Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
BMJ Open. 2023 Oct 30;13(10):e073184. doi: 10.1136/bmjopen-2023-073184.
This study aims to identify and critically examine the components of health complexity, and explore the factors that allow it to exist, among urban Indigenous peoples in Canada.
Qualitative exploration with relational conversations.
Calgary, Alberta, Canada.
A total of nine urban Indigenous patients were recruited from a multidisciplinary primary healthcare clinic that serves First Nations, Métis and Inuit peoples. Recruitment and data collection took place between September and November 2021.
Thematic analysis revealed three main themes, namely: sources of health complexity, psychological responses to adversity, and resilience, strengths, and protective factors. Key sources of health complexity arose from material resource disparities and adverse interpersonal interactions within the healthcare environment, which manifest into psychological distress while strengths and resilience emerged as protective factors.
The healthcare system remains inapt to address complexity among urban Indigenous peoples in Canada. Healthcare violence experienced by Indigenous peoples only further perpetuates health complexity. Future clinical tools to collect information about health complexity among urban Indigenous patients should include questions about the factors defined in this study.
本研究旨在识别和批判性地审视加拿大城市原住民健康复杂性的组成部分,并探讨使其存在的因素。
具有关系对话的定性探索。
加拿大阿尔伯塔省卡尔加里市。
总共从一家为第一民族、梅蒂斯人和因纽特人服务的多学科初级保健诊所招募了 9 名城市原住民患者。招募和数据收集工作于 2021 年 9 月至 11 月进行。
主题分析揭示了三个主要主题,即健康复杂性的来源、对逆境的心理反应以及韧性、优势和保护因素。健康复杂性的主要来源来自物质资源的差距和医疗环境中的不良人际互动,这会导致心理困扰,而优势和韧性则成为保护因素。
加拿大的医疗保健系统仍然无法解决城市原住民的健康复杂性问题。原住民所经历的医疗保健暴力只会进一步加剧健康复杂性。未来用于收集城市原住民患者健康复杂性信息的临床工具应包括有关本研究中定义的因素的问题。