The Resilience of Indigenous Women of the U.S. Who Experience Cancer: Transcending Adversity

"Prayer is Universal": How Integrative Faith Practices Enable Indigenous Peoples' Persistence and Resistance to Transcend Historical Oppression

Objective

Indigenous faith practices have enabled persistence, resistance, and transcendence despite centuries of settler colonial historical oppression. Spirituality, ceremony, and religious practices are fundamental aspects of Indigenous wellness, resilience, and liberation from a colonial mindset. The purpose of this research was understand U.S. Indigenous peoples' perspectives of spirituality and religion from the settler colonial framework of historical oppression, resilience, and transcendence (FHORT) as it relates to wellness.

Methods

Data from critical ethnographic interviews with 31 participants from rural reservation communities in the Southeast and an urban Northwest environment were analyzed using reconstructive thematic qualitative analysis.

Results

Themes include: (a) "You'd be persecuted … for your beliefs": Historical Oppression of Indigenous beliefs; (b) "I was always told that church was wherever you were": Integrative faith practices and (c) "No matter how hard times get … never forget to pray": Prayer through adversity.

Conclusions

Results clarified how settler colonial power differentials tended to relegate Indigenous spiritual and faith practices to a lower status than Western European religions, namely Christianity. Participants resisted this oppression by ingeniously integrating tribal and Western European faith practices to promote wellness. This article provides pathways to prevent clinical bias and harm by expanding awareness and familiarity with localized and heterogenous faith practices among Indigenous communities. Practitioners can honor Indigenous peoples' preferences, acknowledge Indigenous faith practices as central for wellness, and become reflexive about how an internalized settler colonial mindset may cause bias and perpetuate historical oppression by delegitimizing Indigenous worldviews and faith practices.

"It's in the family circle": Communication promoting Indigenous family resilience

OBJECTIVE

We use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to investigate the framework's core concept of family resilience and related protective and promotive factors that contribute to greater resilience, namely communication.

BACKGROUND

Scant research has examined communication in Indigenous families; yet general research suggests that family communication is a prominent aspect of family resilience.

METHODS

In this exploratory sequential mixed-methods study with data from 563 Indigenous participants (n = 436 qualitative and n = 127 quantitative survey), thematic reconstructive analysis was used to qualitatively understand participants' experiences of family communication and quantitatively examine protective factors for family resilience.

RESULTS

The following themes related to family communication as a component of family resilience emerged from qualitative analysis: "It's in the Family Circle": Discussing Problems as a Family with the subtheme: Honesty between Partners; (b) "Never Bring Adult Business into Kids' Lives": Keeping Adult Conversations Private; and (c) "Trust Us Enough to Come to Us": Open Communication between Parents and Children. Regression analysis indicated that higher community and social support, relationship quality, and life satisfaction were associated with greater family resilience.

CONCLUSIONS

Positive communication practices are a strong component of resilience, healthy Indigenous families. Promotive factors at the community (social and community support), relational (relationship quality), and individual (life satisfaction) levels positively contribute to Indigenous family resilience.

IMPLICATIONS

Clinical programs providing practical tools to foster healthy communication - both about difficult topics as well as positive topics - are promising avenues to foster resilience.

Sâkipakâwin: Assessing Indigenous Cancer Supports in Saskatchewan Using a Strength-Based Approach

Given that the health care system for Indigenous people tends to be complex, fragmented, and multi-jurisdictional, their cancer experiences may be especially difficult. This needs assessment study examined system-level barriers and community strengths regarding cancer care experiences of Indigenous people in Saskatchewan. Guided by an advisory committee including Indigenous patient and family partners, we conducted key informant interviews with senior Saskatchewan health care administrators and Indigenous leaders to identify supports and barriers. A sharing circle with patients, survivors, and family members was used to gather cancer journey experiences from Indigenous communities from northern Saskatchewan. Analyses were presented to the committee for recommendations. Key informants identified cancer support barriers including access to care, coordination of care, a lack of culturally relevant health care provision, and education. Sharing circle participants discussed strengths and protective factors such as kinship, connection to culture, and spirituality. Indigenous patient navigation, inter-organization collaboration, and community relationship building were recommended to ameliorate barriers and bolster strengths. Recognizing barriers to access, coordination, culturally relevant health care provision, and education can further champion community strengths and protective factors and frame effective cancer care strategies and equitable cancer care for Indigenous people in Saskatchewan.