Defining culturally safe primary care for people who use substances: a participatory concept mapping study
| Autor: | Bernadette Pauly, Elizabeth Hartney, Fred Cameron, Troy Haddad, Bruce Wallace, Grant Schlotter, Dakota Inglis, Conor Rosen, Paige Phillips, Jack J. Phillips, Karen Urbanoski |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Canada medicine.medical_specialty Cultural safety Community-based participatory research Participatory action research Substance use Health administration 03 medical and health sciences 0302 clinical medicine Nursing Health care medicine Humans 030212 general & internal medicine 030505 public health Primary Health Care business.industry 4. Education Health Policy Public health Nursing research 1. No poverty Primary care Anxiety Disorders Focus group Community based participatory research Stigma Female Concept mapping 0305 other medical science business Delivery of Health Care Research Article |
| Zdroj: | BMC Health Services Research |
| ISSN: | 1472-6963 |
| Popis: | Background People who use substances experience high levels of substance-related stigma, both within and outside of health care settings, which can prevent people from help-seeking and contribute further to health inequities. Recognizing and respecting how political, social, economic, and historical conditions influence health and health care, cultural safety, with origins in addressing Indigenous racism, is a potential strategy for mitigating stigma and marginalization in health care. Using a participatory research approach, we applied the concept of cultural safety to develop a model of safe primary care from the perspective of people who use substances. Methods People who use or used substances were involved in all phases of the research and led data collection. Study participants (n = 75) were 42.5 years old on average; half identified as female and one quarter as Indigenous. All were currently using or had previous experience with substances (alcohol and/or other drugs) and were recruited through two local peer-run support agencies. Concept mapping with hierarchical cluster analysis was used to develop the model of safe primary care, with data collected over three rounds of focus groups. Results Participants identified 73 unique statements to complete the focus prompt: “I would feel safe going to the doctor if …” The final model consisted of 8 clusters that cover a wide range of topics, from being treated with respect and not being red-flagged for substance use, to preserving confidentiality, advocacy for good care and systems change, and appropriate accommodations for anxiety and the effects of poverty and criminalization. Conclusions Developing a definition of safe care (from the patient perspective) is the necessary first step in creating space for positive interactions and, in turn, improve care processes. This model provides numerous concrete suggestions for providers, as well as serving as starting point for the development of interventions designed to foster system change. |
| Databáze: | OpenAIRE |
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