The study reports findings of the inquiry phase of appreciative inquiry to understand the problem space of remote wound care within the First Nations communities.
The appreciative inquiry method was employed in the study after a partnership with the Matawa First Nations focusing on providers’ strengths and ability to give care. When discussing strategies that helped augment the level of care, providers also discussed the barriers to care and why they had employed specific strategies to overcome them. Appreciative inquiry has four phases: inquire, imagine, innovate, and implement. Healthcare providers were interviewed during the inquiry phase, focusing on understanding the current state regarding wounds, provider strengths and what worked well.
Findings: Seven dominant themes emerged from the research: building trust with the community, cultural unpreparedness, empowerment, patient connection and lived experiences, communication with staff and community members, discontinuity of care, and limited resources. A strength-based, positive-interview approach uncovered strategies for treating wounds in remote communities: empowering patients, giving them an active role in their care, and making them feel heard were all adopted by healthcare providers.
Barriers leading to difficulty in providing care included disconnected healthcare, limited resources, insufficient infrastructure, a lack of clean water, limited cultural understanding, and environmental challenges. Understanding the barriers to care requires a recognition of the social and historical effects of colonialism on these communities. There are also complex systemic issues that aggregate and worsen how care is provided within these communities. It is important to understand and acknowledge these fundamental issues while simultaneously helping augment the strategies that have been shown to improve wound care in these communities.