Academic Journal
Atikamekw needs and perspectives for culturally safe health care.
| Τίτλος: | Atikamekw needs and perspectives for culturally safe health care. |
|---|---|
| Συγγραφείς: | Tremblay MC; Université Laval, Québec, QC, Canada. Marie-claude.tremblay@fmed.ulaval.ca., Olivier-D'Avignon G; Université Laval, Québec, QC, Canada., Sportès S; Université Laval, Québec, QC, Canada., Echaquan S; Université de Montréal, Montréal, QC, Canada.; Centre de Santé Masko-Siwin, Manawan, QC, Canada., Ottawa A; Centre de Santé Masko-Siwin, Manawan, QC, Canada., Neashish E; Conseil Des Atikamekw de Wemotaci, Wemotaci, QC, Canada., Niquay T; Conseil Des Atikamekw de Wemotaci, Wemotaci, QC, Canada., Awashish YR; Conseil Des Atikamekw d'Opitciwan, Opitciwan, QC, Canada., Coocoo C; Conseil de La Nation Atikamekw, La Tuque, QC, Canada., Weizineau PY; Conseil Des Atikamekw d'Opitciwan, Opitciwan, QC, Canada. |
| Πηγή: | Canadian journal of public health = Revue canadienne de sante publique [Can J Public Health] 2026 Aug; Vol. 117 (4), pp. 647-657. Date of Electronic Publication: 2025 Nov 12. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer Nature Country of Publication: Switzerland NLM ID: 0372714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1920-7476 (Electronic) Linking ISSN: 00084263 NLM ISO Abbreviation: Can J Public Health Subsets: MEDLINE |
| Imprint Name(s): | Publication: Switzerland : Springer Nature Original Publication: Ottawa : Canadian Public Health Association |
| Ιατρικοί όροι (MeSH): | Health Services, Indigenous*/organization & administration , Indigenous Canadians*/psychology , Indigenous Canadians*/statistics & numerical data , Cultural Competency* , Culturally Competent Care* , Health Services Needs and Demand* , Needs Assessment*, Female ; Humans ; Male ; Community-Based Participatory Research ; Quebec |
| Περίληψη: | Objectives: This research is part of a larger participatory project aimed at co-developing an intervention to ensure cultural safety in care, conducted with and by the Atikamekw Nehirowisiwok (First Nation, Quebec Canada). A decolonizing research approach, integrating Atikamekw perspectives and ways of knowing, was adopted. The objectives of this phase of the project were to better understand the health care needs and perspectives of the Atikamekw peoples on cultural safety. Methods: Three talking circles were conducted from June 2022 to July 2022 in each of the three Atikamekw communities (Manawan, Wemotaci, and Opitciwan). Each talking circle comprised six to eight participants (a total of 21 participants) recruited on a voluntary basis. Talking circles lasted an average of 2 h and were conducted in French and Atikamekw. Data from talking circles were transcribed verbatim and analyzed using inductive thematic analysis by two members of the team. Collective interpretation of the results was informed by Atikamekw perspectives on the medicine wheel and the concept of Pimatisiwin. Results: The themes that emerged represent different Atikamekw needs regarding cultural safety in health care. These results highlight language accessibility, a welcoming approach, an anti-racist environment of care, the inclusion of traditional medicine and cultural perspectives, as well as self-determination as fundamental elements of culturally safe health care. Conclusion: This research project, carried out with and by the Atikamekw Nation, exemplifies how a decolonizing approach centered on the expertise of Indigenous communities can be used to develop culturally safe interventions that respect their needs, values, and cultural practices. Résumé Objectifs: Cette étude fait partie d'un projet participatif plus large visant à co-développer une intervention pour assurer la sécurité culturelle dans les soins, menée pour, par et avec les Atikamekw Nehirowisiwok (Première Nation, Québec, Canada). Une approche de recherche décolonisatrice, intégrant les perspectives et les modes de connaissance atikamekw, a été adoptée. Les objectifs de cette phase du projet étaient de mieux comprendre les besoins en matière de soins de santé et les points de vue des personnes Atikamekw sur la sécurité culturelle. Méthodes: Trois cercles de parole ont été organisés dans trois communautés atikamekw avec 6 à 8 participants (n = 21). Les cercles de parole ont duré en moyenne deux heures et se sont déroulés en français et en atikamekw. Les données des cercles de parole ont été transcrites et analysées par deux membres de l'équipe selon une approche thématique inductive. L'interprétation collective des résultats a été éclairée par les perspectives atikamekw de la roue de la médecine et le concept de Pimatisiwin. Résultats: Les résultats mettent en évidence l'importance de l'accessibilité linguistique, une approche accueillante, un environnement de soins antiraciste, l'inclusion de la médecine traditionnelle et des perspectives culturelles, ainsi que l'autodétermination comme éléments fondamentaux des soins de santé culturellement sécuritaires. Conclusion: Ce projet de recherche, mené avec et par la Nation Atikamekw, illustre comment une approche décolonisatrice centrée sur l'expertise des communautés autochtones peut être utilisée pour développer des interventions culturellement sécuritaires qui respectent leurs besoins, leurs valeurs et leurs pratiques culturelles. (© 2025. The Author(s) under exclusive license to The Canadian Public Health Association.) |
| Competing Interests: | Declarations. Conflict of interest: The authors declare no competing interests. Ethics approval: This study was approved by the Research Ethics Board of Université Laval (2019–351 R-4/13–05-2024). All participants provided informed written consent to take part in the study. Consent for publication: The researchers obtained the participants’ consent to include anonymized verbatims in the manuscript. |
| References: | Allan, B., & Smylie, J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada (p. 17). The Wellesley Institute. Retrieved September 1st, 2025, from https://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Summary-First-Peoples-Second-Class-Treatment-Final.pdf. Assemblée des Premières Nations du Québec-Labrador. (2023). Déclaration sur les droits des Premières Nations à l’autodétermination et à la sécurisation culturelle (p. 8). APNQL. Retrieved September 1st, 2025 from https://cssspnql.com/produit/declaration-sur-les-droits-des-premieres-nations-a-lautodetermination-et-a-la-securisation-culturelle/. Association Canadienne des Écoles de Sciences Infirmières. (2020). Cadre stratégique en matière de formation infirmière, en réponse aux appels à l’action de la Commission de vérité et réconciliation du Canada (p. 13). CASN, ACESI. Retrieved on September 1st, 2025 from https://www.casn.ca/wp-content/uploads/2020/11/FR-TRC-RESPONSE-STRATEGIES-FOR-NURSING-EDUCATIONTRC-Discussion-Paper-Revised-date-Final.pdf. Association des infirmières et des infirmiers autochtones du Canada, Association canadienne des écoles de sciences infirmières, & Canada. (2009). Compétence culturelle et sécurité culturelle en enseignement infirmier des Premières nations, des Inuits et des Métis. Programme d’études pour la profession infirmière autochtone (p. 28). Association des infirmières et des infirmiers autochtones du Canada. Retrieved September 1st, 2025 from https://casn.ca/wp-content/uploads/2014/12/FrenchFinalReviewofliterature.pdf. Association des Médecins Indigènes du Canada, & Association des facultés de médecine du Canada. (2009). Les Compétences essentielles en matière de santé des Inuits, des Métis et des Premières nations (p. 17). AFMC. Atikamekw Sipi. (2019). Atikamekw Sipi. Retrieved June, 13th, 2025 from http://www.atikamekwsipi.com/fr. Bartlett, C., Marshall, M., & Marshall, A. (2012). Two-eyed seeing and other lessons learned within a co-learning journey of bringing together indigenous and mainstream knowledges and ways of knowing. Journal of Environmental Studies and Sciences, 2(4), 331–340. https://doi.org/10.1007/s13412-012-0086-8. (PMID: 10.1007/s13412-012-0086-8) Blanchet Garneau, A., & Pepin, J. (2012). La sécurité culturelle : Une analyse du concept. Recherche En Soins Infirmiers, 4(111), 22–35. (PMID: 10.3917/rsi.111.0022) Boyer, Y., & Bartlett, J. (2017). External review: Tubal ligation in the Saskatoon health region: The lived experience of Aboriginal women (p. 56). Saskatoon Health Region. Brascoupé, S., & Waters, C. (2009). Cultural safety: Exploring the applicability of the concept of cultural safety to Aboriginal health and community wellness, Journal of Aboriginal Health, 5(2), 6–41. Browne, A. J., Smye, V. L., Rodney, P., Tang, S. Y., Mussell, B., & O’Neil, J. (2011). Access to primary care from the perspective of Aboriginal patients at an urban emergency department. Qualitative Health Research, 21(3), 333–348. (PMID: 10.1177/104973231038582421075979) Cameron, B. L., Plazas, Md. P. C., Salas, A. S., Bearskin, R. L. B., & Hungler, K. (2014). Understanding inequalities in access to health care services for Aboriginal people: A call for nursing action. Advances in Nursing Science, 37(3), E1–E16. (PMID: 10.1097/ANS.000000000000003925102218) Centre national de collaboration de la santé autochtone. (2012). L'état des connaissances sur la santé des Autochtones : examen de la santé publique autochtone au Canada (p. 132). CNCSA. Conseil des Atikamekw de Manawan, & Conseil de la Nation Atikamekw. (2020). Principe de Joyce : Mémoire présenté par le Conseil des Atikamekw de Manawan et le Conseil de la Nation Atikamekw. CNA. Cooke, M., & Shields, T. (2024). Anti-Indigenous racism in Canadian healthcare: A scoping review of the literature. International Journal for Quality in Health Care, 36 (3), mzae089. https://doi.org/10.1093/intqhc/mzae089. Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S.-J., & Reid, P. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: A literature review and recommended definition. International Journal for Equity in Health, 18, 174. https://doi.org/10.1186/s12939-019-1082-3. Denison, J., Varcoe, C., & Browne, A. J. (2014). Aboriginal women’s experiences of accessing health care when state apprehension of children is being threatened. Journal of Advanced Nursing, 70(5), 1105–1116. https://doi.org/10.1111/jan.12271. (PMID: 10.1111/jan.1227124131206) Gerlach, A. J. (2012). A critical reflection on the concept of cultural safety. Canadian Journal of Occupational Therapy, 79(3), 151–158. https://doi.org/10.2182/cjot.2012.79.3.4. (PMID: 10.2182/cjot.2012.79.3.4) Gone, J. P. (2013). Redressing First Nations historical trauma: Theorizing mechanisms for indigenous culture as mental health treatment. Transcultural Psychiatry, 50(5), 683–706. https://doi.org/10.1177/1363461513487669. (PMID: 10.1177/136346151348766923715822) Jacklin, K. M., Henderson, R. I., Green, M. E., Walker, L. M., Calam, B., & Crowshoe, L. J. (2017). Health care experiences of Indigenous people living with type 2 diabetes in Canada. Canadian Medical Association Journal, 189(3), E106–E112. https://doi.org/10.1503/cmaj.161098. (PMID: 10.1503/cmaj.161098282461555250516) Kamel, G. (2021). Rapport d’enquête concernant le décès de Joyce Echaquan (p. 28). Bureau du coroner. Martin, D. H. (2012). Two-eyed seeing: A framework for understanding Indigenous and non-Indigenous approaches to indigenous health research. Canadian Journal of Nursing Research, 44(2), 20–42. National Aboriginal Health Organization. (2008). Cultural competency and safety: A guide for health care administrators, providers and educators (p. 33). NAHO. National Collaborating Centre for Aboriginal Health. (2014). Indigenous experiences with racism and its impacts (p. 16). NCCAH. Retrieved on September, 1st, 2025 from https://www.nccih.ca/docs/determinants/FS-Racism2-Racism-Impacts-EN.pdf. Nursing Council of New Zealand. (2005). Guidelines for cultural safety, the treaty of Waitangi and Maori health in nursing education and practice (p. 23). Nursing Council of New Zealand. Picou, J. S. (2000). The “talking circle” as sociological practice: Cultural transformation of chronic disaster impacts. Sociological Practice, 2(2), 77–97. (PMID: 10.1023/A:1010184717005) Ramsden, I. (1990). Cultural safety. The New Zealand Nursing Journal = Kai Tiaki, 83(11), 18–19. (PMID: 2267106) Ramsden, I. (1992). Teaching cultural safety. The New Zealand Nursing Journal = Kai Tiaki, 85(5), 21–23. (PMID: 1635685) Ramsden, I. (2002). Cultural safety and nursing education in Aotearoa and Te Waipounamu. (p. 211).Thesis, Victoria University of Wellington. Reading, C., & Wien, F. (2009). Inégalités en matière de santé et déterminants sociaux de la santé des peuples autochtones (p. 41). Centre de collaboration nationale de la santé autochtone. Regroupement des centres d’amitié autochtones du Québec. (2018). Les Autochtones en milieu urbain et l’accès aux services publics: Portrait de la situation au Québec. RCAAQ. Retrieved on September 1st, 2025 from https://www.rcaaq.info/wp-content/uploads/2019/08/RCAAQ_Portrait_Montreal_FR.pdf. Rieth, B. (2023). Empowered circles: Using talking circles in research. New England College Journal of Applied Educational Research, 4, 1–23. Shaheen-Hussain, S. (2023). L’approche coloniale de la CAQ en matière de sécurisation culturelle. Le Devoir, 17. Retrieved on September 1st, 2025 from https://www.ledevoir.com/opinion/idees/793139/point-de-vue-l-approche-coloniale-de-la-caq-en-matiere-de-securisation-culturelle?utm_source=recirculation&utm_medium=hyperlien&utm_campaign=corps_texte. Smye, V., Josewski, V., & Kendall, E. (2010). Cultural safety: An overview (p. 28). First Nations, Inuit and Métis Advisory Committee, Mental Health Commission of Canada. Struthers, R., Hodge, F. S., Geishirt-Cantrell, B., & De Cora, L. (2013). Participant experiences of talking circles on type 2 diabetes in two Northern Plains American Indian tribes. Qualitative Health Research, 13(8), 1094–1115. (PMID: 10.1177/1049732303256357) Tang, S. Y., & Browne, A. J. (2008). “Race” matters: Racialization and egalitarian discourses involving Aboriginal people in the Canadian health care context. Ethnicity & Health, 13(2), 109–127. https://doi.org/10.1080/13557850701830307. (PMID: 10.1080/13557850701830307) The Association of Faculties of Medicine of Canada. (2019). Joint commitment to action on indigenous health (p. 24). AFMC. Tremblay, M. C. (2022). L’approche à double perspective en recherche en santé autochtone: Une approche de recherche participative et décolonisatrice In C. In Loignon, Dupéré, S., Godrie, B., Gervais, L., & Doudenkova, V. (Eds.), Recherches participatives en santé des populations : Un levier pour contrer les inégalités sociales de santé et l’exclusion sociale? (p. 197). Presses de l’Université Laval. Tremblay, M.-C., Bradette-Laplante, M., Witteman, H. O., Dogba, M. J., Breault, P., Paquette, J.-S., Careau, E., & Echaquan, S. (2020). Providing culturally safe care to Indigenous people living with diabetes: Identifying barriers and enablers from different perspectives. Health Expectations (First published December 22nd, 2020). https://doi.org/10.1111/hex.13168. Tremblay, M. C., & Echaquan, S. (2022). Fostering cultural safety in healthcare through a decolonizing approach to research with, for and by Indigenous communities. In D. Jourdan, & L. Potvin (Eds.), Global handbook of health promotion research (Vol. 1, pp. 841). Springer Nature. Tremblay, M. C., & Martin, D. E. (2022). Etuaptmumk/Two-eyed seeing: A guiding principle to respectfully embrace Indigenous and Western systems of knowledge. In D. a. P. In Jourdan, L. (Ed.), Global handbook of health promotion research (Vol. 3, pp. 336). Springer Nature. Tremblay, M.-C., Olivier-D’Avignon, G., Garceau, L., Échaquan, S., Fletcher, C., Leclerc, A.-M., Poitras, M.-E., Neashish, E., Maillet, L., & Paquette, J.-S. (2023). Cultural safety involves new professional roles: A rapid review of interventions in Australia, the United States, Canada and New Zealand. AlterNative: An International Journal of Indigenous Peoples, 19(1), 166–175. https://doi.org/10.1177/11771801221146787. (PMID: 10.1177/11771801221146787) Viens, J. (2019). Commission d'enquête sur les relations entre les Autochtones et certains services publics : écoute, réconciliation et progrès. Rapport final (p. 520). Gouvernement du Québec. |
| Grant Information: | 421162 Institute of Indigenous Peoples' Health |
| Contributed Indexing: | Keywords: Cultural competency; Health services research; Indigenous Canadians; Indigenous Peoples |
| Entry Date(s): | Date Created: 20251112 Date Completed: 20260901 Latest Revision: 20260904 |
| Update Code: | 20260904 |
| PubMed Central ID: | PMC13536478 |
| DOI: | 10.17269/s41997-025-01126-1 |
| PMID: | 41222869 |
| Βάση Δεδομένων: | MEDLINE |
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