ABSTRACT
BACKGROUND AND PURPOSE: Evidence suggests that Gender-based violence (GBV) is prevalent throughout the perinatal period. Women during this time have frequent contact with healthcare providers (HCPs), and there are many opportunities that HCPs can identify GBV and support women by early intervention during routine prenatal care. However, evidence shows that HCPs are still hesitant to address this issue. This study was conducted to explore the experiences of Survivors and HCPs on how to manage a meaningful conversation about GBV with survivors during perinatal care. METHODS: A thematic approach has been used in this qualitative study. RESULTS: Twenty-eight semi-structured interviews were conducted with survivors and HCPs. Three main themes emerged from the data analysis, including: "Knock gently on the door to enter the client's private world", "Show interest in clients' stories that are beyond their physical problems" and "Gradually and cautiously cross the hidden borders." CONCLUSION: HCPs play a pivotal role in identifying GBV and providing support for survivors, particularly during their perinatal period. However, initiating a conversation around this sensitive topic needs time, skill, and enough knowledge. Validating survivors' experiences, providing a private and safe atmosphere without judgment, and creating empathy could lead to more disclosure of GBV. To have a meaningful conversation, HCPs need to have a holistic approach toward care, show interest in clients' stories beyond their physical problems, and support clients who have shared sensitive information.
Subject(s)
Gender-Based Violence , Pregnancy , Child , Infant, Newborn , Humans , Female , Perinatal Care , Qualitative Research , CommunicationABSTRACT
Theories on the importance of holistic and spiritual healing within nonconventional models of care are vast, yet there is little written about the practical, clinical-level interventions required to deliver such practices in collaborative cross-cultural settings. This article describes the learning experiences and transformative journeys of non-Indigenous nurse practitioners working with a Cultural Lead from an Indigenous community in British Columbia, Canada. The goal of the Seven Sisters Healthy Heart Project was to improve heart health promotion in an Indigenous community through a model of knowledge translation. The article describes the development of a bridge between two cultures in an attempt to deliver culturally responsive programming. Our journeys are represented in a phenomenological approach regarding relationships, pedagogy, and expertise. We were able to find ways to balance two worlds-the medical health services model and Indigenous holistic models of healing. The key to building the bridge was our willingness to be vulnerable, to trust in each other's way of teaching and learning, and allowing diverse viewpoints and knowledge sources to be present. Our work has vast implications for health promotion in Indigenous communities, as it closes the gap between theory and practice by demonstrating how Indigenous models can be integrated into mainstream health promotion practices.
Subject(s)
Culturally Competent Care/standards , Indians, North American/psychology , Spiritual Therapies/psychology , Canada , Culturally Competent Care/methods , Health Promotion/methods , Health Promotion/standards , Heart Diseases/prevention & control , Heart Diseases/psychology , Heart Diseases/therapy , Humans , Qualitative Research , Spiritual Therapies/methods , WorkforceABSTRACT
Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs.