scholarly journals Seldom heard voices: a meta-narrative systematic review of Aboriginal and Torres Strait Islander peoples healthcare experiences

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Benjamin Jones ◽  
David Heslop ◽  
Reema Harrison
Keyword(s):  
Health System ◽  
Patient Experience ◽  
Torres Strait Islander ◽  
Healthcare Quality ◽  
Health Inequities ◽  
Patient Experiences ◽  
Healthcare Provision ◽  
Australian Health ◽  
Healthcare Experiences ◽  
Torres Strait

Abstract Background It is well established that Aboriginal and Torres Strait Islander populations face considerable health inequities, exacerbated by poorer healthcare quality. Patient experience is recognised as a major contributing factor to healthcare quality and outcomes, therefore, enriched knowledge of the patient experiences of Aboriginal and Torres Strait Islander populations is critical to redress health inequities. This review synthesises evidence of the healthcare experiences amongst Aboriginal and Torres Strait Islander patients through a metanarrative synthesis of qualitative literature. Methods A systematic search strategy was developed and applied to six electronic databases between January 2000 and July 2019. Titles and abstracts were screened before applying the inclusion criteria to full text articles. A meta-narrative synthesis was undertaken. Results Fifty-four publications were identified from four research traditions; each with a unique conceptualisation of patient experience. Three themes emerged that demonstrate Aboriginal and Torres Strait Islander patient experiences are informed by 1) beliefs about wellbeing and healthcare provision, 2) their level of trust in the healthcare system, and 3) individual and community health system interactions. The findings highlight a range of aspects of patient experience that were important to participating Aboriginal and Torres Strait Islanders in the included studies but not captured currently in health system surveys. Conclusion This review highlights the influence of beliefs about health and wellbeing on the patient experience amongst Aboriginal and Torres Strait Islander populations in the Australian health system. Patient experiences were informed by past experience and their trust in the health system. The different factors influencing patient experience and the gravity of their influence must be considered in current approaches to capturing patient experience data collection methods. Trial registration PROSPERO (ID: CRD42019134765).

… but what about the Aboriginal and/or Torres Strait Islander Health Worker academic? Transcending the role of ‘unknowing assistant’ in health care and research through higher education: a personal journey

2020 ◽  
Vol 49 (2) ◽  
pp. 119-126
Author(s):  
Janet Stajic
Keyword(s):  
Higher Education ◽  
Health System ◽  
Health Worker ◽  
Indigenous Peoples ◽  
Torres Strait Islander ◽  
Clinical Skills ◽  
Educational Institutions ◽  
Australian Health ◽  
Torres Strait ◽  
Torres Strait Islander Health

AbstractThe Aboriginal and Torres Strait Islander Health Worker/Practitioner (A&TSIHW) workforce provides not only clinical skills but also responds to specific social and cultural needs of the communities they serve bringing knowledge derived from lived and embodied knowledges. The A&TSIHW is a recognised health professional within the Australian health system; however, this workforce continues to be under-supported, under-recognised and under-utilised. A common discourse in literature written about A&TSIHWs focused on the need to empower and enhance the A&TSIHW capabilities, or rendered the A&TSIHW as part of the problem in improving the health of Indigenous peoples. In contrast, articles written by A&TSIHWs, published in the Aboriginal and Islander Health Worker Journal, tell a different story, one about the limitations of the health system in its ability to care for Indigenous peoples, recognising A&TSIHW leadership. This paper deals with two interrelated tensions—the undervaluing of the A&TSIHW as a clinician and the undervaluing of the A&TSIHW as an academic—both of which the author has had to navigate. It explores the specific challenges of the A&TSIHW academic who too seeks recognition beyond that of ‘assistant’ within the research enterprise, drawing upon personal experiences and engagement with educational institutions, including higher education.

scholarly journals #CoveringClimateNow: A social journalism project profiling climate and health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Williams ◽  
M Sweet ◽  
M McInerney ◽  
S Finlay
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Media Coverage ◽  
Torres Strait Islander ◽  
Poor Quality ◽  
Global Media ◽  
Practical Advice ◽  
Australian Health ◽  
Climate And Health ◽  
Torres Strait

Abstract Concerns about poor quality media reporting of climate change has led to many initiatives seeking to influence coverage. In 2019/2020, a global media collaboration was established with the aim of generating a sustained media focus on key climate-related events. This paper reports an analysis of an Australian health media organisation's contribution to the collaboration, and the opportunities this provided for public health advocates, Aboriginal and Torres Strait Islander researchers and communities, and the wider community. It presents key reflections from Croakey Health Media's contribution to the global #CoveringClimateNow collaboration, with the aim of providing practical advice to enable further such collaborations and activities in other countries. This project was run on a very small budget, and this presentation is likely to be particularly relevant for low-budget organisations and contexts. Key messages Poor quality media coverage of climate change has stimulated innovation. Collaboration locally and globally can convey solutions to climate change.

Burn Injuries in Hospitalized Australian Children—An Epidemiological Profile

2020 ◽  
Author(s):  
Courtney Ryder ◽  
Tamara Mackean ◽  
Kate Hunter ◽  
Kris Rogers ◽  
Andrew J A Holland ◽  
...  
Keyword(s):  
First Nations ◽  
Torres Strait Islander ◽  
Total Body Surface Area ◽  
Health Inequities ◽  
Hospital Length ◽  
Burn Injuries ◽  
Hospital Length Of Stay ◽  
Indigenous Research ◽  
Torres Strait ◽  
Epidemiological Profile

Abstract Globally, First Nations children sustain burns at a higher rate than other children. Little is understood about how health inequities contribute, especially from an Indigenous viewpoint. We analyzed data from the Burns Registry of Australian and New Zealand (BRANZ) for acute burns in children (<16 years) admitted to hospital between October 2009 and July 2018. Descriptive statistics examined equity variables in patient and injury characteristics. Poisson regression was used to describe factors associated with bacterial infection. Indigenous research methods were used throughout. Aboriginal and Torres Strait Islander children represented 10.4% of the study population. Health inequities were present for Aboriginal and Torres Strait Islander children with longer hospital length of stay (9.5 vs 4.6 days), rural residency (61.3% vs 13.9%), lower socioeconomic status (72.2% vs 34.9%), and more flame burns (19.5% vs 10.6%) compared to other Australian children. Streptococcus sp. infection risk was four times greater in Aboriginal and Torres Strait Islander children compared to other Australian children. Flame burns and high percentage total body surface area burns were a risk for Staphylococcus sp. and Streptococcus sp. infection in all children. The epidemiological profile for burn injuries managed in Australian burns centers differs between Aboriginal and Torres Strait Islander children and other children, indicating persistent health inequities. These differences should be considered in the development of injury prevention strategies and the clinical management of burn injuries for Aboriginal and Torres Strait Islander children and their families.

scholarly journals Culturally Adaptive Governance—Building a New Framework for Equity in Aboriginal and Torres Strait Islander Health Research: Theoretical Basis, Ethics, Attributes and Evaluation

2021 ◽  
Vol 18 (15) ◽  
pp. 7943
Author(s):  
Daniel L.M. Duke ◽  
Megan Prictor ◽  
Elif Ekinci ◽  
Mariam Hachem ◽  
Luke J. Burchill
Keyword(s):  
Health Research ◽  
Theoretical Basis ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Health Inequities ◽  
Adaptive Governance ◽  
Research Projects ◽  
Governance Framework ◽  
Torres Strait ◽  
Indigenous Governance

Indigenous health inequities persist in Australia due to a system of privilege and racism that has political, economic and social determinants, rather than simply genetic or behavioural causes. Research involving Aboriginal and Torres Strait Islander (‘Indigenous’) communities is routinely funded to understand and address these health inequities, yet current ethical and institutional conventions for Indigenous health research often fall short of community expectations. Typically, mainstream research projects are undertaken using traditional “top-down” approaches to governance that hold inherent tensions with other dominant governance styles and forms. This approach perpetuates long-held power imbalances between those leading the research and those being researched. As an alternative, Indigenous governance focuses on the importance of place, people, relationships and process for addressing power imbalances and achieving equitable outcomes. However, empowering principles of Indigenous governance in mainstream environments is a major challenge for research projects and teams working within organisations that are regulated by Western standards and conventions. This paper outlines the theoretical basis for a new Culturally Adaptive Governance Framework (CAGF) for empowering principles of Indigenous governance as a prerequisite for ethical conduct and practice in Indigenous health research. We suggest new orientations for mainstream research project governance, predicated on translating theoretical and practical attributes of real-world ethics, adaptive governance and critical allyship frameworks to Indigenous health research. The CAGF is being implemented in a national Indigenous multicenter trial evaluating the use of continuous blood glucose monitors as a new technology with the potential to improve diabetes care and treatment for Indigenous Australians—the FlashGM Study. The CAGF is a governance framework that identifies the realities of power, acknowledges the complexities of culture and emerging health technologies, and foregrounds the principle of equity for mainstream Indigenous health research.

Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service

2019 ◽  
Vol 43 (2) ◽  
pp. 217 ◽  
Author(s):  
Craig Wotherspoon ◽  
Cylie M. Williams
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Outcomes ◽  
Torres Strait Islander ◽  
Healthcare Services ◽  
Patient Experiences ◽  
Culturally Appropriate ◽  
Torres Strait ◽  
Healthcare Administrators ◽  
Culturally Appropriate Services

Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.

Narrative review of European healthcare benchmarking experiences: shared goals, different focuses and formats (Preprint)

2021 ◽  
Author(s):  
Anna García-Altés ◽  
Cristina Adroher ◽  
Viky Morón ◽  
Boi Ruiz
Keyword(s):  
Quality Improvement ◽  
Health System ◽  
Patient Experience ◽  
Healthcare Quality ◽  
European Countries ◽  
Data Sources ◽  
Web Based ◽  
European Healthcare ◽  
System Review ◽  
Conflicting Goals

BACKGROUND Benchmarking experiences have been flourishing in Europe during the last years with the idea of improving healthcare quality. OBJECTIVE This paper aims to review the European benchmarking experiences, analysing their main characteristics and highlighting common and differential ones. METHODS The identification of benchmarking experiences was based on the list of European countries for which there exists an electronic “HiT health system review”. Predefined variables were identified, mainly data sources, formats, topics, and target audiences. RESULTS 14 benchmarking experiences were identified. Most of them are governmental. All of them are web-based. The easiness to navigate through the websites and materials and to understand them varies among experiences. Most common data sources are registries. Few experiences include patient experience indicators. None of them explicitly mentions if they use results as the basis to start quality improvement efforts. CONCLUSIONS Benchmarking is essential for transparency and accountability, and to support improvement. To do this effectively it must reconcile important and potentially conflicting goals: meaningful accountability, requiring real consequences from underperformance, and an environment that encourages open and honest reporting. Enhancing reporting websites is needed.

Sign in / Sign up

Export Citation Format

Share Document