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UBC Theses and Dissertations

Tuberculosis (TB) storytelling : improving community nursing TB program delivery MacNaughton, April Dawn


This study explores the effectiveness of the traditional First Nations practice of storytelling as a tool in improving Community Health Nurse (CHN) continuing education, regarding tuberculosis (TB) programming in First Nations communities. The first part of this study involves a critical analysis of literature regarding the evolution of Canada’s First Nations policies and health care, and the use of storytelling as a learning tool in Western and First Nations contexts. Informed by critical social justice as a theoretical lens, and decolonising perspectives in health care, the analysis of the literature focuses on (a) shifting factors and societal values shaping the evolution of health care policy and regimes in First Nations health, and (b) the use of storytelling as an educational tool for CHNs working in First Nations communities. The analysis indicates that generations of inequities have resulted in First Nations mistrust of the Western health care system and a widening gap between the health status of First Nations and that of the broader Canadian population. The analysis also reveals that storytelling is an essential component of traditional First Nations education. Finally, the literature shows that there is increasing recognition by current health care policy makers that narrowing the gap in health outcomes requires that First Nations health care programming reflects First Nations input and community needs. The second part of this study evaluates the use of storytelling in CHN TB continuing education. TB continuing education sessions for CHNs included first person accounts by First Nations Elders, as part of the TB Tapestries Project, after which 70 CHNs were invited to provide written feedback. Thematic analysis of this feedback reveals increased appreciation for First Nations traditional storytelling as an important tool in provision of First Nations health care; recognition of the effectiveness of storytelling compared to other teaching methods; and a desire to change future TB programming by including storytelling. Based on the analysis of literature and CHN responses to the TB continuing education sessions, the primary recommendation of this study is to incorporate storytelling into TB education sessions for CHNs and broader health care programming for First Nations communities.

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