Shifting Power to Improve First Nation Peoples’ Access and Outcomes in Kidney Care

http://www.kireports.org/article/S2468024922018538/pdf

Identifying Drivers of Poor Kidney Transplant Outcomes in Indigenous Populations

This research represents an in-depth exploration of the lived experience, demands and risks of facilitating Indigenous cultural safety and the impact it has on the health and wellness of Indigenous cultural safety facilitators. Using Indigenous and qualitative methodologies, this study gathered data from 11 Indigenous cultural safety facilitators in the Vancouver Island and Vancouver regions through in-depth interviews. Issues around training, preparation, boundaries and capacity within Indigenous cultural safety spaces were examined, as well as the resistance, harm, violence, emotional taxation, hardships and burnout often experienced by Indigenous cultural safety facilitators. With a focus on how facilitating Indigenous cultural safety affects physical, emotional, mental and spiritual wellness, as well as emphasizing the high risk of burnout, this research demonstrates that Indigenous cultural safety environments can be unsafe for Indigenous cultural safety facilitators and exposes a need to explore further how social and structural supports can better protect the health and wellness of Indigenous cultural safety facilitators.

https://journals.sagepub.com/doi/pdf/10.1177/11771801231168140

The cost of Indigenous cultural safety training: examining facilitator burnout and the impacts on health and wellness

Rationale & Objective Cultural Safety is being prioritized within health care around the world. As a concept, Cultural Safety centers upon power relations between health providers and indigenous recipients of care, ensuring that all people feel safe and respected in the health care system. In this article, we explored the breadth of the literature regarding Cultural Safety within the context of indigenous kidney health care. Study Design & Populations As a systematic narrative review, this work engaged widely across a diverse range of the available literature to broaden understanding of Cultural Safety within indigenous kidney health care and indigenous populations from Australia, New Zealand, Canada, and the United States. Search Strategy & Analytical Approach Guided by the research question focused on how Cultural Safety occurs within care for indigenous people with kidney disease, an initial database search by the university librarian resulted in retrieval of 2,232 articles, of which 96 potential articles were screened by the research team. Results 15 articles relevant to the research question were identified and study findings were assembled within 3 broad clusters: relationality, engagement, and health care self-determination; systemic issues, barriers, and access; and addressing legacies of colonialism for health care providers. Limitations The review summarizes mainly qualitative articles given the paucity of articles found specific to Cultural Safety within indigenous contexts. Conclusions Of particular interest to health care providers are the collation of solutions by cluster and the findings of this review that contribute to further understanding of the concept of Cultural Safety in health care for indigenous people with kidney disease. Also, findings address the importance of community-driven kidney care in which language, ways of knowing and being, and traditional ways of healing are prioritized.

Valerie Monague

Papers

Furthering Cultural Safety in Kidney Care Within Indigenous Communities: A Systematic Narrative Review