Knowing our patients: a cross-sectional study of adult patients attending an urban Aboriginal and Torres Strait Islander primary healthcare service

2019 ◽  
Vol 25 (5) ◽  
pp. 449 ◽  
Author(s):  
Deborah A. Askew ◽  
Warren J. Jennings ◽  
Noel E. Hayman ◽  
Philip J. Schluter ◽  
Geoffrey K. Spurling
Keyword(s):  
Chronic Disease ◽  
Primary Healthcare ◽  
Urban Areas ◽  
Healthcare Service ◽  
Torres Strait Islander ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Electronic Health Record Data ◽  
Cross Sectional ◽  
Torres Strait

Many Aboriginal and Torres Strait Islander people live in urban areas, but epidemiological data about their health status and health needs are lacking. This knowledge is critical to informing and evaluating initiatives to improve service delivery and health outcomes. One potential data source is de-identified routinely collected clinical data. This cross-sectional study, conducted in an urban Aboriginal and Torres Strait Islander primary healthcare service, involved randomly selecting a sample of 400 patients aged ≥15 years, and manually extracting electronic health record data. In the sample, 49% of patients were aged <35 years, 56% were female and 38% were employed. Overall, 56% of females and 47% of males aged 35–54 years had depression, 26% had experienced a bereavement within the last 12 months, and while 44% were alcohol abstainers, 35% were drinking at high-risk levels. The present study cannot demonstrate causal relationships between the observed high rates of chronic disease in older people and frequent experiences of bereavement and high levels of mental ill health in young- and middle-aged adults. However, a life course approach provides a framework to understand the interconnectedness of these results, and suggests that strategies to blunt the intergenerational burden of chronic disease need to address the social and emotional wellbeing of youth.

scholarly journals Understanding health talk in an urban Aboriginal and Torres Strait Islander primary healthcare service: a cross-sectional study

2017 ◽  
Vol 23 (4) ◽  
pp. 335 ◽  
Author(s):  
Prabha Lakhan ◽  
Deborah Askew ◽  
Mark F. Harris ◽  
Corey Kirk ◽  
Noel Hayman
Keyword(s):  
Health Literacy ◽  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Visual Aids ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adequate Health Literacy ◽  
Torres Strait

Health literacy is an important determinant of health status. This cross-sectional study aimed to describe the prevalence of adequate health literacy among Aboriginal and Torres Strait Islander patients or their carers including parents of sick children attending an urban primary healthcare clinic in Australia, and their experiences of communication with General Practitioners (GPs). A questionnaire, including questions from the Brief Health Literacy Screen (BHLS) and questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS): Communication with Provider, was administered to 427 participants. Descriptive statistics, Pearson’s Chi-Square test and logistic regression analysis were used to describe the prevalence and risk factors associated with health literacy and any associations between the CAHPS questions and health literacy. In total, 72% of participants had adequate health literacy. An age of ≥50 years was independently associated with inadequate health literacy, and completion of secondary or post-secondary schooling was protective. Communication questions that identified areas for improvement included less use of incomprehensible medical words and more frequent use of visual aids. The study provides useful information on health literacy among Aboriginal and Torres Strait Islander patients, or their carers, and their experiences of communication with GPs. Further population-based research is required to investigate the effect of health literacy on health outcomes of Aboriginal and Torres Strait Islander patients.

scholarly journals Visual impairment among Aboriginal and Torres Strait Islander patients attending an Australian Indigenous primary health service: a cross-sectional study

2020 ◽  
Vol 26 (4) ◽  
pp. 287
Author(s):  
Prabha Lakhan ◽  
Uchechukwu L. Osuagwu ◽  
Deborah Askew ◽  
Noel Hayman ◽  
Geoffrey Spurling
Keyword(s):  
Visual Impairment ◽  
Torres Strait Islander ◽  
Care Delivery ◽  
Health Assessment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Period Prevalence ◽  
Snellen Chart ◽  
Torres Strait

This cross-sectional study aimed to identify the period prevalence of visual impairment (VI) and blindness among Aboriginal and Torres Strait Islander people attending an Indigenous urban primary healthcare service, eye care practitioner referrals for those with VI and any opportunities to improve care delivery. Visual acuity (VA) examinations, using a Snellen chart, are performed as part of routine annual health assessments offered to children and adults. This study included patients aged ≥5 years (n=1442) who had a health assessment conducted between 1 January 2015 and 31 December 2016 and provided consent for the use of their health assessment information for research. Of patients with available data, 2.4% (33/1374) experienced VI, defined as presenting VA worse than 6/12 to 6/60 in the better-seeing eye. VI was more common in those aged ≥60 years (14/136; 10.3%) and was significantly associated with increasing age (P<0.001). No patients experienced blindness, defined as presenting VA worse than 6/60 in the better-seeing eye. All patients with VI were aged ≥16 years. Nine (27%) of the 33 patients with VI in the better-seeing eye were referred to an optometrist or an ophthalmologist. The low period prevalence of VI and no blindness in this study are positive findings. The findings also indicate that routine VA testing of older adults, especially those aged ≥60 years, should be conducted to avoid missing those not having an annual health assessment.

scholarly journals Cognitive impairment in a primary healthcare population: a cross-sectional study on the island of Crete, Greece

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035551
Author(s):  
Antonios Konstantinos Bertsias ◽  
Ioanna Tsiligianni ◽  
Sophia Papadakis ◽  
Ioannis Zaganas ◽  
George Duijker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Primary Healthcare ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Cognitive Status ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sleep Complaints

ObjectivesCognitive impairment is known to have a significant impact on the quality of life of individuals and their caregivers, yet it is often underdiagnosed. The objective of this study is to assess the extent of cognitive impairment among elders visiting primary healthcare (PHC) practice settings, to explore associated risk factors and discuss current care challenges for PHC providers.DesignA cross-sectional study was conducted between March 2013 and May 2014.SettingFourteen PHC units located in rural and urban areas of the Heraklion district in Crete, Greece.ParticipantsConsecutive visitors aged at least 60 years attending selected PHC practices.Primary and secondary outcome measuresThe Mini-Mental State Examination (MMSE) was used to indicate cognitive status. Associations of low MMSE scores (≤23/24, adjusted for education level) with 12 socio-demographic factors, comorbidities and lifestyle factors were assessed.ResultsA total of 3140 PHC patients met inclusion criteria (43.2% male; mean age 73.7±7.8 years). The average MMSE score was 26.0±3.8; 26.7±3.5 in male and 25.4±3.9 in female participants (p<0.0001). Low MMSE scores were detected in 20.2% of participants; 25.9% for females vs 12.8% for males; p<0.0001. Female gender (adjusted OR (AOR)=2.72; 95% CI 2.31 to 3.47), age (AOR=1.11; 95% CI 1.10 to 1.13), having received only primary or no formal education (AOR=2.87; 95% CI 2.26 to 3.65), alcohol intake (AOR=1.19; 95% CI 1.03 to 1.37), reporting one or more sleep complaints (AOR 1.63; 95% CI 1.14 to 2.32), dyslipidaemia (AOR=0.80; 95% CI 0.65 to 0.98) and history of depression (AOR=1.90; 95% CI 1.43 to 2.52) were associated with low MMSE scores.ConclusionsThis study identified a relatively high prevalence of low MMSE scores among persons attending PHC practices in a southern European community setting and associations with several known risk factors.

scholarly journals Aboriginal and Torres Strait Islander oral health and its impact among adults: A cross-sectional study

2016 ◽  
Vol 62 (1) ◽  
pp. 84-94 ◽  
Author(s):  
PJ Schluter ◽  
DA Askew ◽  
GK Spurling ◽  
M Lee ◽  
N Hayman
Keyword(s):  
Oral Health ◽  
Torres Strait Islander ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Torres Strait

scholarly journals Urban Aboriginal and Torres Strait Islander children's exposure to stressful events: a cross‐sectional study

2013 ◽  
Vol 199 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Deborah A Askew ◽  
Philip J Schluter ◽  
Geoffrey K P Spurling ◽  
Chelsea J R Bond ◽  
Alex D H Brown
Keyword(s):  
Torres Strait Islander ◽  
Cross Sectional Study ◽  
Stressful Events ◽  
Sectional Study ◽  
Cross Sectional ◽  
Torres Strait ◽  
Children’S Exposure

scholarly journals Fatigue among children with a chronic disease: a cross-sectional study

2021 ◽  
Vol 5 (1) ◽  
pp. e000958
Author(s):  
Merel M Nap-van der Vlist ◽  
Geertje W Dalmeijer ◽  
Martha A Grootenhuis ◽  
Kors van der Ent ◽  
Marry M van den Heuvel-Eibrink ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Social Factors ◽  
Participation Rate ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multivariable Regression Model ◽  
Multivariable Regression ◽  
Multidimensional Fatigue Scale

ObjectiveTo determine: (1) which biological/lifestyle, psychological and/or social factors are associated with fatigue among children with a chronic disease and (2) how much each of these factors contributes to explaining variance in fatigue.Design and settingThis was a cross-sectional study across two children’s hospitals.PatientsWe included children aged 8–18 years who visited the outpatient clinic with cystic fibrosis, an autoimmune disease or postcancer treatment.Main outcome measuresFatigue was assessed using the PedsQL Multidimensional Fatigue Scale. Generic biological/lifestyle, psychological and social factors were assessed using clinical assessment tools and questionnaires. Multiple linear regression analyses were used to test the associations between these factors and fatigue. Finally, a multivariable regression model was used to determine which factor(s) have the strongest effect on fatigue.ResultsA total of 434 out of 902 children were included (48% participation rate), with a median age of 14.5 years; 42% were male. Among these 434 children, 21.8% were severely fatigued. Together, all biopsychosocial factors explained 74.6% of the variance in fatigue. More fatigue was uniquely associated with poorer physical functioning, more depressive symptoms, more pressure at school, poorer social functioning and older age.ConclusionsFatigue among children with a chronic disease is multidimensional. Multiple generic biological/lifestyle, psychological and social factors were strongly associated with fatigue, explaining 58.4%; 65.8% and 50.0% of the variance in fatigue, respectively. Altogether, almost three-quarters of the variance in fatigue was explained by this biopsychosocial model. Thus, when assessing and treating fatigue, a transdiagnostic approach is preferred, taking into account biological, psychological and social factors.

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