Violence against Indigenous women is a major public health concern worldwide and Canada is no exception. Multiple forms of violence inform the broader context of violence against Indigenous women. Nurses are likely to encounter Indigenous women in a variety of settings, but evidence suggests that nurses may lack understandings of violence. This thesis explored the following question: How does extant qualitative research conducted in Canada, contribute to understanding the health and wellbeing of First Nations, Métis and Inuit (Indigenous) women who have experienced violence? During the development of this thesis, significant gaps were highlighted including underrepresentation of Inuit women in the literature, limited focus on health promotion, and lack of methodological approaches to systematic reviews that were participatory and inclusive of the community. Therefore, a secondary aim of this thesis was to privilege perspectives of Inuit women and their communities, by developing a study protocol for a collaborative and community centered approach to reviewing and assessing the extant literature. A configurative and inductive approach based on thematic synthesis was used to systematically search, retrieve, analyze and synthesize extant literature. Post-colonial feminist theory and intersectionality were used as theoretical lenses to emphasize intersections between multiple forms of violence and locate the problem within the broader context of colonization and oppression. Sixteen studies were included in this review, fifteen qualitative and one mixed methods study. Four themes with subthemes emerged based on analysis and synthesis of findings in the included studies: 1) ruptured connections between family and home, 2) that emptiness… my spirit being removed, 3) seeking help and feeling unheard, and 4) a core no one can touch. These themes represent interconnected pathways that influenced health among Indigenous women, and have implications for healthy public policy, clinical practice, and nursing education.

Mothers typically act as gatekeepers to health care for their children, yet many Indigenous mothers report poor access to health services. Inadequate access to health services may contribute to the poor health outcomes experienced by Indigenous infants. Understanding how urban-dwelling Indigenous mothers experience selecting and using health services to meet the health needs of their infants is important to informing how health services can best support the needs of these families. This study employs qualitative interpretive description methodology guided by the Two-Eyed Seeing framework and Andersen’s Behavioural Model of Health Services Use. Interviews facilitated by ecomaps and a discussion group were conducted with 19 Indigenous mothers living in Hamilton with infants under the age of 2 years. Additional interviews with 12 health providers added further context to the mothers’ experiences. Results relate to three domains of health service use: primary care, acute care and early childhood health promotion services. Findings suggest that health providers can improve the access and use of health services by Indigenous mothers and infants through integrating three approaches to care: culturally safe care, trauma and violence-informed care and family centred care. While Indigenous-led supports may be better suited to meet the needs of Indigenous families, mainstream services can improve access and promote health service use through integrating these approaches to care. The findings have numerous implications for nursing education, practice and research as well as for health policy. Application of this evidence may result in equitable access to care, improved use of health services and better health outcomes for Indigenous infants and their families. / Thesis / Doctor of Philosophy (PhD) / Access and use of health care are important to health and wellness. Indigenous infants are known to have poorer health outcomes than non-Indigenous infants in Canada, yet little is understood of how their parents access health care to meet their health needs. This thesis uses qualitative methods, including interviews and a discussion group, to ask Indigenous mothers living in a city about their experiences selecting and using health services to meet their infant’s health needs. Interviews with health providers assist with understanding how health care is delivered to these families. The results provide important strategies for nurses and other health providers to improve how they provide care. This may then improve access to health services for Indigenous parents and ultimately lead to improved health outcomes for Indigenous infants and their families.