An exploration of Canadian Indigenous worldviews and palliative care: An integrative review
Bibliographic record
Abstract
Background: Some Indigenous people suffer from a disproportionate prevalence of life limiting conditions, with increased mortality and decreased life-expectancy compared to non-Indigenous populations. Reduced uptake of palliative care services by Indigenous populations is concerning and further cultural understanding is needed to improve delivery of palliative care services. This review explores Indigenous user experiences with palliative care in Canada through the research question: How does a worldview affect the delivery of palliative care services to Indigenous people living with life limiting conditions? Method: Seven primary source articles are analyzed concerned Inuit and First Nation and Métis perspectives on palliative care. Summative themes identified including traditional and contemporary experiences, EOL beliefs, EOL preferences, EOL communication, EOL capacity, EOL resource and policy limitations, and recommendations for palliative care improvements. Dialogue examples accompanying the themes are analysed with Hiebert's Worldview Model concerning nine worldview features including time, self-concept, space, feeling, preference, sensation, food, beliefs, emotion and ethics, values, and judgement. Results: some Canadian Indigenous people's self-concept and spiritual beliefs may conflict with western individualistic delivery of care, and serious illness conversations. Conclusion: Culturally sensitive and competent approaches to palliative care marginally improve care delivery for Indigenous populations, but the do not improve health equity. A cultural safe approach to palliative care can help address health equity for Indigenous people and lead to increased culturally accessible, accommodating, and acceptable EOL care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.009 | 0.015 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".