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两种医学现实之间的桥梁:巴西亚马孙地区土著医学和护理学生对蛇伤护理的看法。

Bridges between two medical realities: Perspectives of Indigenous medical and nursing students on snakebite care in the Brazilian Amazon.

机构信息

Higher School of Health Sciences, State University of Amazonas, Manaus, Brazil.

Directorate of Teaching and Research, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Brazil.

出版信息

Nurs Inq. 2024 Oct;31(4):e12667. doi: 10.1111/nin.12667. Epub 2024 Aug 13.

DOI:10.1111/nin.12667
PMID:39138916
Abstract

In the Brazilian Amazon, snakebite envenomations (SBEs) disproportionately affect Indigenous populations, and have a significantly higher incidence and lethality than in non-Indigenous populations. This qualitative study describes the Indigenous and biomedical healthcare domains for SBE care from the perspective of the Indigenous medical and nursing students in Manaus, Western Brazilian Amazon. In-depth interviews were conducted with five Indigenous students from the Amazonas State University, between January and December 2021. The interviews were analyzed using inductive content analysis. We organized an explanatory model with five themes: (1) participants' identities; (2) causality levels in Indigenous and biomedical systems; (3) therapeutic itineraries in Indigenous and biomedical systems; (4) ideological implications of adding biomedical devices to Indigenous healing systems; and (5) therapeutic failure in and efficacy of Indigenous and biomedical systems. From a noncolonial perspective and seeking to increase the quality and acceptability of health care for the Indigenous populations of the Brazilian Amazon, the training of Indigenous health professionals presents itself as a promising strategy. For this goal, universities should serve as empowering settings for Indigenous health students that support them in their growth and development, raise their awareness of injustice, and catalyze change toward a culturally adapted and effective service for the users.

摘要

在巴西亚马逊地区,蛇伤(SBE)对原住民人口的影响不成比例,其发病率和死亡率明显高于非原住民人口。本定性研究从马瑙斯西部巴西亚马逊地区原住民医学生和护理学生的角度描述了 SBE 护理的原住民和生物医学保健领域。2021 年 1 月至 12 月期间,对亚马孙州立大学的五名原住民学生进行了深入访谈。使用归纳内容分析法对访谈进行了分析。我们组织了一个具有五个主题的解释模型:(1)参与者的身份;(2)原住民和生物医学系统中的因果关系层次;(3)原住民和生物医学系统中的治疗轨迹;(4)将生物医学设备添加到原住民治疗系统中的意识形态影响;以及(5)原住民和生物医学系统的治疗失败和疗效。从非殖民化的角度出发,并寻求提高巴西亚马逊地区原住民人口的医疗保健质量和可接受性,原住民卫生专业人员的培训呈现出一种有前途的策略。为此,大学应为原住民卫生学生提供赋权环境,支持他们的成长和发展,提高他们对不公正的认识,并促进朝着为用户提供文化适应和有效的服务的方向变革。

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