Characteristics of sources of evidence.

Worldwide, Indigenous and ethnic minority women encounter discrimination in access to high quality healthcare and other advantageous social determinants of health. Cultural safety is the concept of proactively considering social, economic, and political situations, and power relationships in healthcare. By identifying ways in which culturally unsafe healthcare practices can intensify institutional discrimination and replicate traumatic experiences in historically oppressed populations, interventions may be crafted to improve patient experiences and outcomes. The purpose of this paper is to conduct a scoping review of research on experiences with culturally safe healthcare among adult Indigenous and ethnic minority women in Europe. All research articles within Europe, without set date parameters, addressing the experiences of individuals who self-identify as adult women or gender non-normative individuals who are members of Indigenous or ethnic minority communities were included. A total of four peer reviewed articles were identified for this scoping review. Participants in four studies described healthcare providers’ lack of knowledge of their culture and healthcare needs. The studies suggest that this lack of knowledge may lead to patient sentiments of inferiority, prejudice, increased barriers to access care, inadequate healthcare intervention and ineffective healthcare service. The articles propose the implementation of cultural safety to close the gap of health disparities in Indigenous and ethnic minority populations. There are limited data on the implementation of cultural safety in Europe, potentially indicating a lack of awareness regarding the concept of cultural safety or its core tenets, as well as regarding the importance of culture, racism and biases in healthcare related to ethnic minority populations. Overall, this scoping review reiterates the gap in research and knowledge in the implementation of culturally safe healthcare in Europe.

全球范围内，原住民与少数族裔女性在获取高质量医疗保健及其他有益健康的社会决定因素（social determinants of health）方面均面临歧视。文化安全（Cultural Safety）是指在医疗保健场景中主动考量社会、经济与政治处境及权力关系的理念。通过识别不安全文化医疗实践加剧制度性歧视、重演历史受压迫群体创伤经历的路径，可制定干预措施以改善患者体验与医疗结局。本研究旨在对欧洲范围内成年原住民与少数族裔女性的文化安全医疗体验相关研究开展范围综述（Scoping Review）。本综述纳入所有发表于欧洲范围内、未限定时间范围的研究论文，涵盖自我认定为成年女性或性别非规范性个体的原住民与少数族裔群体成员的相关体验研究。本次范围综述共纳入4篇同行评议论文。四项研究的参与者均提及，医疗服务提供者对其文化背景与医疗需求缺乏了解。研究表明，这种认知缺失可能导致患者产生自卑情绪、遭遇偏见，增加就医障碍，获得不充分的医疗干预与低效的医疗服务。相关论文建议推行文化安全理念，以缩小原住民与少数族裔群体间的健康差距。目前欧洲范围内有关文化安全实践落地的数据较为有限，这可能反映出学界与医疗界对文化安全理念及其核心原则的认知不足，同时也反映出对涉及少数族裔群体的医疗场景中文化、种族主义与偏见问题的重要性认知不足。总体而言，本次范围综述再次证实，欧洲在文化安全医疗实践的落地研究与认知层面仍存在空白。