Assessing Challenges and Barriers to Effective Wound Care in Rural Indigenous Communities
Polycronis P. Akouris, Jonah W. Perlmutter, Arshia P. Javidan, Asha Behdinan, Jackie Walker, Ahmed Kayssi, R. Gary Sibbald, Rachel N. AsiniwasisOBJECTIVE:
To explore the lived experiences of patients with chronic wounds from a remote Indigenous community in Northern Manitoba, Canada, focusing on challenges in wound management, the impact on quality of life, barriers to wound care access, and the role of traditional healing practices.
METHODS:
A qualitative descriptive study was co-created with members of the Nisichawayasihk Cree Nation (NCN) and conducted in alignment with OCAP (Ownership, Control, Access, and Possession) principles. Fifteen participants with current or past chronic wounds participated in semi-structured, in-person interviews at the NCN Family and Community Wellness Centre in June 2024. Interviews were audio-recorded, transcribed verbatim, and analyzed inductively using NVivo to identify key thematic domains.
RESULTS:
Five thematic domains emerged: (1) access to health care—limited local services, long wait times, and substantial travel and financial burden to obtain specialty care; (2) inadequate wound care—inconsistent follow-up and reliance on self-management at home; (3) patient education—focused largely on diabetes control with little wound-specific guidance; (4) living with pain—persistent pain limiting mobility, sleep, and emotional well-being; and (5) traditional Indigenous medicine—frequent use of culturally rooted treatments, though often not acknowledged or integrated by Western providers.
CONCLUSIONS:
Indigenous patients experience major barriers to timely, effective wound care, driven by geographic isolation, fragmented services, and gaps in patient education. Integrating traditional healing with Western practice, strengthening community-based care pathways, and improving specialist access may support limb preservation, reduce preventable amputation, and enhance quality of life.