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Am J Community Psychol ; 64(1-2): 159-171, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31444914


Nunavimmiut (people of the land) are the Indigenous peoples of the northern peninsula of the province of Quebec. Communities of Nunavik and its regional organizations have been making concerted efforts in implementing community-based strategies to support family wellbeing. These community strategies are grounded in many of the values underpinning community psychology: favoring empowerment-oriented approaches, fostering community capacity, and transforming organizational cultures to allow for new modes of interaction, as well as new policies and practices that are grounded in community and culture. Despite the growing support and expectation for community mobilization, there is still very little research on the processes and challenges to such mobilization. In this study, we explored the unique challenges and facilitators to community endeavors in northern Quebec in order to better understand the complex dynamics and the strengths that Inuit build upon. We first used a focused ethnographic approach in the context of a 5-year community mobilization project in Nunavik. We then conducted 12 individual interviews and two small group interviews with Inuit working on community-based wellbeing-oriented mobilization projects in four additional communities. Results expose how sociogeographical realities and colonialism influence the process of community mobilization. They also highlight the values and motivational factors that lead community members to move beyond these influences.

Serviços Comunitários de Saúde Mental/métodos , Inuítes/psicologia , Saúde Mental/etnologia , Motivação , Antropologia Cultural , Humanos , Relações Interpessoais , Entrevistas como Assunto , Quebeque/etnologia
Int J Circumpolar Health ; 76(1): 1291868, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28270034


BACKGROUND: Inuit interpreters are key players in end-of-life (EOL) care for Nunavik patients and families. This emotionally intensive work requires expertise in French, English and Inuit dialects to negotiate linguistic and cultural challenges. Cultural differences among medical institutions and Inuit communities can lead to value conflicts and moral dilemmas as interpreters navigate how best to transmit messages of care at EOL. OBJECTIVES: Our goal was to understand the experience of Inuit interpreters in the context of EOL care in Nunavik in order to identify training needs. DESIGN: In the context of a larger ethnographic project on EOL care in Nunavik, we met with 24 current and former interpreters from local health centres and Montreal tertiary care contexts. Data included informal and formal interviews focusing on linguistic resources, experiences concerning EOL care, and suggestions for the development of interpretation training. RESULTS: Inuit working as interpreters in Nunavik are hired to provide multiple services of which interpretation plays only a part. Many have no formal training and have few resources (e.g. visual aids, dictionaries) to draw upon during medical consultations. Given the small size of communities, many interpreters personally know their clients and often feel overwhelmed by moral dilemmas when translating EOL information for patients and families. The concept of moral distress is a helpful lens to make sense of their experience, including personal and professional repercussions. CONCLUSIONS: Inuit interpreters in Nunavik are working with little training yet in context with multiple linguistic and cultural challenges. Linguistic and cultural resources and focused training on moral dilemmas unique to circumpolar contexts could contribute to improved work conditions and ultimately to patient care.​​​​.

Agentes Comunitários de Saúde/organização & administração , Competência Cultural/psicologia , Assistência Terminal/organização & administração , Tradução , Regiões Árticas , Comunicação , Agentes Comunitários de Saúde/ética , Humanos , Capacitação em Serviço , Inuítes , Princípios Morais , Quebeque , Assistência Terminal/ética
J Palliat Med ; 20(6): 647-655, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28177857


BACKGROUND: Increasing longevity for Inuit living in Nunavik, northern Quebec, has resulted in heightened rates of cancers and chronic diseases necessitating complex treatments. Consequently, end-of-life (EOL) care, once the domain of Inuit families and communities, has come to include professionalized healthcare providers with varying degrees of awareness of factors to consider in providing care to Inuit populations. OBJECTIVE: To better understand the factors shaping EOL care in Nunavik to support the development of a sustainable model of care. METHODS: Using focused ethnography, we conducted participant observations and informal and semistructured interviews with 103 participants (community members, healthcare practitioners, and administrators) across Nunavik and in Montreal, the affiliated tertiary care center. Data domains included the following: care trajectories; patient and family experiences receiving and providing EOL care; local and urban resources and challenges; and ways forward. RESULTS: Sociocultural, historical, and geographic factors shape EOL care in Nunavik, presenting a complex set of challenges for Inuit patients, families, and healthcare providers. A sustainable model of EOL care requires building on shared initiatives, capitalizing on the existing strengths in communities, and attending to the multiple bereavement needs in the region. DISCUSSION: Building a sustainable model of EOL care requires respectful collaboration among governing structures, healthcare institutions, and community members. It must centrally value local knowledge and initiatives. To ensure Inuit families and patients are supported throughout the dying process, future initiatives must centrally include local stakeholders in both the design and evaluation of any changes to the current healthcare system.

Inuítes , Assistência Terminal , Feminino , Pessoal de Saúde , Humanos , Entrevistas como Assunto , Longevidade , Masculino , Pesquisa Qualitativa , Quebeque , Assistência Terminal/organização & administração , Confiança
Health Place ; 34: 74-82, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25957925


In this article, we draw on a 2012 Montreal-based study that examined the embodied, every day practices of immigrant children and families in the context of urban greenspaces such as parks, fields, backyards, streetscapes, gardens, forests and rivers. Results suggest that activities in the natural environment serve as a protective factor in the health and well-being of this population, providing emotional and physical nourishment in the face of adversity. Using the Social Determinants of Health model adopted by the World Health Organization (WHO, 1998), we analyze how participants accessed urban nature to minimize the effects of inadequate housing, to strengthen social cohesion and reduce emotional stress. We conclude with a discussion supporting the inclusion of the natural environment in the Social Determinants of Health Model.

Emigrantes e Imigrantes/psicologia , Natureza , Parques Recreativos/estatística & dados numéricos , Determinantes Sociais da Saúde , Adulto , Criança , Família , Feminino , Humanos , Masculino , Quebeque , Características de Residência , Fatores Socioeconômicos