1. Objectifs

Intentions :
«Upon the invitation of local health administration concerned with the changing demographics and rising EOL [end of life] care needs, this study was designed to identify key factors shaping historical and current care provision with the goal of contributing knowledge to future initiatives by local municipalities and health institutions as they engage in the development of a sustainable model of EOL care services.» (p. 648)

2. Méthode

Échantillon/Matériau :
L’étude est basée sur la participation de 103 acteurs-clés de communauté Inuits du Nunavik (infirmières, interprètes, personnel administratifs d’établissements de santé, travailleuses sociales, médecins, guides spirituels, éducatrices etc.).

Instruments :
Guide d’entretien semi-directif

Type de traitement des données :
Analyse de contenu

3. Résumé

One of the key factors identified was the need for trust building: «trust and confidence in the nurses and physicians were necessary conditions for Inuit patients and families to open up to healthcare providers.» (p. 652) As for the social suffering and bereavement needs, «Inuit families have suffered from epidemics, starvation, loss of livelihood, and disrupted relationships directly resulting from colonial policies and structures. Inuit in Nunavik live daily with the consequences of this history, some coping in ways that actually multiply this suffering. […] Participants in community and health center contexts indicated the need for culture-specific services to address the deep and multilayered grief experiences that exist before, and are exacerbated by, patient illnesses.» (p. 653) As for knowledge exchange, authors found «that both elders and younger members of the community continue to draw on land-based food sources and embodied practices in EOL care and several were happy to describe these to us. Traditional family values related to the grief process had also been maintained. These practices are at risk of disappearing when undervalued by healthcare structures. Inviting this knowledge and these practices into collaborative care would permit better EOL care provision. In turn, translating ''medical knowledge'' into audiovisual materials translated in Inuktitut concerning disease progression, palliative care interventions, and options to patients and families will serve to reduce some of the confusion concerning advanced care planning decisions.» (p. 653)