurotrauma in indigenous populations and potential strategies to address this health care issue at a global level.
A search was performed in Medline (1974-2021) and Embase (1946-2021) to identify studies pertaining to neurotrauma in indigenous populations of Canada. Search terms included 'Aboriginal', 'First Nation', 'Indigenous', 'traumatic brain injury', and 'traumatic spine injury'. Thematic analysis was then used to synthesize the information collected. A gray literature search was also performed.
The original literature search yielded 1609 articles, with 17 selected for the scoping review. Through thematic analysis, the factors contributing to neurotrauma burden in indigenous populations of Canada were summarized into 3 themes: inadequate resources available, social problems in indigenous communities, and challenges within the health care system. The potential strategies to address neurotrauma were also summarized into 3 themes: system-level changes to Canadian health care, community-based initiatives, and culturally appropriate solutions. The gray literature search revealed a lack of government reports on the topic and notable advocacy work from community organizations.
Systems-level interventions guided by indigenous community members will help to address the disparities that indigenous peoples face in the care and rehabilitation of neurotrauma. This study will inform further research of culturally appropriate approaches to reduce neurotrauma among indigenous peoples at a global level.
在加拿大,神经外伤每年导致超过 24000 人住院,在许多发达国家也有重大影响。在受影响的人群中,原住民受到的影响不成比例。本范围综述探讨了导致原住民群体神经外伤的因素,以及在全球范围内解决这一医疗保健问题的潜在策略。
在 Medline(1974-2021 年)和 Embase(1946-2021 年)中进行了检索,以确定与加拿大原住民群体神经外伤相关的研究。检索词包括“原住民”、“第一民族”、“土著”、“创伤性脑损伤”和“创伤性脊柱损伤”。然后使用主题分析来综合收集到的信息。还进行了灰色文献检索。
原始文献检索产生了 1609 篇文章,其中 17 篇被选为范围综述。通过主题分析,总结出导致加拿大原住民群体神经外伤负担的因素可归纳为 3 个主题:现有资源不足、原住民社区的社会问题以及医疗保健系统中的挑战。解决神经外伤的潜在策略也可归纳为 3 个主题:加拿大医疗保健系统的系统层面变革、基于社区的举措和文化上适当的解决方案。灰色文献检索显示,关于这一主题的政府报告很少,社区组织的倡导工作引人注目。
由原住民社区成员指导的系统层面干预措施将有助于解决原住民在神经外伤的护理和康复方面面临的差异。本研究将为进一步研究在全球范围内减少原住民神经外伤的文化上适当方法提供信息。