Author abstracts

This thread is where we will be posting abstracts of chapters by authors in the order that they were submitted. We invite everyone from our team of authors to review each other’s abstracts.

We are hopeful that this process will help to spark ideas and strengthen the entire textbook.

Childhood Sexual Abuse: Consequences and Holistic Intervention by Dr. Sigrún Sigurðardóttir

Aim: To increase the knowledge and deepen the understanding of the consequences of CSA for men and women. To develop and explore a holistic therapy for female CSA survivors and look into the experience of the healthcare system.

Methods: A phenomenological research approach was used to increase the knowledge and deepen the understanding of the above phenomena.

Results: The consequences of CSA for both men and women, were serious for their health and well-being. They felt they had not received adequate support and understanding from healthcare professionals, but participation in the Wellness-Program seemed to improve the health and well-being of those attending.

Conclusions: CSA can have serious and far-reaching consequences for the health and well-being of both men and women. It is important to continue to develop a holistic program for CSA survivors. Through an organized program much can be gained for the individual, family and society as a whole.

Keywords: Child Sexual Abuse (CSA), Consequences of CSA, Men, Women, Holistic intervention, Phenomenology.

Oral health and health promotion in northern and Indigenous communities by Sisko Honkala and Eino Honkala

Untreated dental caries and severe periodontitis in permanent teeth and untreated caries in deciduous teeth are among the most prevalent chronic non-communicable diseases world-wide. Caries is more prevalent among the indigenous than among the non-indigenous people in the circumpolar region. Oral diseases are causing pain, discomfort, increasing absenteeism from school and/or work and reducing quality of life. Untreated dental decay is also affecting child growth.

Sugar is the main risk factor for dental caries. High intake of free sugars (sugar-sweetened beverages) is also associated with body weight, metabolic syndrome and type 2 diabetes. Periodontitis is caused by poor oral hygiene and it has been shown to associate with cardiovascular diseases inflammation and hypertension.

Both most common oral diseases, dental caries and periodontal disease can be considered as behavioural diseases which could be prevented. They share risk factors with the other chronic, non-communicable diseases. Promoting oral health benefits also general health.

Northern Partnership between Two Schools of Nursing in Norway and Canada: A Historical Perspective by Pertice Moffitt and Grete Mehus

In nursing curricula around the world, educators are recognizing the need to develop undergraduate nurses as global citizens. This occurs in both developed and developing countries in a milieu of collaboration, partnership and relationship between institutions offering undergraduate programs. The aim of this chapter is to highlight a partnership between two schools of nursing in northern regions of Norway and Canada. This partnership is unique because of the circumpolar locations of each school and their rural and remote practice setting. This chapter will highlight the journey of two nurse educators as they engage and develop a collegial relationship between their two facilities. The narrative begins with an initial student exchange from northern Canada to northern Norway; continues with shared lecturing and/or presentations in the host country; and carries on with scholarship and research activities.

How to use telehealth to enhance care in isolated northern practices by Michael Jong

Aim: To learn how use telehealth to enhance access to enhance care in northern practices

Methods: A descriptive study on how telehealth can be implemented and what it can used for.

Results: Telehealth allows for care where the capacity to provide the service is not available locally. It benefits patients through allowing for treatment closer to home and local health providers through expedient advice from consultants at a distant site. Telehealth has the potential to save lives and cost to the health care system. Training on the use of telehealth and the proper setup of the equipment is necessary to make the telehealth effective.

Conclusions: Telehealth is a useful system that support nurses in isolated northern practices

Keywords: Telehealth, Northern practices

Weaving Western and Traditional Healing Practices by Michael Jong

Aim: To discover the benefits of learning how to incorporate traditional healing practices into Western medicine

Methods: This descriptive study elucidates the potential benefits of enquiring into traditional practices in a culturally safe way and how this may augment the care of clients by incorporating this into Western medicine.

Results: Traditional healing practices have potential benefits for improving health. There is a need to know of potential side-effects of traditional herbal remedies and interaction of drugs from Western medicine. Incorporating traditional healing practices and utilizing the synergies of traditional healing with Western medicine can enhance care.

Conclusions: The is a role for both traditional healing practices and Western medicine.

Keywords: Traditional healing, Western medicine

Nurse-deaconess education in the Sámi region by Dr. Lea Rättyä and MnSc Tiina Ervelius

Aim: To enable cultural themes as a part of professional academic studies in nurse-deaconess education.

Methods: Developing the nurse-deaconess curriculum in cooperation with the Sámi Education Institute. Adding to the curriculum Sámi cultural and Sámi language studies and organizing education in the Sámi region in a project funded by the EU. This also includes developing a model of a culturally sensitive nurse-deaconess education within the Sámi culture.

Results: Culture has an important role in people’s health. Through adding culturally sensitive knowledge of Sámi culture into the curriculum, the graduating nurse-deaconesses have better competence in culturally sensitive, individual, holistic and client-centered care of patients with a Sámi background.

Conclusions: After this project the model of culturally sensitive nurse-deaconess education can also be used and tested in other cultures.

Keywords: culturally sensitive, Sámi, registered nurse, deaconess, curriculum

Some results from a study about patients’ everyday life with chronic illness and their perspectives on health care practice in Greenland, and the significance of involving patients’ knowledge and perspectives in health professional practice by Tine Aargaard

The background of the research was the growing number of chronically ill patients worldwide. The research was conducted as an ethnographic field study. A conclusion of the study is that the disease-oriented healthcare system is not geared to manage the psychosocial problems of patients. Academic and scientific knowledge is given precedence over patients’ perspectives and knowledge about their own lives. Therefore, professionals often have no insight into the circumstances under which patients have to conduct their lives when suffering from a chronic illness. In addition, professionals often embrace prevailing concepts of disease and health, not realizing that patients and citizens may have differing, culturally shaped views of what constitutes a good and meaningful life. There is an urgent need, therefore, to develop means and procedures to incorporate patients’ knowledge and perspectives into professional practice in order to create professional interventions that are efficient, relevant, culture-sensitive and meaningful for patients.

Ethics, Culture and Knowledge by Tine Aargaard

The article discusses some issues concerning the significance of culture and knowledge for the healthcare professionals’ possibilities for treating patients in the Greenlandic healthcare system in ethically proper ways. The article presents some reflections on a meeting between the Nurses’ Council of Ethics in the Scandinavian countries and the Greenlandic nurses’ organization in Nuuk, Greenland, in 2015. It is questioned whether it is reasonable to distinguish between ‘indigenous’ and ‘western’ cultural values and practices, and it is argued that cultural differences more significantly have to do with people’s everyday practices in relation to making a living. This approach to culture implies recognition of patients’ knowledge about their everyday lives as crucial to involve in professional practice. The involvement of knowledge of patients’ everyday lives and perspectives is a way to improve both the quality and the culture-sensitivity of professional practice, regardless of ethnicity or nationality.

Infant Feeding Teachings from Indigenous Grandmothers: Generating Knowledge through Sharing Circles by Pertice Moffitt, Sabrina Lakhani and Sheila Cruz

Traditional practices of mothering are important to the identities of Indigenous women, families and their communities. Infant feeding is central to mothering. Traditional knowledge shared by Indigenous Elders is deeply respected in Canada’s north and is alive in stories shared by grandmothers and great-grandmothers. Unfortunately, women’s acquisition of breastfeeding knowledge and cultural practices were interrupted by the impact of colonization, patriarchy, residential schooling and subsequent loss of knowledge transmission between Elders and youth. The grandmothers wish to restore historical aspects of mothering and share their knowledge and mothering expertise with future generations. The purpose of this chapter is to introduce and recognize traditional knowledge gathered through sharing circles and interviews with grandmothers and great-grandmothers whom share their own infant feeding practices those of their ancestors and their children.

Professionalism and Professional Conduct in the Northwest Territories and Nunavut by Pertice Moffitt, Rachel Munday and Jan Inman

The practice of nursing in the Canadian Arctic has mostly been conducted by nurses from away who are recruited to the North. Recruitment is often aimed at nurses with a background in critical and emergency care so that they can be somewhat prepared for a new expanded and primary care role in the remote communities. This targeted consideration may address some of the clinical skills required for remote nurses but is short-sighted in terms of professionalism, cultural competency and healthy workplace rapport. Nurses do not always know or understand the Northern context and in particular the worldviews and practices of Indigenous peoples of the north. Orientation to the community and the community health nurse role in a remote setting is often lacking. In adjusting to a change in scope of practice, personal and professional isolation and/or unhealthy behaviours acquired over years of practice and not so apparent in an urban setting, some nurses demonstrate incompetence, bullying and slander, and addiction. This chapter looks at professional conduct as it is regulated in the NWT and Nunavut in light of the context and seeks to identify professional values and practices along with socially just and culturally safe care.

Keywords: professionalism, professional conduct, professional nursing and ethics

Addressing Intimate Partner Violence in the Northwest Territories, Canada: Findings and Implications from a Study on Northern Community Response (2011-2017) by Pertice Moffitt and Heather Fikowski

Death, posttraumatic stress, depression and other chronic physical conditions are reported outcomes of intimate partner violence (IPV) that contributes to personal suffering, wellbeing and mental health of victims, their families, and their communities. The Northwest Territories experiences IPV at a rate seven times higher than the national average. As well, homicides occurred every year of a recent study and were linked to domestic violence. It is apparent that IPV is problematic for individuals, families and communities and has a negative impact on the health of territorial residents. The purpose of this chapter is to share research findings from a five year Social Sciences and Humanities Research Council funded project about northern community response to IPV. From the grounded theory model, highlighting the central phenomenon “our hands are tied,” frustration and normalization of violence has occurred. The implications are outlined in an action plan to guide future education, research and advocacy efforts.

Educating Health Care Workers in the Yukon (1963-present) by Kim Diamond and Susan Starks

Yukon College, located in Canada’s northwest, has offered a variety of nursing and health-related programs since its inception in 1963. Programs and courses have prepared students to develop nursing skills, enhance well-being in communities, and meet their continuing education needs as northern health care workers. Educating students in the north allows them the opportunity to live, learn, and work in place. Close to 30% of credit students at Yukon College are First Nations, often contributing to the health of Yukon communities upon graduation. The College is committed to decolonization, indigenization, and reconciliation and this continues to inform evolving health program content, and delivery.

This chapter provides a historical snapshot of Yukon nursing and health-related programming as well as a glimpse of an educational future that continues to respond to the changing needs of the Yukon, First Nations, and the wider northern community.

Self-care/mental health for health care practitioners by Brenda Dawyduk

Health professionals in northern communities are often exposed to high levels of occupational stress in their day-to-day work and are at greater risk of experiencing burnout. By virtue of their work they are exposed to a plethora of challenges including workload, rapidly advancing knowledge, jurisdictional and bureaucratic requirements, workforce issues and social isolation. This can lead to severe distress, burnout or physical illness. In the end, healthcare workers may be unable to provide high quality healthcare services. Stress and burnout can also be costly because affected healthcare workers take sick leave and may even change jobs.

It is important to have an optimal balance between self-care and other-care. Being aware of the joys and hazards of the work, the essence of burnout, ways to maintain the personal and professional self, and having a personalized self-care action plan is vital to endurance of working in the north

Effects of sexual abuse on physical, mental, and psychological health by Geoffrey Maina

Sexual abuse is any unwanted sexual contact or activity in which the perpetrator uses force, threats or takes advantage of victims without consent. Sexual abuse include: attempted rape, unwanted sexual touch, forcing a victim to perform sexual acts and rape. Child sexual abuse is a form of sexual abuse to a minor. Sexual exploitation happens when a victim is persuaded or forced to send or post sexually explicit images of self, take part in sexual activity via webcam or have sexual conversation by text or voice. Sexual abuse can happen to both men and women of any age and in most instance the perpetrator is known to the victim.

Sexual abuse has devastating consequences to the victim. These include: risk for sexually transmitted infections, injuries, depression, flashback and post traumatic stress disorders, guilt, blame and shame. Victims often manifest with low self esteem, have difficulty forming and sustaining relationships and struggle with addictions.

The difference a stone’s throw can make: barriers to access experienced by First Nations and Metis in Manitoba by Elizabeth Cooper and S Michelle Driedger

Recognizing the uniqueness of different Indigenous communities and groups is essential towards ensuring that research, policies, programming and services truly meet relevant needs. While these divisions are necessary, it can become problematic when multiple cultural groups live within the same geographic region, and are part of the same family units. Within Manitoba, Metis and First Nations people often live side-by-side, but have unequal access to health services and supports due to differences between federal and provincial fiduciary responsibilities. These different fiduciary responsibilities reproduce health inequities and challenges the uptake of research, policies, programming and services. In this chapter, we explore some of the challenges we have faced when working in community-based research with such communities. We explore some of the key challenges research participants have raised during the past decade, and discuss how we have approached these issues with varying degrees of success.

Water and well-being by Lalita Bharadwaj

In Canada, a nation recognized for its natural wealth of fresh water supplies, the provision of safe drinking water is a pressing public health issue confronting Indigenous communities. Many communities in Canada live with long-term drinking water advisories, high-risk drinking water systems and experience health status and water quality below that of the general population. A mixed-method community-based participatory research approach was applied to heighten understanding, and gather information from the voices of the communities on the nature of existing drinking water issues and associated health related challenges. Drinking water quality and supply were key challenges identified. Health consequences, extend from the individual to community levels and beyond physical impacts. Inadequate drinking water has widespread implications to the well-being of Indigenous people. To better inform policy decisions for drinking water provision, a more holistic understanding of the relationship between drinking water challenges and Indigenous well-being is needed.

Key Words: Indigenous Communities, Drinking Water, Community-Based Participatory Research, Health and Well-Being.

eHealth as a support in remote areas by Päivi Juuso

In several industrializes countries, healthcare and social services are challenged by the growing and aging population. An increased number of older adults leads to increased need of help and support in daily life. A shortage of younger people who can care for the aging population, especially in remote areas, necessitates better and more effective health care systems and technologies. eHealth can be a complement to traditional health- and social services. For a sustainable and long-term plan for the person in need of support, it is important to reason about values affected when implementing and using eHealth as support at home. Implementation should therefore, always be done based on the individuals’ needs. This paper focuses on challenges when implementing eHealth solutions as support for older adults in remote areas.

At a Crossroads: Understanding the Determinants of Northern and Indigenous Peoples’ Health by Julie Bull

This chapter provides an overview of the intersection of determinants of health for Northern and Indigenous Peoples. Though a pan-northern (or pan-Indigenous) approach is not recommended, this chapter will highlight key themes that weave together the interconnectedness of health and wellbeing by drawing on elements such as economics, education, employment, food availability, geographic location, cultural variance, and systemic barriers. All of these collective level determinants are critically important in understanding both community-health and individual wellbeing and are integral in addressing health disparities and inequities in health care access in Northern and Indigenous Communities. It is only when these multiple factors are included, analyzed, and understood, that meaningful research, health care delivery, policy development, and program design can occur. We cannot artificially separate some components from others and must approach health in a wholistic manner, inclusive of a myriad of determinants.

An Ethical Imperative for Working with Northern and Indigenous Communities by Julie Bull

Indigenous Peoples around the world have been mobilizing to (re)assert their inherent right to self-determination, a movement that has both shaped and been reshaped by globally significant developments, such as the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) and the Truth and Reconciliation Commission (TRC) in Canada. Innovations in policies to enhance the ethical conduct of research involving Indigenous Peoples have led many around the world to look to Canada to understand how we are creating policy in this area. Despite increased documentation about what to do in research involving Indigenous Peoples, there is little description of how to do it. Through the lens of both academic and grassroots Indigenous initiatives at the intersection of multiple knowledge systems, and the movement to decolonize research by Indigenizing methods and ethics, this chapter provides contextual and practical information with actionable suggestions for researchers to implement immediately.