Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Surgery, University of Calgary, Calgary, AB, Canada.
CJEM. 2024 Jul;26(7):488-498. doi: 10.1007/s43678-024-00687-3. Epub 2024 Apr 29.
Indigenous health equity interventions situated within emergency care settings remain underexplored, despite their potential to influence patient care satisfaction and empowerment. This study aimed to systematically review and identify Indigenous equity interventions and their outcomes within acute care settings, which can potentially be utilized to improve equity within Canadian healthcare for Indigenous patients.
A database search was completed of Medline, PubMed, Embase, Google Scholar, Scopus and CINAHL from inception to April 2023. For inclusion in the review, articles were interventional and encompassed program descriptions, evaluations, or theoretical frameworks within acute care settings for Indigenous patients. We evaluated the methodological quality using both the Joanna Briggs Institute checklist and the Ways Tried and True framework.
Our literature search generated 122 publications. 11 articles were selected for full-text review, with five included in the final analysis. Two focusing on Canadian First Nations populations and three on Aboriginal Australians. The main intervention strategies included cultural safety training, integration of Indigenous knowledge into care models, optimizing waiting-room environments, and emphasizing sustainable evaluation methodologies. The quality of the interventions was varied, with the most promising studies including Indigenous perspectives and partnerships with local Indigenous organizations.
Acute care settings, serving as the primary point of access to health care for many Indigenous populations, are well-positioned to implement health equity interventions such as cultural safety training, Indigenous knowledge integration, and optimization of waiting room environments, combined with sustainable evaluation methods. Participatory discussions with Indigenous communities are needed to advance this area of research and determine which interventions are relevant and appropriate for their local context.
尽管在急诊环境中实施的原住民健康公平干预措施有可能影响患者的护理满意度和赋权，但这些干预措施仍未得到充分探索。本研究旨在系统地回顾和确定急性护理环境中的原住民公平干预措施及其结果，这些干预措施有可能被用于改善加拿大原住民患者的医疗保健公平性。
从创建到 2023 年 4 月，对 Medline、PubMed、Embase、Google Scholar、Scopus 和 CINAHL 数据库进行了数据库搜索。为了被纳入审查，文章必须是干预性的，并涵盖急性护理环境中针对原住民患者的项目描述、评估或理论框架。我们使用 Joanna Briggs 研究所清单和 Ways Tried and True 框架评估了方法学质量。
我们的文献搜索生成了 122 篇出版物。有 11 篇文章被选作全文审查，其中 5 篇被纳入最终分析。其中 2 篇关注加拿大第一民族人口，3 篇关注澳大利亚原住民。主要的干预策略包括文化安全培训、将原住民知识纳入护理模式、优化候诊室环境以及强调可持续的评估方法。干预措施的质量参差不齐，最有前途的研究包括原住民观点和与当地原住民组织的合作。
急性护理环境是许多原住民群体获得医疗保健的主要途径，非常适合实施健康公平干预措施，如文化安全培训、原住民知识整合和优化候诊室环境，同时结合可持续的评估方法。需要与原住民社区进行参与性讨论，以推进这一研究领域，并确定哪些干预措施在他们的当地环境中是相关和适当的。
