title: Providers' perceptions of Aboriginal palliative care in British Columbia's rural interior.
abstract: Aboriginal Canadians experience a disproportionate burden of ill-health and have endured a history of racism in accessing and using health care. Meanwhile, this population is rapidly growing, resulting in an urgent need to facilitate better quality of living and dying in many ways, including through enhancing (cultural) access to palliative care. In this article, we report the findings from a qualitative case study undertaken in rural British Columbia, Canada through exploring the perceptions of Aboriginal palliative care in a region identified as lacking in formal palliative care services and having only a limited Aboriginal population. Using interview data collected from 31 formal and informal palliative care providers (May-September 2008), we thematically explore not only the existing challenges and contradictions associated with the prioritisation and provision of Aboriginal palliative care in the region in terms of (in)visibility but also identify the elements necessary to enhance such care in the future. The implications for service providers in rural regions are such that consideration of the presence of small, and not always 'visible', populations is necessary; while rural care providers are known for their resilience and resourcefulness, increased opportunities for meaningful two-way knowledge exchange with peers and consultation with experts cannot be overlooked. Doing so will serve to enhance culturally accessible palliative care in the region in general and for Aboriginal peoples specifically. This analysis thus contributes to a substantial gap in the palliative care literature concerning service providers' perceptions surrounding Aboriginal palliative care as well as Aboriginal peoples' experiences with receiving such care. Given the growing Aboriginal population and continued health inequities, this study serves to not only increase awareness but also create better living and dying conditions in small but incremental ways.
authors.affiliation: School for Resource and Environmental Studies, Kenneth C Rowe Management Building, Dalhousie University, Halifax, NS, Canada. heather.castleden@dal.ca
authors.forename: Heather
authors.initials: H
authors.lastname: Castleden
authors.forename: Valorie A
authors.initials: VA
authors.lastname: Crooks
authors.forename: Neil
authors.initials: N
authors.lastname: Hanlon
authors.forename: Nadine
authors.initials: N
authors.lastname: Schuurman
mesh_terms: D001293:Attitude to Death / Q000208:ethnology; D001955:British Columbia; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D003144:Communication Barriers; D003159:Community-Institutional Relations; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D020380:Needs Assessment / Q000706:statistics & numerical data; D010166:Palliative Care / Q000379:methods*; D012424:Rural Population / Q000706:statistics & numerical data*