Perceptions of care, Aboriginal patients at the Winnipeg Health Sciences Centre

Abstract

Aboriginal people comprise a large percentage of admissions to the Health Sciences Centre, an 850-bed tertiary care teaching hospital in Winnipeg. Issues such as the perception of systemic and individual discrimination have come up at the hospital in the past decades. The objective of this study was to develop an in-depth understanding of the current urban hospitalization experience of Aboriginal patients on medical, surgical and rehabilitation wards. Semi-structured qualitative interviews were done, both in English and in Ojibway with patients who self-identified as Aboriginal. As directed by key informants, the areas explored included communication, family involvement, discharge planning, and racism. Interview data was analyzed, coded and categorized and emerging themes were corroborated with the key informants. A case study of Aboriginal people's involvement at the hospital was done also, in particular looking at the outcome of a 1992 report on Aboriginal services. Important themes to emerge from the interviews were control, and endurance. Racism, separation from both family and community, and communication problems were frequent concerns. Many patients lacked knowledge about the Aboriginal Services Department, with few interpreter-caseworkers involved with patients. Increased utilization of the Aboriginal Service Department's interpreter-caseworkers as patient advocates and promotion of the hospital's cultural awareness workshops could contribute to resolving some of the problems described by patients. The partial fulfillment of the 1992 'Report of the Aboriginal Services Review Committee' recommendations, including increased Aboriginal representation in employment and governance at the hospital may point to inherent difficulties in resolving such issues or to systemic discrimination towards Aboriginal people. Leadership at the highest corporate levels will be needed to ensure they are implemented so that Aboriginal people can feel well served in the Winnipeg health care system.