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Open Access Discourses Influencing Nurses' Perceptions of First Nations Patients Les discours influençant les perceptions des infirmières à l'égard des patients autochtones

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Abstract:

This study explores the social and professional discourses that influence nurses' knowledge and assumptions about First Nations patients. Through the use of an ethnographic design, in-depth interviewing, and participant observation, data were collected over a 9-month period of immersion in a midsized hospital located in western Canada. Purposive sampling was used to recruit 35 participants: nurses, First Nations women who were patients in the hospital, and key informants with expertise in Aboriginal health. The findings indicate that 3 overlapping discourses were shaping nurses' perspectives concerning the First Nations women they encountered: discourses about culture, professional discourses of egalitarianism, and popularized discourses about Aboriginal peoples. Cultural assumptions were intertwined with dominant social stereotypes and were sometimes expressed as fact even when they conflicted with egalitarian ideals. Conclusions highlight the need for strategies to help nurses think more critically about their understandings of culture, the sociopolitical context of health-care encounters, and the wider social discourses that influence the perspectives of nurses.

French
Cette étude explore les discours sociaux et professionnels ayant une influence sur les connaissances et les présupposés des infirmières à l'égard des patients autochtones. Elle est fondée sur un modèle d'investigation ethnographique, des entrevues en profondeur et l'observation des participants. Les données ont été recueillies au cours d'une immersion de neuf mois effectuée par l'auteure dans un hôpital de taille moyenne, situé dans l'Ouest canadien. Trente-cinq participants ont été recrutés grâce à un sondage par choix raisonné, soit des infirmières, des patientes autochtones hospitalisées et des informateurs clés spécialisés en santé des Autochtones. Les résultats indiquent que les perceptions des infirmières à l'égard de leurs patientes autochtones sont façonnées par le chevauchement de trois discours : un discours concernant la culture, un discours professionnel sur l'égalitarisme et un discours populaire sur les peuples autochtones. Ils révèlent que les présupposés culturels sont entrelardés des stéréotypes entretenus par la société dominante et sont parfois présentés comme des faits même lorsqu'ils contredisent les idéaux égalitaires du locuteur. Les conclusions de l'étude mettent en lumière la nécessité de concevoir des stratégies pour stimuler chez les infirmières une réflexion critique sur la culture, le cadre sociopolitique qui détermine les rapports dans le milieu de la santé et, dans une perspective plus large, les discours sociaux ayant une influence sur leurs attitudes.

Keywords: ABORIGINAL PEOPLES; CANADA; COLONIALISM; CULTURAL SAFETY; CULTURE; FIRST NATIONS; FIRST NATIONS WOMEN; INDIGENOUS PEOPLE; NURSES' ATTITUDES; PROVIDER-PATIENT RELATIONS

Document Type: Research Article

Publication date: 2009-03-01

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