Development of rehabilitation services in an Inuit sociocultural context: challenges, strategies and considerations for the future

ABSTRACT

In recent years, a new rehabilitation programme has been developed on the Hudson Bay coast of Nunavik. The purpose of this article is to reflect on the experience of an occupational and physical therapy programme development in an Inuit sociocultural context. To do so, the challenges encountered during the first years following the implementation of rehabilitation services and the strategies implemented by the professionals to overcome them were identified, examined in the light of the literature, and discussed with members of the rehabilitation team. The challenges encountered and strategies implemented were divided into 10 major themes: (1) diverse clinical needs; (2) communication issues; (3) acquisition of cross-cultural interaction and population-specific knowledge; (4) adaptation of clinical practice to Nunavimmiut; (5) client engagement in rehabilitation; (6) professional isolation; (7) lack of awareness around the objectives and scope of rehabilitation practice; (8) use of culturally safe assessment tools; (9) staff turnover; (10) large geographic area to be served. This exercise highlighted the need to adapt clinical rehabilitation practices to Nunavimmiut’s worldviews and culture, as well as to adopt a reflective practice in order to improve the quality, relevance and effectiveness of rehabilitation services.

KEYWORDS:

• Inuit
• Nunavik
• rehabilitation
• occupational therapy
• physiotherapy
• health services
• Indigenous

Acknowledgments

We would like to thank Valérie Ferland, Christophe Lavoie and Isabelle Sanon, members of the rehabilitation team, for their participation in the meeting and for their relevant comments which helped enrich the paper. We would also like to thank the employees of the Inuulitsivik Health Centre as well as the community stakeholders who contributed to the development and improvement of rehabilitation services. Finally, we would like to thank the clients and the communities for their welcome and trust in this programme development process.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Financing

As part of her master’s degree, the first author received funding from ArcticNet - Networks of Centres of Excellence of Canada through the Qanuikkat Siqinirmiut project, the Canadian Federation of University Women, the Canadian Occupational Therapy Foundation, the Centre interdisciplinaire de recherche en réadaptation et intégration sociale, the Centre interuniversitaire d’études et de recherches autochtones, the Chaire Louis-Edmond Hamelin de recherche nordique en sciences sociales, and the Ordre des ergothérapeutes du Québec.