Working Right Ways: Investigating Health Practitioners' Perspectives of Foot Health and Needs for Providing Good Foot Care With and for First Nations Peoples.

Background

History of invasion, ongoing colonisation, and systemic racism excluding First Nations Peoples from healthcare are root causes of health inequalities including disparities in foot health outcomes. Sources of inquiry into current practice, learning, and experience, which may shape reform of providing good foot care with and for First Nations Peoples in the land now known as Australia are health practitioners working in the space. This work seeks to explore foot care service delivery by investigating First Nations and non-Indigenous health practitioners' perspectives regarding providing foot care with and for First Nations Peoples.

Methods

Ways of working are documented in previous work; 'Working right ways in foot health with and for First Nations Peoples: research method guided and governed by First Nations ways of knowing, being, and doing in cross-sectional qualitative study design'. First Nations and non-Indigenous health practitioners provided perspectives with culturally responsive semi-structured interviews guiding talking with consenting participants. Coding utilised constant comparison techniques to explore patterns across the dataset. Data were analysed using reflexive thematic analysis.

Results

Two talking points engaged health practitioners' perspectives of providing foot care with and for First Nations Peoples: (1) What does foot health mean to you as a First Nations or non-Indigenous health practitioner? (2) What are needs for providing good foot care with and for First Nations Peoples? Within responses, themes emerged of mobility and participation, overall health and wellbeing, clinical and biomedical perspective, and advocacy being related to the meaning of foot health. The requirements of cultural safety, workforce, and holistic care were perceived as needed for provision of good foot care with and for First Nations Peoples.

Conclusion

Participants described a meaning of foot health that is relational to physical and spiritual constructs, and central to reclamation of, and continuation of, First Nations cultures; amidst a project of ongoing colonisation. Needs for good foot care provision with and for First Nations Peoples included a workforce continually learning and unlearning to develop cultural capabilities to work with and for, and support, First Nations foot health. This study provides distinct and real first-hand accounts from health practitioners working in the space which the podiatry profession must listen to and receive direction and learning from.

Keywords

First Nations Peoples (Australia), cultural safety, foot health, participatory action research, practitioner perspective, systemic racism