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BACKGROUND: The Royal Australasian College of Surgeons (RACS) recently instituted cultural safety and cultural competency as its 10th competency with formalized cultural safety training yet to be instituted. Wananga are Indigenous Maori teaching institutions that can be used contemporarily for cultural safety training. METHODS: In 2022, surgical registrars based at Taranaki Base Hospital (TBH) held in-hospital wananga ranging from 1 to 3 h focussed on cultural safety, professionalism and wellbeing. This study explores the perspectives of these registrars who attended wananga using a Kaupapa Maori aligned methodological stance and interpretive phenomenological analysis. RESULTS: Twenty-six wananga were held from March 22nd 2022 to January 30th 2023. Six registrars provided their perspectives with four major themes emerging from their stories including: cultural safety; unity; time, place and person; and a new era. Registrars valued the wananga which was scheduled for Friday afternoons after daily clinical duties. Wananga facilitated unity and understanding with registrars being able to reflect on the context within which they are practicing - describing it as a new era of surgical training. 'Time' was the biggest barrier to attend wananga however, the number of wananga held was testament to the commitment of the registrars. CONCLUSIONS: Regular wananga set up by, and for, surgical registrars cultural safety development is feasible and well subscribed in a rural or provincial NZ setting. We present one coalface method of regular cultural safety training and development for surgical registrars and trainees in NZ.
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INTRODUCTION: Rates of common cancers are continuously increasing among Indigenous peoples and are above the incidence rates of non-Indigenous Canadians. When considering the intersecting social determinants of health such as culture, geography, funding, and access to basic health services, these all contribute to the unique cancer burden faced by Indigenous people. Indigenous patients sometimes feel alienated by the word "cancer", intimidated in the oncology setting and often avoid or delay seeking care, bypass screening and preventative care, and cease prescribed treatment before it is finished. Providing culturally competent, safe care to improve Indigenous health outcomes have been suggested and prioritized in health care systems across Canada. METHODS: Using an Indigenous methodology, sharing circles were held in Northern Alberta, Canada. Five Indigenous survivors of cancer and two Indigenous caregivers shared their experiences with oncology treatment in the radiation therapy centre. Results were transcribed verbatim and thematic analysis was conducted. RESULTS: This resulted in four main themes (1) historical and cultural understandings (2) reduce systemic harm by having dedicated Indigenous staff, cultural competency, and Indigenous specific supports (3) meaningful time commitment and relationship building (4) importance of kinship and Indigenous-centred, family-and-patient-centred care. These themes fed into the development of nine recommendations for policy and decision makers to improve cultural safety in the Alberta radiation therapy centres. CONCLUSION: Support for Indigenous patients and caregivers is essential to improve care in the radiation therapy centres. The findings from this work will support recommendations for health decision and policy makers within radiation therapy centres, which may be transferable to other centres within oncology and health.
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As a result of overlapping social, economic, historical, and political influences, and intersecting experiences of racism, stigma and discrimination within healthcare, Indigenous Peoples in Canada experience inequitable access to healthcare and oncology care. The aim of this paper is to highlight some of the barriers contributing to inequitable access to oncology care, research examining oncology nurses' perspectives on these barriers and their roles in addressing barriers, and implications for nursing practice. Importantly, the role of nurses is not often considered in relation to healthcare access. By highlighting recent research evidence, I aim to open space to see the valuable work of oncology nurses, and to consider where and how we, as a profession, could better address inequities in access to oncology care for Indigenous Peoples.
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El presente estudio fue llevado a cabo con el objetivo de analizar y comparar los elementos de la seguridad cultural en la aplicación de los instrumentos de evaluación Test de desarrollo psicomotor 2-5 años (TEPSI) y Escala de Juego pre-escolar de Knox (RKPPS) aplicados por Terapeutas Ocupacionales en población pre-escolar valdiviana. Dicha investigación fue realizada a través de un enfoque cualitativo, con el abordaje metodológico de Teoría Fundamentada, realizando entrevistas semi-estructuradas a cuatro Terapeutas Ocupacionales que aplican ambos instrumentos. Como resultado se obtuvo que ninguno de los dos instrumentos se acercan al espectro de lo culturalmente seguro, sin embargo, es la RKPPS la que incorpora más elementos de dicha conceptualización. Finalmente se concluye que los profesionales de la disciplina se ven desafiados a permanecer en la dicotomía de, por una parte, utilizar instrumentos cuantitativos para validarse ante otros profesionales y tener un lenguaje común, y por otro lado, instrumentos cualitativos para realizar intervenciones integrales con usuarios. Esa elección se ve influenciada por una serie de variables, dadas por las distintas demandas en su desempeño laboral, impactando en su forma de evaluar.
The following study was developed with the intention of analysing and comparing the elements of cultural safety in the application of these two assessment tools, the Revised Knox Preschool Play Scale(RKPPS) and the Test de Desarrollo Psicomotor 2-5 Años(TEPSI) on preschool Valdivian population by Occupational Therapists. This research was conducted through a qualitative approach, using Grounded Theory as methodological approach, and semi-structured interviews to four Occupational Therapists that regularly use both assessment tools were done. As a result, neither the RKPPS nor the TEPSI, are close to the culturally safe spectrum. However, the RKPPS is the one that embodies more elements from this conceptualization. Finally, it has been concluded that professional OTs are being challenged to remain in this dichotomy: On the one hand, using quantitative tools to validate themselves in front of other professionals and in order to have a common language; on the other hand, using qualitative tools to do comprehensive interventions with clients. This choice is influenced by a series of variables, due to different demands in their job performance, impacting on their way of evaluating.