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从真相到行动:原住民医疗保健专业人员应对原住民特定种族主义的亲身经历。

Truth to Action: Lived Experiences of Indigenous Healthcare Professionals Redressing Indigenous-Specific Racism.

作者信息

Bourque Bearskin Mona Lisa, Seymour Meste'si Llucmetkwe Colleen, Melnyk Rose, D'Souza Melba, Sturm Judy, Mooney Tracy, Hunter-Porter Nikki Rose, Ward Audrey Elaine, Bell Blythe

机构信息

Beaver Lake Cree Nation, BC IHNR Chair, Associate Professor, School of Nursing, University of Victoria, Kamloops, BC, Canada.

Tk'emlúps te Secwépemc (Secwepemc Nation), Knowledge Holder BC IHNR, Kamloops, BC, Canada.

出版信息

Can J Nurs Res. 2025 Mar;57(1):94-111. doi: 10.1177/08445621241282784. Epub 2024 Oct 4.

Abstract

Study BackgroundThe experience of discrimination through stereotyping, profiling, and bias-informed care not only leads to poor access to healthcare services, but low retention rates of Indigenous health professionals (IHP). As health systems transformation evolves, a significant gap remains in supporting IHP to safely address racism, to be supported culturally to bring their authentic selves and voices to work, and to attend to one's own intellectual, physical, relational, cultural and spiritual wellness within a westernized model of care.PurposeThe aim of the study was to investigate the experiences of IHP working in mainstream healthcare in order to understand how their work environment impacts the delivery of cultural safe practices. What is reported in this manuscript, as an exercise in truth-telling, is findings about lived experiences of IHP working in one mainstream provincial healthcare region, and not the whole context and outcomes of the study.MethodsUsing Indigenous research methodologies, we embodied our Indigeneity into every facet of the research process. We facilitated three talking circles with participants grounded in a distinct cultural and ceremonial context following Secwepemc protocols.ResultsThe collective voices of IHP revealed the following common experiences: confronting genocide; addressing Indigenous-specific racism; uprooting toxicity and inequities; and upholding Indigenous human rights while enhancing accountability of systems transformation.ConclusionsThe experience of IHP working in health systems goes beyond mere individual employment obligations, its often about a families and communities advocacy for Indigenous rights, culturally safe working environments and access to dignified and respectful healthcare service. This study highlights the need for IHP to be actively involved in health system transformation to ensure the redesigning and restructuring of healthcare service delivery by and for Indigenous Peoples remains centered on Indigenous health and human rights.

摘要

研究背景

通过刻板印象、 profiling以及基于偏见的护理所经历的歧视,不仅导致难以获得医疗服务,还导致原住民卫生专业人员(IHP)的留存率较低。随着卫生系统转型的发展,在支持IHP安全应对种族主义、在文化上得到支持以便将真实的自我和声音带入工作,以及在西方化的护理模式中关注自身的智力、身体、人际关系、文化和精神健康方面,仍然存在巨大差距。

目的

本研究的目的是调查在主流医疗保健机构工作的IHP的经历,以了解他们的工作环境如何影响文化安全实践的提供。本手稿中所报告的内容,作为一次讲真话的实践,是关于在一个主流省级医疗保健地区工作的IHP的生活经历的发现,而非该研究的整个背景和结果。

方法

我们采用原住民研究方法,将我们的原住民身份融入研究过程的每个方面。我们按照Secwepemc协议,在独特的文化和仪式背景下,为参与者组织了三个谈话圈。

结果

IHP的集体声音揭示了以下共同经历:直面种族灭绝;应对针对原住民的种族主义;根除毒性和不平等;维护原住民人权,同时加强系统转型的问责制。

结论

IHP在卫生系统中的工作经历不仅仅是个人的就业义务,通常还关乎家庭和社区对原住民权利、文化安全的工作环境以及获得有尊严和受尊重的医疗服务的倡导。本研究强调IHP需要积极参与卫生系统转型,以确保由原住民并为原住民重新设计和重组医疗服务的提供仍然以原住民健康和人权为中心。

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Work and health challenges of Indigenous people in Canada.加拿大原住民的工作和健康挑战。
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Racism in healthcare: a scoping review.医疗保健中的种族主义:范围综述。
BMC Public Health. 2022 May 16;22(1):988. doi: 10.1186/s12889-022-13122-y.

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