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PubMed2002

A post-colonial analysis of healthcare discourses addressing aboriginal women.

Annette Browne and Vicki Smye use post-colonial theoretical perspectives to inform a critical analysis of healthcare discourses related to cervical cancer among Canadian aboriginal women. They also examine how decontextualised discourses addressing aboriginal women's risks for cervical cancer can perpetuate negative stereotypical images of aboriginal women while downplaying or ignoring the historical, social and economic context of women's health risks.

American Indian or Alaska Native↗
PubMedDate not supplied

Improving mental health services for urban First Nations: policy issues relevant to health care reform.

This paper discusses issues related to the development of plans to improve the effectiveness of mental health services for urban First Nations people. The discussion focuses on emerging issues related to health care reform and regionalization. While it is impossible to make specific recommendations without reference to local conditions, developing an awareness of the general issues involved will help in the process of identifying the principles and approaches needed to frame local solutions.

American Indian or Alaska Native↗
PubMedDate not supplied

What makes us strong: urban aboriginal perspectives on wellness and strength.

The limitations of a needs orientation for aboriginal mental health planning are evaluated in terms of the discrepancy between First Nations and western medical paradigms of health. We propose an alternative approach that focuses on how aboriginal people conceptualize wellness and describe their strengths. This provides a focus for initiatives that promote well-being by enhancing strengths rather than concentrating solely on deficits. We illustrate this approach by highlighting the indigenous knowledge of urban First Nations people in Vancouver's Downtown Eastside neighbourhood. We conclude that supporting existing strengths promotes wellness in holistic, culturally appropriate, and empowering ways.

Adult↗
PubMedDate not supplied

First Nations counsellor training in British Columbia: strengthening the circle.

First Nations people in British Columbia are struggling to overcome the effects of assimilationist practices and cultural loss. Many of the mental health problems facing First Nations people today can be traced to this loss. Their communities believe the best way to address this problem is by training their own people as mental health professionals who could then provide informed and culturally relevant counselling services. In the spring of 1996 a province-wide survey was conducted to determine the nature of counsellor training needed by First Nations people in the province of British Columbia. This article describes the rationale for this survey and the results.

American Indian or Alaska Native↗
PubMed1999

Residents' exposure to aboriginal health issues. Survey of family medicine programs in Canada.

OBJECTIVE: To determine whether Canadian family medicine residency programs currently have objectives, staff, and clinical experiences for adequately exposing residents to aboriginal health issues. DESIGN: A one-page questionnaire was developed to survey the details of teaching about and exposure to aboriginal health issues. SETTING: Family medicine programs in Canada. PARTICIPANTS: All Canadian family medicine program directors in the 18 programs (16 at universities and two satellite programs) were surveyed between October 1997 and March 1998. MAIN OUTCOME MEASURES: Whether programs had teaching objectives for exposing residents to aboriginal health issues, whether they had resource people available, what elective and core experiences in aboriginal health were offered, and what types of experiences were available. RESULTS: Response rate was 100%. No programs had formal, written curriculum objectives for residency training in aboriginal health issues, although some were considering them. Some programs, however, had objectives for specific weekend or day sessions. No programs had a strategy for encouraging enrollment of residents of aboriginal origin. Eleven programs had at least one resource person with experience in aboriginal health issues, and 12 had access to community-based aboriginal groups. Core experiences were all weekend seminars or retreats. Elective experiences in aboriginal health were available in 16 programs, and 11 programs were active on reserves. CONCLUSIONS: Many Canadian family medicine programs give residents some exposure to aboriginal health issues, but most need more expertise and direction on these issues. Some programs have unique approaches to teaching aboriginal health care that could be shared. Formalized objectives derived in collaboration with other family medicine programs and aboriginal groups could substantially improve the quality of education in aboriginal health care in Canada.

Adult↗
PubMed1998

Experience of aboriginal health interpreters in mediation of conflicting values in end-of-life decision making.

This paper examines the experience of Aboriginal medical interpreters working with terminally ill patients, family members, and care providers, and serving as mediators when cultural values and decision frameworks are in conflict. The discussion is based on a qualitative analysis of interaction in 12 patient encounters which were observed and for which transcripts were made of the discourse and interaction. Each case involved intervention by a professional interpreter. Interaction involved the signing of advance directives or other consent agreements in situations in which Aboriginal patients were terminally ill. Analysis will focus on the cultural dimension of value conflict situations, particularly in relation to issues of individual autonomy and biomedical emphasis on truth-telling in the communication of terminal prognosis.

Aged↗
PubMed1998

Premedical program effective in increasing admissions to health professional schools.

The Special Premedical Studies Program (SPSP) has been successful in preparing Aboriginal students in Canada for admission to medicine, dentistry, medical rehabilitation, and pharmacy at the University of Manitoba. The success rate for admission to these faculties is 20%. There is a higher failure rate in the basic years of medical/dental education, but remediation has been 100% successful. Failure rates in the clinical years do not differ from those of the mainstream population. Grade point averages and MCAT scores are given less weight in the special consideration category of application at the University of Manitoba. SPSP students can and do apply to this category. The higher rate of first unsuccessful attempt in the basic years of medical education specifically can be attributed to a variety of factors, including reading skills. Although the numbers are small, we show that there is a correlation between the comprehension score of the Nelson-Denny test and the verbal score of MCAT. But there was no difference on the average between verbal score in MCAT and pass/fail in basic medical years. Students who scored above the 80th percentile on the comprehension portion of the Nelson-Denny test were successful in their first attempt at examinations in medical school.

American Indian or Alaska Native↗
PubMed1998

Using the evaluation of the Dalhousie Outpost Nursing Program for responsive social action.

The Dalhousie Outpost Nursing Program is designed specifically to prepare registered nurses to provide primary health care in northern Canadian Aboriginal communities where there are no resident physicians. In 1993, the program was extensively evaluated, using a responsive participatory approach that is consistent with the direction of health care in Canada. The evaluation documented the effectiveness of the program and permitted diverse views to be expressed. Most importantly, the evaluation enabled the voice of Aboriginal people living in northern communities to be heard. Dalhousie School of Nursing has used the evaluation results to provide some direction for program planning in the context of Canadian health reform.

American Indian or Alaska Native↗
PubMed1998

Benefits of traditional food in Dene/Métis communities.

Data collected in 16 Dene/Métis communities are used to illustrate the many nutritional, economic, and sociocultural benefits associated with the harvest and consumption of traditional food by indigenous peoples. These include exceptional nutrient composition, absence of industrial processing that changes quality and taste properties, taste preference, reasonable cost compared to market food, quality of the time spent on the land, increased physical activity, sharing of the harvest within the community, opportunity to practice spirituality, and encouragement for children to discover the natural environment. The importance of traditional food to the health of individuals and communities can be directly related to the nutritional value of the food itself, the physical activity associated with its procurement, and its role in mediating positive health determinants such as self-efficacy and locus of control.

American Indian or Alaska Native↗
PubMed1998

Gestational diabetes and subsequent development of NIDDM in aboriginal women of northwestern Ontario.

OBJECTIVES: To determine (1) the risk of development of non-insulin-dependent diabetes mellitus (NIDDM) in women with a previous history of gestational diabetes mellitus (GDM), (2) the average duration between diagnoses of GDM and NIDDM, (3) various modes of presentation, and (4) adequacy of follow-up post diagnosis of GDM. METHODS: A retrospective chart review of women diagnosed with GDM in the Sioux Lookout Zone between 1985-1995. There were 4,211 pregnancies and 332 women with a diagnosis of GDM. Sixty-one charts were randomly selected. Both GDM and NIDDM were defined according to World Health Organization standards. RESULTS: Seventy percent of the women with GDM went on to develop NIDDM. The average duration between diagnosis of GDM and diagnosis of NIDDM was three years. Greater than 70% of the women developed NIDDM within four years post diagnosis of GDM. The majority presented with asymptomatic hyperglycemia (88%); 3% presented with acidosis; 6% presented with symptoms of polydipsia and polyuria; and 3% presented with abnormal weight gain. Specific physician-requested follow-up after six weeks postpartum occurred in only 38% of the cases. However six-week follow-up occurred in 41%, a yearly follow-up occurred in 61% of the women, and 81% of the women had some sort of follow-up post diagnosis of GDM. CONCLUSIONS: The risk of developing NIDDM after GDM is very high in Aboriginal women of the Sioux Lookout Zone. There is an urgent need for a structured follow-up program for this group of high-risk women. Furthermore, the offspring of these pregnancies should be a focus for follow-up and preventive programs.

Adolescent↗
PubMed1998

Preventing NIDDM among aboriginal people: is exercise the answer? Description of a pilot project using exercise to prevent gestational diabetes.

Rates of diabetes and its complications have reached epidemic proportions among North American Aboriginal peoples. This appears largely due to changes in diet and activity levels associated with a shift away from traditional lifestyles. Since exercise has been shown to be effective in preventing non-insulin-dependent diabetes mellitus (NIDDM), Aboriginal communities may be able to reduce their rates of the disease by incorporating exercise programs into their public health programs. We describe a pilot project in Saskatoon, Saskatchewan, whose ultimate purpose is to evaluate the effect of exercise in preventing gestational diabetes. If successful, this would reduce the risk of developing NIDDM for both women and their offspring.

Adolescent↗
PubMed1998

Social and cultural impacts of environmental change on aboriginal Peoples in Canada.

Environmental change, often the result of Western industrial development, has had a major impact on Canadian Aboriginal people. Even when there are no provable direct health effects, Aboriginal peoples' holistic concepts of health, balance, and harmony, and the interrelatedness of health and environment lead them to regard social and cultural effects as health effects. This paper explores the links between environmental change and the social and cultural and, hence, health effects these changes produce. It is argued that factors such as Aboriginal holistic concepts of environment and health, perceptions of risk, and difficulties in communication contribute to these social and cultural effects and their subsequent health effects-effects which frequently present a greater problem in Canadian Aboriginal communities than do the direct health effects of environmental change.

American Indian or Alaska Native↗
PubMed1998

Delivery of physiotherapy services to some First Nations communities in Manitoba.

PURPOSE: This program was instituted to extend physiotherapy services to communities without road access to traditional rehabilitation services. METHODS: Physiotherapy consulting services are provided on a monthly basis to communities involved in the program. Service is based in the communities' nursing stations and includes four components: direct care to clients, preventive care, professional resources, and education. RESULTS: Physiotherapy services can be effectively provided in isolated settings by an outreach program using experienced therapists based in a central location.

Adult↗
PubMed1999

Evolving participation of aboriginal communities in health research ethics review: the impact of the Inuvik workshop.

The International Workshop "Ethical Issues in Health Research among Circumpolar Indigenous Peoples" was held in Inuvik on June 2-3, 1995 (1). Its purpose was to bring together researchers, representatives of aboriginal organizations and First Nations leaders to discuss problems in the current ethical review process and to develop new frameworks which would increase community participation in the research process. The paper summarizes some of the ethical and political issues involved in developing such frameworks. It describes developments which have occurred since the Inuvik workshop reflecting the changing process of ethical review and new relationships between researchers, participants and aboriginal communities.

American Indian or Alaska Native↗