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根据加拿大魁北克省的第一民族和医疗保健专业人员的说法,器官移植和捐赠中的文化安全护理障碍和促进因素。

Culturally Safe Care Barriers and Facilitators in Organ Transplantation and Donation According to First Nations and Health Professionals in Quebec, Canada.

机构信息

Centre de recherche Charles-Le Moyne, CISSS de la Montérégie-Centre, Longueuil, Québec, Canada.

Département de médecine de famille et d'urgence, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.

出版信息

Prog Transplant. 2024 Sep;34(3):96-102. doi: 10.1177/15269248241268672. Epub 2024 Aug 14.

Abstract

First Nations are most at risk of developing end-stage kidney disease. Kidney transplantation is the best treatment option for these patients; however, First Nations donors are underrepresented. The aim of this study was to describe and understand barriers and facilitators of culturally safe organ transplantation and donation from the perspective of First Nations and Health Professionals in the Province of Quebec, Canada. This was a qualitative descriptive study using the decolonizing Two-Eyed Seeing approach. The sample consisted of First Nations people and health professionals living in Quebec, Canada, who have had an experience of organ transplantation or donation. Semi-structured interviews were conducted between May and September 2021 with 11 people, including 5 healthcare professionals and 6 First Nations people. This study enrolled 11 participants. Several individual and contextual factors influencing culturally safe organ transplantation and donation among First Nations people were identified: language barrier, impacts of relocation, lack of knowledge about transplantation, mistrust of the healthcare system, family support and accompaniment, and transplant testimonials. This study identified several avenues for reinforcing culturally safe transplantation and donation among First Nations, including the presence of a companion in medical consultations, focusing on access to culturally safe accommodation and sharing transplant testimonials. Further work in partnership with First Nations is needed to improve access to culturally safe organ transplantation.

摘要

第一民族(原住民)群体面临发展为终末期肾病的最大风险。对于这些患者来说,肾移植是最佳的治疗选择;然而,原住民供体的代表性不足。本研究旨在从加拿大魁北克省的原住民和卫生专业人员的角度描述和理解器官移植和捐赠的文化安全性方面存在的障碍和促进因素。这是一项使用去殖民化的“Two-Eyed Seeing”方法的定性描述性研究。样本由居住在加拿大魁北克省的原住民和卫生专业人员组成,他们有器官移植或捐赠的经验。2021 年 5 月至 9 月期间,采用半结构式访谈方式对 11 人进行了访谈,其中包括 5 名医护人员和 6 名原住民。本研究共纳入 11 名参与者。确定了影响原住民群体文化安全器官移植和捐赠的几个个体和背景因素:语言障碍、搬迁的影响、对移植的了解不足、对医疗保健系统的不信任、家庭支持和陪伴,以及移植的见证。本研究确定了在原住民群体中加强文化安全移植和捐赠的几个途径,包括在医疗咨询中配备同伴、关注获得文化安全的住宿条件以及分享移植见证。需要与原住民合作进一步开展工作,以改善文化安全器官移植的可及性。

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