Nursing ETDs

Publication Date

9-16-2014

Abstract

It is well documented that there is decreased access and utilization of healthcare services by minority populations. The purpose of this study was to explore experiences with, and views of, the healthcare system among remotely situated First Nations people of coastal British Columbia (BC), to shed light on elements considered crucial to healthcare delivery. The study was conducted as a critical ethnography with an underlying framework of phenomenology and critical social theory. Multiple sources of data collection included private interviews, community observations, conversations, celebratory gatherings, participant-observer field notes, and the art and music of the people involved. Multiphase data management consistent with immersion and crystallization offered reflective/emotional,structured and synthesis levels of analysis, providing a rich aggregate of themes. Findings revealed that individuals who had developed relationships of trust with providers, or whose family members acted as advocates in healthcare encounters reported a higher level of satisfaction with the healthcare they received. However, many voiced perceptions of prejudice and stigmatization, believing healthcare to be of a lower quality than that received by non-Aboriginal BC residents. These findings were deeply embedded contextually and were framed by the legacy of a colonial past, ongoing 'civilized oppression,' and the socioeconomics of isolated living.

Degree Name

Nursing

Level of Degree

Doctoral

Department Name

College of Nursing

First Advisor

Averill, Jennifer

First Committee Member (Chair)

Averill, Jennifer

Second Committee Member

Mendelson, Cindy

Third Committee Member

Overman, Barbara

Fourth Committee Member

King, Jeffrey

Keywords

Aboriginal, indigenous, remote, isolated, healthcare, oppression, stigmatization, relationships of trust, critical ethnography, cultural safety, phenomenology, critical social theory

Language

English

Document Type

Dissertation

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