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Addressing the realities [correction of realties] of health care in northern aboriginal communities through participatory action research.

https://arctichealth.org/en/permalink/ahliterature175481
Source
J Interprof Care. 2004 Nov;18(4):360-8
Publication Type
Article
Date
Nov-2004
Author
Bruce Minore
Margaret Boone
Mae Katt
Peggy Kinch
Stephen Birch
Author Affiliation
Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada. bruce.minore@lakeheadu.ca
Source
J Interprof Care. 2004 Nov;18(4):360-8
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Community Health Services - economics - supply & distribution
Consumer Participation
Continuity of Patient Care - economics - organization & administration
Diabetes Mellitus - ethnology - therapy
Female
Health Services Accessibility - organization & administration
Humans
Indians, North American
Male
Mental Health Services - supply & distribution
Neoplasms - ethnology - therapy
Rural Health Services - economics - supply & distribution
Abstract
To address concerns about disruptions in the continuity of health care delivered to residents in three remote aboriginal communities in northern Ontario, Canada, the local health authority initiated a study in collaboration with the department of Health Canada responsible for ensuring that aboriginal reserves receive mandatory health services, and an inter-disciplinary team of researchers from two universities. The study focussed on the delivery of oncology, diabetes and mental health care, specifically, as well as systems issues such as recruitment and retention of health human resources and financial costs. The paper discusses the procedures involved, the benefits derived and the challenges encountered in doing this as a community driven participatory action research project. It also summarizes the findings that led to community formulated policy and program recommendations.
PubMed ID
15801551 View in PubMed
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Brain injury from a first nations' perspective: teachings from elders and traditional healers.

https://arctichealth.org/en/permalink/ahliterature130010
Source
Can J Occup Ther. 2011 Oct;78(4):237-45
Publication Type
Article
Date
Oct-2011
Author
Michelle L Keightley
Grace E King
Shu-Hyun Jang
Randy J White
Angela Colantonio
J Bruce Minore
Mae V Katt
D Anita Cameron
Alice M Bellavance
Claudine H Longboat-White
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto Rehabilitation Institute and Holland Bloorview Kids Rehabilitation Hospital, 160-500 University Ave., Toronto, ON, Canada, M5G 1V7. michelle.keightley@utoronto.ca
Source
Can J Occup Ther. 2011 Oct;78(4):237-45
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Brain Injuries - ethnology - rehabilitation - therapy
Canada
Female
Humans
Indians, North American
Male
Medicine, Traditional
Occupational therapy
Abstract
There is a lack of knowledge about how cultural ideas affect First Nations peoples' perception of rehabilitation needs and the ability to access services.
The study explored the perceptions of treating and healing brain injury from First Nations elders and traditional healers in the communities served by Wassay-Gezhig-Na-Nahn-Dah-We-lgamig (Kenora Area Health Access Centre).
A participatory action approach was used, leading to a focus group with elders and traditional healers. Findings, established through a framework analysis method, were member checked prior to dissemination.
Four themes arose from the data: pervasiveness of spirituality, "fixing" illness or injury versus living with wellness, working together in treating brain injury, and financial support needed for traditional healing.
Funding is required for traditional healing services to provide culturallysafe and responsive occupational therapy services to First Nations individuals with brain injury.
PubMed ID
22043555 View in PubMed
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Considering the paraprofessional: one option for overcoming rural health human resource deficits.

https://arctichealth.org/en/permalink/ahliterature158961
Source
Cah Sociol Demogr Med. 2007 Oct-Dec;47(4):511-34
Publication Type
Article
Author
J Bruce Minore
Margaret Boone
Alison Arthur
Author Affiliation
Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada. bruce.minore@lakeheadu.ca
Source
Cah Sociol Demogr Med. 2007 Oct-Dec;47(4):511-34
Language
English
Publication Type
Article
Keywords
Allied Health Personnel
Canada
Continuity of Patient Care
Humans
Patient satisfaction
Quality Assurance, Health Care
Rural Health Services - manpower
Abstract
Canada's rural shortage of health professionals can be offset by employing specially trained, locally-based paraprofessionals to implement professionally developed plans of care. Ontario's Integrated Services for Northern Children Program demonstrated the viability of this option. A review of 327 patient records and interviews with 100 parents, paraprofessionals, and professionals found that there was good continuity of care and satisfaction with care quality because the multidisciplinary professional team of consultants provided constant and consistent monitoring of the paraprofessionals. Ongoing treatment occurred in the community, eliminating the disruption to the children's lives that repeated trips to the city would cause. Rural residents place a premium on care at home. Liability issues for employers and for professionals who delegate caregiving tasks currently restrict the use of paraprofessionals; these can be addressed through certification based on practice standards and improved education programs.
PubMed ID
18251462 View in PubMed
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The economic contribution of the Northern Ontario School of Medicine to communities participating in distributed medical education.

https://arctichealth.org/en/permalink/ahliterature259780
Source
Can J Rural Med. 2015;20(1):25-32
Publication Type
Article
Date
2015
Author
John C Hogenbirk
David R Robinson
Mary Ellen Hill
Raymond W Pong
Bruce Minore
Ken Adams
Roger P Strasser
Joe Lipinski
Source
Can J Rural Med. 2015;20(1):25-32
Date
2015
Language
English
Publication Type
Article
Abstract
The economic contribution of medical schools to major urban centres can be substantial, but there is little information on the contribution to the economy of participating communities made by schools that provide education and training away from major cities and academic health science centres. We sought to assess the economic contribution of the Northern Ontario School of Medicine (NOSM) to northern Ontario communities participating in NOSM's distributed medical education programs.
We developed a local economic model and used actual expenditures from 2007/08 to assess the economic contribution of NOSM to communities in northern Ontario. We also estimated the economic contribution of medical students or residents participating in different programs in communities away from the university campuses. To explore broader economic effects, we conducted semistructured interviews with leaders in education, health care and politics in northern Ontario.
The total economic contribution to northern Ontario was $67.1 million based on $36.3 million in spending by NOSM and $1.0 million spent by students. Economic contributions were greatest in the university campus cities of Thunder Bay ($26.7 million) and Sudbury ($30.4 million), and $0.8-$1.2 million accrued to the next 3 largest population centres. Communities might realize an economic contribution of $7300-$103 900 per pair of medical learners per placement. Several of the 59 interviewees remarked that the dollar amount could be small to moderate but had broader economic implications.
Distributed medical education at the NOSM resulted in a substantial economic contribution to participating communities.
PubMed ID
25611911 View in PubMed
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The effects of nursing turnover on continuity of care in isolated First Nation communities.

https://arctichealth.org/en/permalink/ahliterature174830
Source
Can J Nurs Res. 2005 Mar;37(1):86-100
Publication Type
Article
Date
Mar-2005
Author
Bruce Minore
Margaret Boone
Mae Katt
Peggy Kinch
Stephen Birch
Christopher Mushquash
Author Affiliation
Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada.
Source
Can J Nurs Res. 2005 Mar;37(1):86-100
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Communication
Community Health Nursing - manpower
Continuity of Patient Care - standards
Diabetes Mellitus - nursing
Health Services, Indigenous
Humans
Indians, North American
Interprofessional Relations
Medically underserved area
Mental Disorders - nursing
Neoplasms - nursing
Nurse's Role
Nursing Administration Research
Nursing Audit
Nursing Methodology Research
Nursing Staff - psychology - supply & distribution
Ontario
Outcome and Process Assessment (Health Care) - organization & administration
Personnel Turnover - statistics & numerical data
Quality of Health Care - standards
Questionnaires
Abstract
Many of Canada's northern First Nation communities experience difficulty recruiting and retaining appropriate nursing staff and must rely on relief nurses for short-term coverage. The latter often are not adequately prepared for the demanding nature of the practice. This study examined the consequences of nursing turnover on the continuity of care provided to residents of three Ojibway communities in northern Ontario. The findings are based on a review of 135 charts of oncology, diabetes, and mental health clients, and on interviews with 30 professional and paraprofessional health-care providers who served the communities. Nursing turnover is shown to detrimentally affect communications, medications management, and the range of services offered; it also results in compromised follow-up, client disengagement, illness exacerbation, and an added burden of care for family and community members.
Notes
Erratum In: Can J Nurs Res. 2005 Jun;37(2):2
PubMed ID
15887767 View in PubMed
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Finding temporary relief: strategy for nursing recruitment in northern aboriginal communities.

https://arctichealth.org/en/permalink/ahliterature178378
Source
Can J Nurs Res. 2004 Jun;36(2):148-63
Publication Type
Article
Date
Jun-2004
Author
Bruce Minore
Margaret Boone
Mary Ellen Hill
Author Affiliation
Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada.
Source
Can J Nurs Res. 2004 Jun;36(2):148-63
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Humans
Indians, North American
Inuits
Nursing Staff - supply & distribution
Ontario
Personnel Selection - methods
Rural Health Services - manpower
Transcultural Nursing - manpower
Abstract
To address a recurring shortage of nurses in the aboriginal communities of Northwestern Ontario, the First Nations and Inuit Health Branch, Health Canada, commissioned a study to explore the viability of establishing a relief pool among nurses from nearby small industrial towns. An open/close-ended survey completed by a random sample of 237 nurses from the target population documented levels of awareness, willingness, and preparedness for northern practice, as well as recruitment incentives and disincentives. Findings demonstrate an awareness of the overlap between the professional and personal dimensions characteristic of such practices, and suggest support for innovative rotations that would cut across federal/provincial/community jurisdictions. Although complex, given time and willingness, a regional relief system seems viable.
PubMed ID
15369171 View in PubMed
Less detail

From health care to home community: an Aboriginal community-based ABI transition strategy.

https://arctichealth.org/en/permalink/ahliterature138013
Source
Brain Inj. 2011;25(2):142-52
Publication Type
Article
Date
2011
Author
Michelle Keightley
Victoria Kendall
Shu-Hyun Jang
Cindy Parker
Sabrina Agnihotri
Angela Colantonio
Bruce Minore
Mae Katt
Anita Cameron
Randy White
Claudine Longboat-White
Alice Bellavance
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. michelle.keightley@utoronto.ca
Source
Brain Inj. 2011;25(2):142-52
Date
2011
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Brain Injuries - ethnology - rehabilitation
Community Health Services - standards
Continuity of Patient Care - standards
Female
Focus Groups
Health Services Accessibility
Health Services, Indigenous - standards
Humans
Longitudinal Studies
Male
Ontario
Patient Discharge
Prospective Studies
Qualitative Research
Self Report
Abstract
To explore the barriers and enablers surrounding the transition from health care to home community settings for Aboriginal clients recovering from acquired brain injuries (ABI) in northwestern Ontario.
Participatory research design using qualitative methods.
Focus groups conducted with clients with ABI, their caregivers and hospital and community health-care workers. The Framework Method of analysis was used to uncover emerging themes.
Six main categories emerged: ABI diagnosis accuracy, acute service delivery and hospital care, transition from hospital to homecare services, transition from hospital to community services, participant suggestions to improve service delivery and transition, and views on traditional healing methods during recovery.
A lack of awareness, education and resources were acknowledged as key challenges to successful transitioning by clients and healthcare providers. Geographical isolation of the communities was highlighted as a barrier to accessibility of services and programmes, but the community was also regarded as an important source of social support. The development of educational and screening tools and needs assessments of remote communities were identified to be strategies that may improve transitions.
Findings demonstrate that the structure of rehabilitation and discharge processes for Aboriginal clients living on reserves or in remote communities are of great concern and warrants further research.
PubMed ID
21219087 View in PubMed
Less detail

Planning without facts: Ontario's Aboriginal health information challenge.

https://arctichealth.org/en/permalink/ahliterature151019
Source
J Agromedicine. 2009;14(2):90-6
Publication Type
Article
Date
2009
Author
Bruce Minore
Mae Katt
Mary Ellen Hill
Author Affiliation
Centre for Rural and Northern Health Research, Thunder Bay, Ontario, Canada. bruce.minore@lakeheadu.ca
Source
J Agromedicine. 2009;14(2):90-6
Date
2009
Language
English
Publication Type
Article
Keywords
Censuses
Data Collection
Health Services Needs and Demand - organization & administration
Humans
Indians, North American - statistics & numerical data
Interviews as Topic
Needs Assessment
Ontario
Registries
Rural health services - organization & administration
Rural Population - statistics & numerical data
Abstract
The majority of First Nations, Metis, and Inuit people living in the Canadian province of Ontario have less access to quality health care than the population as a whole. Yet improving the situation is hampered by the lack of an information system that documents fundamental facts about Aboriginal people's health status and services utilization. Without a means to collect such data, these knowledge deficits will persist, making the planning and provision of culturally appropriate services impossible. The Ontario Health Quality Council commissioned a study to (1) review data collection systems in other Canadian jurisdictions and (2) determine what Ontario needs in order to have a comprehensive Aboriginal health information system. The study involved a review of 177 policy and technical documents and interviews with 20 key informants in Ontario, as well as Canada's other provinces and territories. Results showed that the capacity to document Aboriginal peoples' health and service utilization varies significantly, depending on existing provincial/territorial health data sets and the ability to cross-link health data using unique identifiers. Some jurisdictions can locate Aboriginal data using health cards, health benefits payment information, or vital statistics identifiers; others rely on linkages using federal or provincial Aboriginal registry and membership lists. All have the capability to conduct geographical analyses to identify health and service utilization for communities or regions that have significant Aboriginal populations. To improve health information in Ontario, Aboriginal people's collective entitlements to information about their communities must be recognized. The authors outline implications of a set of principles that Canada's First Nations have adopted, commonly referred to as OCAP (Ownership, Control, Access, and Possession), on the collection, storage, use, and interpretation of health data. Only through negotiation with Aboriginal peoples can health information systems be established that meet their needs, as well as those of decision-makers and care providers.
PubMed ID
19437263 View in PubMed
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Realizing potential: improving interdisciplinary professional/paraprofessional health care teams in Canada's northern aboriginal communities through education.

https://arctichealth.org/en/permalink/ahliterature190058
Source
J Interprof Care. 2002 May;16(2):139-47
Publication Type
Article
Date
May-2002
Author
Bruce Minore
Margaret Boone
Author Affiliation
Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada.
Source
J Interprof Care. 2002 May;16(2):139-47
Date
May-2002
Language
English
Publication Type
Article
Keywords
Allied Health Personnel - education
American Native Continental Ancestry Group
Canada
Health Services, Indigenous - manpower - standards
Humans
Ontario
Patient Care Team - standards
Rural Health Services - manpower - standards
Total Quality Management
Abstract
To address a shortage of health professional human resources and to overcome cultural barriers, the interdisciplinary health care teams practicing in most northern Canadian aboriginal communities include a number of paraprofessionals recruited locally. This model has great potential to fill service gaps in many rural contexts; there are challenges, however. Drawing from an extensive program of research in indigenous communities in the northwestern part of the Province of Ontario, we identify factors fundamental to effective team functioning: members' clarity about their own and others' roles, appreciation of their respective 'equal but different' knowledge bases, and confidence in one another's competence. We argue for an extension of the information on interdisciplinary practice included in health science education programs to address these issues, thereby enhancing the utility of paraprofessionals within the health human resource mix in rural areas.
PubMed ID
12028894 View in PubMed
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Rehabilitation challenges for Aboriginal clients recovering from brain injury: a qualitative study engaging health care practitioners.

https://arctichealth.org/en/permalink/ahliterature152713
Source
Brain Inj. 2009 Mar;23(3):250-61
Publication Type
Article
Date
Mar-2009
Author
Michelle L Keightley
Ruwan Ratnayake
Bruce Minore
Mae Katt
Anita Cameron
Randy White
Alice Bellavance
Claudine Longboat-White
Angela Colantonio
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. michelle.keightley@utoronto.ca
Source
Brain Inj. 2009 Mar;23(3):250-61
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude of Health Personnel - ethnology
Brain Injuries - epidemiology - ethnology - rehabilitation
Continuity of Patient Care
Cultural Diversity
Female
Health Services, Indigenous - standards
Humans
Male
Middle Aged
Patient compliance
Qualitative Research
Young Adult
Abstract
To explore the experiences of health care practitioners working with Aboriginal clients recovering from acquired brain injury (ABI).
Participatory research design using qualitative methods.
Fourteen in-depth, semi-structured interviews were conducted. The Framework Method of analysis was used to uncover emerging themes.
Five main categories emerged: practitioners' experience with brain injury, practitioners' experience with Aboriginal clients, specialized needs of Aboriginal clients recovering from brain injury, culturally sensitive care and traditional healing methods. These categories were then further divided into emergent themes and sub-themes where applicable, with particular emphasis on the specialized needs of Aboriginal clients.
Each emergent theme highlighted key challenges experienced by Aboriginal peoples recovering from ABI. A key challenge was that protocols for rehabilitation and discharge planning are often lacking for clients living on reserves or in remote communities. Other challenges included lack of social support; difficulty of travel and socio-cultural factors associated with post-acute care; and concurrent disorders.
Results suggest that developing reasonable protocols for discharge planning of Aboriginal clients living on reserves and/or remote communities should be considered a priority.
PubMed ID
19205962 View in PubMed
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12 records – page 1 of 2.