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      Patient healthcare experiences in the Northwest Territories, Canada: an analysis of news media articles

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          ABSTRACT

          The factors that influence patient healthcare experiences are complex and connected to place. In northern Canada, the socio-historical context and the inequitable distribution of health services are unique influences on patients. The objective of this study was to examine the characteristics of patient healthcare experiences as reported through news media in the Northwest Territories. We used a case series design to examine patient healthcare experiences reported in news media articles. We conducted a systematic search for articles published between 2008 and 2017 in the online database of a media outlet in the Northwest Territories. We used descriptive statistics to summarise the article characteristics and thematic analysis to understand patient experiences in 128 articles related to 71 cases. Most often, cases involved women, concerned mental health, suicidality, or chronic diseases, and were predominantly negative. Patient experiences included problems associated with medical travel, communication difficulties with providers, lack of cultural safety, and barriers in accessing care resulting in poor-quality care, particularly for Indigenous patients. Broadly, these experiences are rooted in the colonial history in the North. Understanding patient experiences and including Indigenous patients in health system decision-making can help focus policies and clinical care on cultural safety and equity.

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          Using thematic analysis in psychology

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            A systematic review of evidence on the links between patient experience and clinical safety and effectiveness

            Objective To explore evidence on the links between patient experience and clinical safety and effectiveness outcomes. Design Systematic review. Setting A wide range of settings within primary and secondary care including hospitals and primary care centres. Participants A wide range of demographic groups and age groups. Primary and secondary outcome measures A broad range of patient safety and clinical effectiveness outcomes including mortality, physical symptoms, length of stay and adherence to treatment. Results This study, summarising evidence from 55 studies, indicates consistent positive associations between patient experience, patient safety and clinical effectiveness for a wide range of disease areas, settings, outcome measures and study designs. It demonstrates positive associations between patient experience and self-rated and objectively measured health outcomes; adherence to recommended clinical practice and medication; preventive care (such as health-promoting behaviour, use of screening services and immunisation); and resource use (such as hospitalisation, length of stay and primary-care visits). There is some evidence of positive associations between patient experience and measures of the technical quality of care and adverse events. Overall, it was more common to find positive associations between patient experience and patient safety and clinical effectiveness than no associations. Conclusions The data presented display that patient experience is positively associated with clinical effectiveness and patient safety, and support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare. It supports the argument that the three dimensions of quality should be looked at as a group and not in isolation. Clinicians should resist sidelining patient experience as too subjective or mood-oriented, divorced from the ‘real’ clinical work of measuring safety and effectiveness.
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              Indigenous health part 2: the underlying causes of the health gap.

              In this Review we delve into the underlying causes of health disparities between Indigenous and non-Indigenous people and provide an Indigenous perspective to understanding these inequalities. We are able to present only a snapshot of the many research publications about Indigenous health. Our aim is to provide clinicians with a framework to better understand such matters. Applying this lens, placed in context for each patient, will promote more culturally appropriate ways to interact with, to assess, and to treat Indigenous peoples. The topics covered include Indigenous notions of health and identity; mental health and addictions; urbanisation and environmental stresses; whole health and healing; and reconciliation.
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                Author and article information

                Journal
                Int J Circumpolar Health
                Int J Circumpolar Health
                International Journal of Circumpolar Health
                Taylor & Francis
                1239-9736
                2242-3982
                18 March 2021
                2021
                18 March 2021
                : 80
                : 1
                : 1886798
                Affiliations
                [a ]Department of Health Research Methods, Evidence, and Impact, McMaster University; , Hamilton, Canada
                [b ]Institute for Circumpolar Health Research; , Yellowknife, Canada
                [c ]School of Public Health, University of Alberta, School of Public Health; , Edmonton, Canada
                [d ]School of Arctic and Subarctic Studies, Labrador Institute, Memorial University, Happy Valley-Goose Bay, Newfoundland and Labrador; , Canada
                [e ]Faculty of Medicine, University of Alberta; , Edmonton, Canada
                [f ]Center for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark; , Copenhagen, Denmark
                [g ]Institute of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto; , Toronto, Canada
                Author notes
                CONTACT Nathaniel J. Pollock nathaniel.pollock@ 123456med.mun.ca School of Public Health, University of Alberta; , Edmonton, Canada
                Author information
                https://orcid.org/0000-0001-9076-5178
                https://orcid.org/0000-0001-5699-7661
                https://orcid.org/0000-0003-2408-6470
                Article
                1886798
                10.1080/22423982.2021.1886798
                8725720
                33734041
                b0d4b807-b6e2-4fc2-b887-afc626c09370
                © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 2, Tables: 3, References: 38, Pages: 9
                Categories
                Research Article
                Original Research Article

                Medicine
                patient-centred care,health systems,health equity,cultural safety,indigenous
                Medicine
                patient-centred care, health systems, health equity, cultural safety, indigenous

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