Barriers and supports for Indigenous youth and young adults with childhood- onset chronic health conditions transitioning from pediatric to adult healthcare: a qualitative study.

Autor: Mackie AS; Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada. andrew.mackie@ualberta.ca., Gray M; Trent University, 1600 West Bank Drive, Peterborough, ON, Canada., Chappell A; Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada., Dlusskaya K; Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada., Lightning R; Faculty of Medicine and Dentistry, University of Alberta, 2J2.00 Walter C. MacKenzie Health Sciences Centre, Edmonton, AB, T6G 2R7, Canada.; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Listener L; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Crier A; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Dumigan-Jackson B; Faculty of Medicine and Dentistry, University of Alberta, 2J2.00 Walter C. MacKenzie Health Sciences Centre, Edmonton, AB, T6G 2R7, Canada.; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Thomas A; Awasisak Indigenous Health Program, Stollery Children's Hospital, 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada., Graham B; Maskwacis Health Services, 14 Ermineskin Avenue, Maskwacis, AB, T0C 1N0, Canada., Littlechild R; Maskwacis Health Services, 14 Ermineskin Avenue, Maskwacis, AB, T0C 1N0, Canada., Lightning J; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Johnson A; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Rain P; Maskwacis Health Services, Pigeon Lake Health Centre, Box 37, Ma-Me-O Beach, AB, T0C 1X0, Canada., Cutarm M; Maskwacis Community Advisory Committee, Maskwacis, AB, T0C 1N0, Canada., Oster RT; Indigenous Wellness Core, Alberta Health Service, #306 Anderson Hall, 10959-102 Street, Edmonton, T5H 2V1, AB, Canada.
Jazyk: angličtina
Zdroj: International journal for equity in health [Int J Equity Health] 2024 Dec 18; Vol. 23 (1), pp. 268. Date of Electronic Publication: 2024 Dec 18.
DOI: 10.1186/s12939-024-02343-9
Abstrakt: Background: This study examined the experiences of Indigenous youth and young adults with pediatric onset chronic health conditions who had or were about to transition from pediatric to adult healthcare services. Transition is the process by which youth develop the knowledge and self-management skills needed to manage their health condition, ideally beginning around age 12-13 and continuing until the mid-20s. There is a growing body of literature on healthcare transition, but there is an absence of literature on Indigenous youth, who face additional barriers to accessing healthcare relative to non-Indigenous Canadians. The primary objective of this study was to identify the supports and barriers for Indigenous youth with childhood-onset chronic health conditions transitioning from pediatric to adult healthcare services.
Methods: The research was done in the province of Alberta, Canada, in collaboration with a Community Advisory Committee comprised of Indigenous healthcare providers, Elders and Knowledge Keepers and guided by a community-based participatory research approach. Semi-structured qualitative interviews (n = 46) were conducted with Indigenous youth, caregivers, and healthcare providers. There were three Talking Circles, two for youth (9 participants) and one for caregivers (6 participants). Three research assistants coded the transcripts thematically using NVivo. The key findings were presented to the Community Advisory Committee for feedback to validate the interpretation of the qualitative data.
Results: The thematic findings include: (1) systemic inequalities exacerbate gaps in healthcare; (2) intergenerational trauma created unique barriers for Indigenous youth; (3) long-term relationships with care providers as a protective factor; (4) the incorporation of Indigenous worldviews into healthcare services to aid transition; and (5) assuming new responsibilities as an adult. The participants provided recommendations to improve healthcare service delivery including the need for Indigenous transition supports in community and improving education for healthcare practitioners about transition and Indigenous worldviews.
Conclusion: This study demonstrates the complexity of the transition experience for Indigenous youth with pediatric onset chronic health conditions. The identified barriers to successful transition could be addressed through systems level changes and the development of Indigenous specific transition support services. Such approaches need to be Indigenous-led and incorporate Indigenous culture, language, and teachings.
Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the University of Alberta Health Research Ethics Board (Pro00095750). All interview and Talking Circle participants provided informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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