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Indigenous people's experiences at the end of life

Published online by Cambridge University Press:  15 June 2015

Wendy Duggleby*
Affiliation:
University of Alberta Faculty of Nursing, Edmonton, Alberta, Canada
Samantha Kuchera
Affiliation:
University of Alberta Faculty of Nursing, Edmonton, Alberta, Canada
Rod MacLeod
Affiliation:
HammondCare and University of Sydney, Sydney, Australia
Paul Holyoke
Affiliation:
Saint Elizabeth Research Center, Saint Elizabeth Health Care, Ontario, Canada
Tracy Scott
Affiliation:
Education Services, Saint Elizabeth First Nations, Inuit and Métis Program, Winnipeg, Manitoba, Canada
Lorraine Holtslander
Affiliation:
College of Nursing, University of Saskatchewan, Saskatoon, Canada
Angeline Letendre
Affiliation:
Alberta Cancer Prevention Legacy Fund, Population, Public, and Aboriginal Health, Alberta Health Services, Edmonton, Alberta, Canada
Tess Moeke-Maxwell
Affiliation:
University of Auckland, Auckland, New Zealand
Linda Burhansstipanov
Affiliation:
Native American Cancer Research Corporation, Pine, Colorado
Thane Chambers
Affiliation:
University of Alberta Faculty of Nursing, Edmonton, Alberta, Canada
*
Address correspondence and reprint requests to Wendy Duggleby, University of Alberta Faculty of Nursing, 11405 87 Avenue, Edmonton, AB T6 G 1C9Canada. E-mail: wendy.duggleby@ualberta.ca.

Abstract

Objective:

The primary purpose of this metasynthesis study was to explore the end-of-life experiences of Indigenous peoples by synthesizing the findings of qualitative research.

Method:

Sandelowski and Barroso's methodology for synthesizing qualitative research was used and included (a) a comprehensive search, (b) appraising reports of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Research team members guided this process. This team was multidisciplinary and included Indigenous and non-Indigenous researchers from Canada, Australia, New Zealand, and the United States. Following a comprehensive search, 2255 studies were reviewed and assessed against five inclusion criteria: (a) studies on the experiences of Indigenous populations (all genders, 18 + years of age) at the end of life, (b) studies published in English from any country, (c) studies using qualitative and mixed-methods designs, and (d) studies published between 1993 and 2013.

Results:

Some 18 studies met the inclusion criteria, and their findings were synthesized. “Preparing the spirit” for transition to the next life was the overarching theme. “Preparing the spirit” occurred within the context of “where we come from.” Processes involved in “preparing the spirit” were healing, connecting, and protecting; through these processes, “what I want at the end of life” was realized. Although not the focus of the metasynthesis, a significant finding was that the studies reviewed identified very clear barriers within healthcare systems and current healthcare provider practices to “preparing the spirit.”

Significance of results:

The findings provide a beginning understanding of the end-of-life experiences of Indigenous peoples and a foundation for future research. More interpretive qualitative research is critical if palliative care services, the healthcare system, and healthcare providers are to reduce current barriers to “preparing the spirit” for the journey at the end of life.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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