Abstract
BackgroundIn Canada, there is a growing need to develop community-based, culturally appropriate palliative care for Indigenous people living in First Nations communities. The public health approach to palliative care, which emphasizes community-based initiatives, is especially relevant in First Nations communities because care is grounded in their distinct social and cultural context. Central to the public health approach are educational strategies that strengthen communities’ capacity to care for their vulnerable members as they die. This paper presents community-based research conducted with First Nations communities in Canada that aimed to assess and address local palliative care educational needs to improve community capacity in palliative care.MethodsParticipatory action research (PAR) was conducted with four First Nations communities in Canada over a six-year period (2010–2016). The research occurred in three phases. Phase 1: focus groups, interviews and surveys were employed to assess community specific needs and resources. Phase 2: recommendations were developed to guide the PAR process. Phase 3: educational resources were created to address the identified educational needs. These resources were implemented incrementally over 4 years. Ongoing process evaluation was employed, and revisions were made as required.ResultsEducational needs were identified for patients, families, community members and internal and external health care providers. A wide and comprehensive range of educational resources were created to address those needs. Those culturally appropriate educational resources are available in a very accessible and useable workbook format and are available for use by other Indigenous people and communities.ConclusionsThis research provides an example of the public health approach and offers implementation strategies around palliative care education. This paper contributes to the international literature on the public health approach to palliative care by presenting a case study from Canada that includes: conducting a culturally appropriate assessment of educational needs, creating recommendations, facilitating development and implementation of educational resources in the community to improve community capacity in palliative care.
Highlights
In Canada, there is a growing need to develop community-based, culturally appropriate palliative care for Indigenous people living in First Nations communities
The Improving End-of-Life Care in First Nations Communities (EOLFN) was a participatory action research project conducted in Canada to build community capacity to provide palliative care in four First Nations communities [1, 2]
This paper focuses on the project data related to palliative care education, and describes the community-led educational initiatives facilitated to address educational needs during the EOLFN research
Summary
In Canada, there is a growing need to develop community-based, culturally appropriate palliative care for Indigenous people living in First Nations communities. The public health approach to palliative care, which emphasizes community-based initiatives, is especially relevant in First Nations communities because care is grounded in their distinct social and cultural context. The public health approach to palliative care, which emphasizes community level initiatives, is especially relevant for people living in First Nations communities because care is grounded in their distinct social and cultural context. This paper focuses on the project data related to palliative care education, and describes the community-led educational initiatives facilitated to address educational needs during the EOLFN research. The research context is described which includes the need to develop palliative care in First Nations communities, and an overview of the EOLFN project during which the education data presented in this paper were collected. The paper concludes with a discussion of the implications of this palliative care education research for research, policy, and practice
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