Qina'au Joanne, Chao Maria T, Austin Seabury Aukahi, Antonio Mapuana C K
Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA.
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Glob Adv Integr Med Health. 2025 Sep 4;14:27536130251375057. doi: 10.1177/27536130251375057. eCollection 2025 Jan-Dec.
Integrative health efforts typically offer clinical services of Western and non-Western origin in a biomedical context. Indigenous communities and other minoritized populations would benefit from improved equity efforts in integrative healthcare.
As an approach to improve healthcare for Kānaka 'Ōiwi (Native Hawaiians), we explore multi-eyed seeing, an elaboration on two-eyed seeing, emphasizing decolonialism and adaptive use of healing traditions from multiple cultural backgrounds. We also discuss the ways multi-eyed seeing may be used to address challenges to integrative health inequities.
Using the transformative paradigm and community-based participatory action research, we conducted 1 focus group and 38 in-depth interviews. Data were analyzed using grounded theory, a decolonial intersectionality method, ho'omana i nā leo (empowering the voices), and thematic analysis. To triangulate data, recruitment targeted 3 categories: mental and behavioral health providers who primarily serve Kānaka 'Ōiwi (n = 12), Kanaka 'Ōiwi clients who experienced depressive symptoms (n = 19), and Kanaka 'Ōiwi cultural leaders (n = 10).
Three primary themes emerged, suggesting that multi-eyed seeing: 1) supports Indigenous wellbeing at multiple levels; 2) necessitates unique spaces for healthcare and healing; 3) may illuminate similarities across cultures and underlying mechanisms for healing and health. Findings also include 2 secondary themes, 1 describing the potential role of multi-eyed seeing in idiographic and transdiagnostic approaches to behavioral and integrative healthcare and another describing potential barriers to multi-eyed seeing.
By drawing upon strengths of Indigenous, Western, Eastern, and other pathways to wellbeing, a synergistic weaving may be stronger than the sum of its parts. At the levels of ontology, epistemology, axiology, and praxis, multi-eyed seeing provides approaches to equity in integrative healthcare. We offer critical reflections and analyses of the processes that may uplift the work of multi-eyed seeing as a decolonial approach and invite dialogue around this concept for future exploration.
综合健康举措通常在生物医学背景下提供源自西方和非西方的临床服务。原住民社区和其他少数群体将从综合医疗保健中改善公平性的努力中受益。
作为改善夏威夷原住民（Kānaka 'Ōiwi）医疗保健的一种方法，我们探索“多视角审视”，这是对“双视角审视”的一种细化，强调去殖民化以及对来自多种文化背景的治疗传统的适应性运用。我们还讨论了“多视角审视”可用于应对综合健康不平等挑战的方式。
采用变革性范式和基于社区的参与性行动研究，我们开展了1次焦点小组讨论和38次深度访谈。使用扎根理论、一种去殖民化的交叉性方法、“赋予声音力量”（ho'omana i nā leo）以及主题分析对数据进行了分析。为了对数据进行三角验证，招募对象针对3类人群：主要为夏威夷原住民提供服务的精神和行为健康提供者（n = 12）、经历过抑郁症状的夏威夷原住民客户（n = 19）以及夏威夷原住民文化领袖（n = 10）。
出现了三个主要主题，表明“多视角审视”：1）在多个层面支持原住民的福祉；2）需要独特的医疗保健和治疗空间；3）可能揭示不同文化之间的相似性以及治疗和健康的潜在机制。研究结果还包括两个次要主题，一个描述了“多视角审视”在行为和综合医疗保健的个案研究及跨诊断方法中的潜在作用，另一个描述了“多视角审视”的潜在障碍。
通过利用原住民、西方、东方和其他通往福祉途径的优势，一种协同的交织可能比其各部分的总和更强大。在本体论、认识论、价值论和实践层面，“多视角审视”为综合医疗保健中的公平性提供了方法。我们对可能提升“多视角审视”作为一种去殖民化方法的工作的过程进行了批判性反思和分析，并邀请围绕这一概念进行对话以供未来探索。
