Using Components of the Medicine Wheel to Develop a Conceptual Framework for Understanding Aboriginal Women in the Context of Pap Smear Screening



An Excerpt



Aboriginal women have lower rates of cervical cancer screening and higher rates of cervical cancer in Canada (Johnson, Boyd, and MacIsaac, 2004). Cervical cancer remains 1.8 to 3.6 times higher for Aboriginal women in comparison to non-Aboriginal women in Canada (Young et al., 2000). Yet, policymakers and researchers have shown little interest in the issues and challenges facing Aboriginal women. Despite the innovative actions in the last 15 years in Canada, Aboriginal women’s health is poorly understood; understanding requires resources that address the economic, social, and political realities of women’s lives (Dion Stout, Kipling, and Stout, 2001; Health Canada, 2004).

Cancer care literature reflects the dominant values and beliefs of Western healthcare upon which cancer care and care prevention have been structured.This patriarchal perspective of health care negates much of Aboriginal women’s health and their traditional ways of knowing (Battiste, 2000; Graveline, 1998). The ethnocentric perspective, which dominates Western healthcare, suggests that one set of values and beliefs will be used as the standard for all health care, disregarding other ways of knowing and doing. Western value systems, particularly health care systems, are linear, singular, static, and objective. In direct contrast, Aboriginal tradition and ways of knowing encompass interconnectedness and holism (Battiste, 2000).

Many of the traditional ways of knowing, such as indigenous knowledge and traditional healing practices of Aboriginal people, have been socially and culturally disrupted by Western medicine and colonization (Browne and Smye, 2002). There is an urgent need for nurses and other health care providers, grounded in Aboriginal ways of knowing, to foster understanding about Aboriginal women’s health, particularly as it relates to Papanicolaou testing (Pap smear screening). The physical, emotional, spiritual, and mental components of the medicine wheel provide a conceptual framework of traditional Aboriginal knowledge, which can guide nurses and other health care providers in understanding Aboriginal women’s experiences of Pap smear screening. The development of this conceptual framework may lead to culturally appropriate and sensitive Pap smear screening approaches for Aboriginal women.

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