Front Page Research Highlights

Culturally Sensitive Healthcare: Insights and Recommendations from Indigenous Patient Experiences

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Patient experiences with their healthcare provider can have a significant impact on their view of all healthcare services. Factors such as the quality of care delivered, administrative practices, and underlying biases in physician training can all shape a patient’s experience with healthcare services. For Indigenous patients, a history of policies that forced assimilation and cultural genocide has resulted in skyrocketing physical and mental health challenges. In a recent study, “Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals,” conducted by WU-CDTR Member and P&F Recipient, Melissa E. Lewis, PhD (University of Missouri School of Medicine) Sky Wildcat, PhD (University of Arkansas), and Amber Anderson, PhD (University of Oklahoma Health Sciences Center), data was gathered from indigenous communities about their experiences with healthcare services to create a checklist for healthcare providers to be able to serve this community’s needs better.

This study was conducted with four focus groups of Indigenous people in the upper Midwest US. Participants were asked to share their experience with healthcare services, and what types of additional training physicians could complete to better understand their population. This research was conducted using Indigenous Research Methodology (IRM), which centers relationality – both within and beyond the research subjects – in creating the research framework used for this study. Adding to the relational and conscious creation of this study design, “all authors are Indigenous, utilize IRM in their work, and worked to prioritize IRM at each analysis meeting.”

With the collected data, physicians can make a conscious effort to eliminate occasions of discrimination faced by Indigenous people. Some of the reported incidents of discrimination include longer wait times, lower prescription opioid-containing prescriptions, and assumptions that Indigenous patients are non-compliant with prescribed treatment plans. These preconceived notions further negatively affect the health and wellness of Indigenous people by deterring them from seeking out healthcare for treatment or prevention of illness in the future.

The transcripts from these focus groups were transcribed by a third party and then analyzed individually and then collectively by the study authors. Through this method, the qualitative data from this study was coded into themes, domains, and definitions, and accompanied by exemplar quotes. The 7 overarching themes were: Ineffective health encounters; Effective health encounters; Improvements needed for healthcare encounters; Systemic and structural barriers; Effective healthcare systems; Improvements needed for healthcare systems; and Indigenous knowledge and beliefs.

A checklist was created from this study “to succinctly summarize participant needs and recommendations for experiencing an effective health encounter (see Table 3). This checklist is based on the concerns and preferences noted by study participants. It is meant to be a starting point for providers to explore the needs of their patient population through their own personal exploration, education, and growth, attendance of community events, and Indigenous mentorship, for example.” Adherence to the items on this list was shown to strengthen the patient-provider relationship, increase patient compliance, and support healthy eating habits.

Transcripts from this project demonstrated that Indigenous people feel very aware of the impact of colonization on all parts of their lived experience, specifically in the healthcare delivery they receive. Biases from healthcare providers, and a lack of intentional cultural integration in health clinics, turn indigenous patients away from seeking the preventative care they want. The community “has created curriculum frameworks and content for [healthcare providers] to improve cultural safety for Indigenous patients” in healthcare services.

With adaptations to a local level, frameworks and checklists such as the one produced by this study can guide the way to creating more effective and welcoming healthcare delivery for indigenous patients.

This journal article can be viewed and accessed here.