Barnabe, CherylCrowshoe, Lindsay (Lynden)Sehgal, Anika2023-04-212023-04-212023-04-20Sehgal, A. (2023). Improving the health of Indigenous peoples: exploring patient health complexity among urban Indigenous patients in Canada (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.http://hdl.handle.net/1880/116095https://dx.doi.org/10.11575/PRISM/dspace/40941Patient complexity is deemed to arise from a combination of personal, social, and external factors that can complicate medical approaches to care. Formal tools called patient complexity assessment tools (PCATs) have been developed to help identify and address these factors. However, current PCATs are not inclusive of the unique determinants of health impacting Indigenous peoples, including those which arise from a legacy of colonialism. The current thesis aimed to address this gap by identifying the domains and components that should be included in a PCAT designed specifically for Indigenous patients. The first study of this thesis was a scoping review that explored the extent to which existing PCATs are inclusive of the realities that shape the health of Indigenous peoples. Findings identified a major gap in the capacity of existing PCATs to effectively address the realities that shape the health of Indigenous patients. The second study of this thesis was a qualitative study that explored how health complexity is experienced by urban Indigenous peoples and the contexts that allow health complexity to persist. Findings revealed material resource disparities and adverse interpersonal interactions within the healthcare environment to be sources of health complexity. The third study of this thesis aimed to determine the critical components that are indicative of health complexity among Indigenous patients. An Indigenous-centered patient complexity assessment framework was developed to serve as a source of reference for healthcare providers, and policy/decision makers. This thesis presents a framework to understand the root causes of health complexity among Indigenous patients, identify where there may be gaps in healthcare systems to effectively address complexity, and provide reference for future clinical tools that will assess complexity among Indigenous patients.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Health Sciencesdoctoral thesis