"我的感受和想法就是我的生活经历,而不是他们在纸上给我看的数字":加拿大不列颠哥伦比亚省原住民的肝移植经历。

IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal of Circumpolar Health Pub Date : 2024-12-01 Epub Date: 2024-05-28 DOI:10.1080/22423982.2024.2359747
Chenoa Cassidy-Matthews, Margo Pearce, Trana Hussaini, Patricia Spittal, Nadine Caron, Cole Daley, Ruth Alfred, Eric M Yoshida
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引用次数: 0

摘要

加拿大原住民面临着医疗保健方面的不平等,这影响了他们获得实体器官移植的机会。关于原住民患者在肝脏移植过程中的经历,以及移植专业人员如何看待原住民面临的挑战,尚未进行过研究。2021 年 4 月至 2022 年 5 月期间,我们通过远程医疗与加拿大不列颠哥伦比亚省的原住民肝移植患者(7 人)和移植护理提供者(6 人)进行了 13 次半结构化定性访谈。访谈确定了主题,以便为临床方法和移植护理规划提供信息,并由原住民健康专家进行验证。在患者参与者中:移植手术发生在 1992-2020 年间;所有参与者均为女性;接受访谈时的平均年龄为 60 岁。在移植护理提供者参与者中:角色包括护理、社会工作和外科;83% 为女性;从事移植护理的年数中位数为 10 年。我们确定了三大主题:原住民的优势和资源、系统性和结构性障碍,以及各医疗专业间护理和文化安全的不一致影响了肝移植期间对原住民患者的护理。这项研究有助于深入了解肝移植过程中的系统性障碍和原住民的适应能力。我们需要消除结构性障碍,及早联系护理,并强烈建议对移植临床医生进行有关土著历史、文化协议和文化安全的培训。
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"My feelings and my thoughts are my lived experience, not the numbers they show me on a piece of paper": Indigenous experiences of liver transplantation in British Columbia, Canada.

Indigenous Peoples in Canada face healthcare inequities impacting access to solid organ transplantation. The experiences of Indigenous patients during the liver transplant process, and how transplant professionals perceive challenges faced by Indigenous Peoples, has not been studied. Thirteen semi-structured qualitative interviews were conducted via telehealth with Indigenous liver transplant patients (n = 7) and transplant care providers (n = 6) across British Columbia, Canada between April 2021-May 2022. Themes were identified to inform clinical approaches and transplant care planning and validated by Indigenous health experts. Among patient participants: transplants occurred between 1992-2020; all were women; and the mean age at the time of interview was 60 years. Among transplant care provider participants: roles included nursing, social work, and surgery; 83% were women; and the median number of years in transplant care was ten. Three broad themes were identified: Indigenous strengths and resources, systemic and structural barriers, and inconsistent care and cultural safety across health professions impact Indigenous patient care during liver transplantation. This study contributes insights into systemic barriers and Indigenous resilience in the liver transplant journey. Dismantling structural barriers to early linkage to care is needed, and training for transplant clinicians on Indigenous histories, cultural protocols, and cultural safety is strongly recommended.

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来源期刊
International Journal of Circumpolar Health
International Journal of Circumpolar Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.10
自引率
15.40%
发文量
51
审稿时长
6-12 weeks
期刊介绍: The International Journal of Circumpolar Health is published by Taylor & Francis on behalf of the Circumpolar Health Research Network [CircHNet]. The journal follows the tradition initiated by its predecessor, Arctic Medical Research. The journal specializes in circumpolar health. It provides a forum for many disciplines, including the biomedical sciences, social sciences, and humanities as they relate to human health in high latitude environments. The journal has a particular interest in the health of indigenous peoples. It is a vehicle for dissemination and exchange of knowledge among researchers, policy makers, practitioners, and those they serve. International Journal of Circumpolar Health welcomes Original Research Articles, Review Articles, Short Communications, Book Reviews, Dissertation Summaries, History and Biography, Clinical Case Reports, Public Health Practice, Conference and Workshop Reports, and Letters to the Editor.
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