Jillian Harding

Topic

Indigenous Peoples’ Experiences with Culturally Safe Health Care

School of Nursing

Date & location

• Thursday, June 6, 2024
• 10:00 A.M.
• Human & Social Development Building, Room A451

Examining Committee

Supervisory Committee

• Dr. Esther Sangster-Gormley, School of Nursing, University of Victoria (Co-Supervisor)
• Dr. Gweneth Doane, School of Nursing, UVic (Co-Supervisor)
• Dr. Karen MacKinnon, School of Nursing, UVic (Member)
• Dr. Colleen Varcoe, School of Nursing, University of British Columbia (Outside Member)

External Examiner

• Dr. Megan Aston, School of Nursing, Dalhousie University

Chair of Oral Examination

• Dr. Boualem Khouider, Department of Mathematics and Statistics, UVic

Abstract

It is widely recognized that Indigenous peoples have a lower life expectancy and higher rates of chronic health conditions and infectious diseases than non-Indigenous people do. Factors contributing to such health inequities include the impact of colonization on Indigenous peoples’ health and racism that Indigenous peoples often endure in mainstream health care settings. To promote Indigenous peoples’ health and reduce stigma and discrimination in health care, cultural safety is a promising approach. Although there is a substantial body of literature and research on cultural safety, there is a lack of resources to guide health care providers in practicing cultural safety effectively.

The overarching purpose of this dissertation was to gain insight into Indigenous peoples’ experiences with culturally safe health care. Two research questions guided the research process:

1. What are Indigenous peoples’ experiences with culturally safe health care encounters?
2. How is cultural safety enacted in health care as described by Indigenous peoples?

Two methodologies were used to explore these questions. For the first question, I used the Joanna Briggs Institute meta-aggregative approach to conduct a qualitative systematic literature review. For the second question, I used a descriptive qualitative methodology informed by relational inquiry, which is a nursing approach that is grounded in critical theoretical perspectives, hermeneutic phenomenology, and pragmatism. While the systematic review provided a synthesis of existing evidence, the qualitative study explored the ‘how’ of cultural safety, specifically, how health care providers created positive and safe health care experiences as described by Indigenous peoples, in contrast to much of the existing research that mainly focuses on the ‘what’ of cultural safety.

This publication-based dissertation is organized into three papers. The first paper is a published protocol for the qualitative systematic review. The second paper is the completed qualitative systematic review. The third paper is a practice-oriented paper aimed at assisting nurse practitioners in implementing culturally safe practice at the point of care through the creation of a mnemonic. The mnemonic was intended to provide a way for nurse practitioners to think about culturally safe care and enhance their ability to provide that care in specific health care situations.