UBC Theses and Dissertations
Champions of cultural safety : an exploration of how cultural safety can be implemented as a routine aspect of health care. Foster, Paula
Background: This study explores the perspectives of Champions of Cultural Safety and will potentially contribute to an Aboriginal Health team’s knowledge development of a current pilot project on Indigenous Cultural Competency transformation. This study identified healthcare providers (HCPs) who are Champions of Cultural Safety and explored their experiences practicing culturally safe care in their hospital. This study is timely given the current commitment to cultural safety and cultural humility in health services within the BC Tripartite Framework Agreement. Conducted with the guidance of the health authority’s Aboriginal Health Team, this inquiry may also assist HCPs in taking a cultural safety approach when providing healthcare in the face of ongoing racism and discrimination towards Indigenous people in healthcare and society. Methods: Using an exploratory, ethnographic, qualitative research design, recruitment began with Aboriginal Patient Navigators (APNs) who identified health care providers representing Champions of Cultural Safety. Snowball sampling was used until 8 participants from a variety of health care disciplines were recruited. Semi structured, in depth interviews were conducted with the APNs, an Elder and HCPs. Post-colonial theoretical perspectives informed the analysis and overall inquiry. A thematic analysis was conducted using constant comparison methods. Findings: The key findings are: 1) The client and health care provider relationship is the cornerstone of cultural safety (CS), 2) The organizational strategies to support CS are insufficient in the current, pervasive and conventional biomedical, organizational context, 3) Structural barriers to CS persist in the colonial context. These findings demonstrate the complexities and intersections of the HCP/client relationship, the organizational strategies to support CS and the current systemic barriers constraining the participants’ abilities to provide CS care. Discussion: The findings prompt three discussion areas: 1) The client and health care provider relationship is the cornerstone of CS, for both the client and health care provider when analyzed from a CS lens, 2) Many key characteristics of the hospital and wider health care context conflicts with a CS approach to care, 3) Structural violence characterized by racism and discrimination exists within the hospital environment, demonstrating a need for organizational interventions to address the continued Indigenous health inequities.
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