The power of talk and power in talk: a systematic review of Indigenous narratives of culturally safe healthcare communication
Warren Jennings A B E , Chelsea Bond C and Peter S. Hill DA The University of Queensland, Discipline of General Practice, Level 8, Health Sciences Building, Building 16/910, Royal Brisbane & Women’s Hospital, Herston, Qld 4029, Australia.
B Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, 37 Wirraway Parade, Inala, Qld 4077, Australia.
C The University of Queensland, Aboriginal and Torres Strait Islander Studies Unit, Level 2, Bookshop Building 4, St Lucia, Qld 4072, Australia.
D University of Queensland, School of Public Health, Faculty of Medicine, Level 2, Public Health Building (887), Corner Herston Road and Wyndham Street, Herston, Qld 4006, Australia.
E Corresponding author. Email: w.jennings@uq.edu.au
Australian Journal of Primary Health 24(2) 109-115 https://doi.org/10.1071/PY17082
Submitted: 9 June 2017 Accepted: 6 November 2017 Published: 1 March 2018
Journal compilation © La Trobe University 2018 Open Access CC BY-NC-ND
Abstract
The study aimed to explore Indigenous narrative accounts of healthcare access within qualitative research papers, to better understand Indigenous views on culturally safe healthcare and health communication represented in that literature. A systematic literature review of peer-reviewed academic qualitative studies identified 65 papers containing Indigenous respondents’ views on accessing healthcare. Analysis included all Indigenous voice (primary quotations) and author findings describing healthcare access across these studies. Healthcare communication, or ‘talk’, emerged as a key theme. Indigenous clients valued talk within healthcare interactions; it was essential to their experience of care, having the power to foster relationships of trust, strengthen engagement and produce positive outcomes. By mediating the power differentials between health professionals and Indigenous clients, talk could either reinforce powerlessness, through judgmental down-talk, medical jargon or withholding of talk, or empower patients with good talk, delivered on the client’s level. Good talk is a critical ingredient to improving Indigenous accessibility and engagement with healthcare services, having the ability to minimise the power differentials between Indigenous clients and the healthcare system.
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