Dissertations / Theses on the topic 'Aboriginal Australians Medical care'
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1
Paradies, Yin Carl. "Race, racism, stress and indigenous health /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002514.
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Mills, David. "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia /." Title page, table of contents and abstract only, 2005. http://web4.library.adelaide.edu.au/theses/09MD/09mdm6571.pdf.
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Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005.Includes publications published as a result of ideas developed in this thesis, inserted at end. "April 2005" Includes bibliographical references (leaves 210-242).
3
Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." University of Sydney, 2007. http://hdl.handle.net/2123/3538.
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Master of PhilosophyAs Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.
4
Helen, Maureen. "Other people's country: A memoir; and, Developing a trustworthy narrator: An essay." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/1796.
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This thesis comprises two interrelated sections. The first section is a substantial piece of creative writing, which l have cailed 'Other People's Country: A Memoir, in the genre of travel memoir, and an essay. The memoir borrows techniques from fiction, drama and poetry to tell a story of a middle-aged, middle-class city nurse, who travels to a remote settlement at the edge of the Western Desert of Western Australia to provide health care for a fluctuating population of around 400 people, for whom English is a third or fourth language.
Writing that includes stories about vulnerable people from another culture, whose lives have touched those of the writer, demands sensitivity to differences, as well as an ethical approach. Writing about Aboriginal people also demands an awareness of what is appropriate when writing about cultural material. To achieve the voice of a trustworthy narrator is a challenge that faces all writers of narrative non-fiction, including memoir. The truth is subjective; perception is unreliable; memory can be distorted; error slips in unwittingly; deliberate falsification is possible. In spite of all this, a writer of memoir makes a contract with the reader that the story is significant, and that it is the writer's truth, told as honestly as possible. The pivotal concern of this thesis is the question, 'What are some of the important considerations for a memoirist who is attempting to develop the voice of an ethical and trustworthy narrator writing about experiences encountered when living and working within an unfamiliar culture?
The second part of the thesis is an essay which develops a theoretical framework in response to some of the major dilemmas I encountered in this undertaking. It embraces memory, aspects of Aboriginal vulnerability, and ethics through which to explore the concepts of truth and honesty in memoir-writing.
5
Lansingh, Van Charles. "Primary health care approach to trachoma control in Aboriginal communities in Central Australia." Connect to thesis, 2005. http://repository.unimelb.edu.au/10187/984.
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This study concerned a primary health care approach to trachoma control in two Central Australian Aboriginal communities. The World Health Organization (WHO) has advocated that the best method to control trachoma is the SAFE strategy (Surgery, Antibiotics, Facial hygiene, and Environmental improvements), and this approach was adopted.The communities, Pipalyatjara and Mimili, with populations slightly less than 300 each, are located in the Anangu Pitjantjatjara (AP) lands of Central Australia, in the northwest corner of the South Australia territory. At Pipalyatjara, a full SAFE-type intervention was undertaken, with the ‘E’ component designed and implemented by the NHC (Nganampa Health Council Inc.). At Mimili, only a SAF-type of intervention was implemented.
Baseline data was gathered for 18 months from March 1999 through September 2000 (five visits to Pipalyatjara and four at Mimili), and included determining trachoma prevalence levels using the WHO system, facial cleanliness, and nasal discharge parameters. A trachoma health program was implemented at the end of this period and a one-time dose of azithromycin was given in September of 2000. The chief focus of the study was children under 15 years of age.
Improvements in road sealing, landscaping, and the creation of mounds were started to improve dust control. Concurrently, efforts were made in the houses of the residents to improve the nine healthy living practices, which were scored in two surveys, in March 1999 and August 2001. Trachoma prevalence, and levels of facial cleanliness and nasal discharge were determined at 3, 6, and 12 months following antibiotic administration.
In children less than 15 years of age, the pre-intervention prevalence level of TF (Trachoma Follicular) was 42% at Pipalyatjara, and 44% at Mimili. For the 1-9 year age group, the TF prevalence was 47% and 54% respectively. For TI (Trachoma Intense), the pre-intervention prevalence was 8% for Pipalyatjara, and 9% for Mimili. The TF prevalence, adjusted for clustering, and using only individuals present at baseline and follow-up (3, 6, and 12 months post-intervention), was 41.5%, 21.2%, 20.0%, and 20.0% at Pipalyatjara respectively. For Mimili, the corresponding prevalence figures were 43.5%, 18.2%, 18.2%, and 30%.
In the 1-9 year age group, a lower TF prevalence existed between the pre-intervention and 12-month post-intervention points at Pipalyatjara compared to Mimili. The TF prevalence after the intervention was also lower for males compared to females, when the cohorts were grouped by gender, rather than community. It is posited that reinfection was much higher at Mimili within this age group, however, in both communities, there appeared to be a core of females whose trachoma status did not change. This is speculated as mainly being caused by prolonged inflammation, though persistent infection C. Trachomatis cannot be ruled out.
Facial cleanliness and nasal discharge continued to improve throughout the intervention at both communities, but at the 3-month post-intervention point no longer became a good predictor of trachoma.
It is not known whether the improvements in the environment at Pipalyatjara were responsible for the reduction in trachoma prevalence 12 months after the intervention, relative to Mimili.
6
Eades, Anne. "Factors that influence participation in self-management of wound care in three indigenous communities in Western Australia : clients' perspectives /." Murdoch University Digital Theses Program, 2008. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20090702.111437.
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Paul, David. "Casting shadows and struggling for control : silence, resistance and negotiation in Australian Aboriginal health." University of Western Australia. School of Primary, Aboriginal and Rural Health Care, 2007. http://theses.library.uwa.edu.au/adt-WU2008.0015.
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Self determination has been recognised as a basic human right both internationally and, to an extent, locally, but it is yet to be fully realised for Aboriginal Peoples in Australia. The assertion of Aboriginal community control in Aboriginal health has been at the forefront of Aboriginal peoples' advocacy for self determination for more than thirty years. Aboriginal Community Controlled Health Services and their representative organisations have been the site of considerable resistance and contestation in the struggles involved in trying to improve Aboriginal health experiences. Drawing on some of these experiences I explore the apparent inability of policy and decision makers to listen to systematic voices calling for change from the Aboriginal Community Controlled Health sector. It is government inability to act more fully on clear and repeated messages that is a source of much disquiet within representative Aboriginal organisations. Such disquiet is grounded in a belief that colonial notions continue to influence decision making at policy, practice and research levels resulting in a significant impediment to the realisation of self determination and associated human rights in Aboriginal health matters and Aboriginal Affairs more broadly.
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McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm1682.pdf.
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Grootjans, John. "Both ways and beyond : in Aboriginal and Torres Strait Islander health worker education /." View thesis, 1999. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030725.103057/index.html.
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King, Julie Anne. "Weaving yarns : the lived experience of Indigenous Australians with adult-onset disability in Brisbane." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/34447/1/Julie_King_Thesis.pdf.
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Indigenous Australians have lower levels of health than mainstream Australians and (as far as statistics are able to indicate) higher levels of disability, yet there is little information on Indigenous social and cultural constructions of disability or the Indigenous experience of disability. This research seeks to address these gaps by using an ethnographic approach, couched within a critical medical anthropology (CMA) framework and using the “three bodies” approach, to study the lived experience of urban Indigenous people with an adult-onset disability. The research approach takes account of the debate about the legitimacy of research into Indigenous Australians, Foucault‟s governmentality, and the arguments for different models of disability. The possibility of a cultural model of disability is raised. After a series of initial interviews with contacts who were primarily service providers, more detailed ethnographic research was conducted with three Indigenous women in their homes and with four groups of Indigenous women and men at an Indigenous respite centre. The research involved multiple visits over a period extending more than two years, and the establishment of relationships with all participants. An iterative inductive approach utilising constant comparison (i.e. a form of grounded theory) was adopted, enabling the generation and testing of working hypotheses. The findings point to the lack of an Indigenous construct of disability, related to the holistic construction of health among Indigenous Australians. Shame emerges as a factor which affects the way that Indigenous Australians respond to disability, and which operates in apparent contradiction to expectations of community support. Aspects of shame relate to governmentality, suggesting that self-disciplinary mechanisms have been taken up and support the more obvious exertion of government power. A key finding is the strength of Indigenous identity above and beyond other forms of identification, e.g. as a person with a disability, expressed in forms of resistance by individuals and service providers to the categories and procedures of the mainstream. The implications of a holistic construction of health are discussed in relation to the use of CMA, the interpretation of the “three bodies”, governmentality and resistance. The explanatory value of the concept of sympatricity is discussed, as is the potential value of a cultural model of disability which takes into account the cultural politics of a defiant Indigenous identity.
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Harrington, Zinta, and zintah@bigpond com. "B Cell antigen D8/17 as a marker of susceptibility to rheumatic fever in Australians and The sharp end of the needle: Rheumatic fever prophylaxis and concepts of care for Yolngu patients A thesis in two parts." Flinders University. School of Medicine, 2005. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20060219.200649.
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Aboriginal Australians have some of the world�s highest rates of rheumatic fever. Two approaches to reducing the burden of rheumatic fever are discussed in this thesis. The B cell antigen D8/17 has a strong association with rheumatic heart disease and may be a universal marker of inherited susceptibility to rheumatic fever. Identifying a population at increased risk of rheumatic fever provides an opportunity to focus primary prevention measures. In part one of the thesis I evaluate the accuracy of D8/17 as a marker of past rheumatic fever amongst Australians from the Northern Territory. D8/17 levels were measured and compared in patients with acute rheumatic fever, rheumatic heart disease or past rheumatic fever, first-degree relatives and healthy, unrelated controls. The mean percentage of B cells positive for D8/17 was 83.7%, 38.9%, 20.2% and 11.6% respectively. The difference between the groups was significant (p-value less than 0.0001). A receiver operator curve analysis indicated that 22.1% of B cells positive for D8/17 was the most accurate cut-off to distinguish patients with acute or past rheumatic fever from healthy subjects. These results indicated that the B cell antigen D8/17 is an accurate marker of past rheumatic fever in Aboriginal Australians and could be a helpful addition to the Jones Criteria for strengthening or excluding a diagnosis of acute rheumatic fever. The intermediate levels of D8/17 expression in the relatives of index cases supports the hypothesis that D8/17 is a marker of an inherited susceptibility to rheumatic fever, although prospective trials are required to provide conclusive proof of this hypothesis.
Non-compliance with secondary prophylaxis was suspected to be the cause of increasing rates of rheumatic fever in the Top End. In part two of the thesis I discuss the �problem of compliance� with respect to Aboriginal patients, and investigate the factors that affected the delivery and uptake of prophylaxis for rheumatic fever in an Aboriginal community. Patients, relatives and health practitioners were interviewed on the topic of the care of patients with rheumatic heart disease. The data were analysed using the principles of grounded theory.
The main finding was the desire for more personalised care and support for patients with rheumatic heart disease from the community clinic, rather than simple medical care. These ideas crystallised through two Yolngu terms to describe care: djaka (to physically care for) and gungayun (to encourage). Thus even from the outset there was divergence in the focus of the �consumer�- holistic care - and that of the health-care professional/ researcher � improving the rate of secondary prophylaxis coverage.
With regards to service provision, a significant reason for failure to receive secondary prophylaxis was the differing approaches of urban and community health services, patient mobility, and a differing understanding of the responsibilities of patients and health service providers in the different settings. Other factors pertaining to service provision, such as staff motivation, administrative issues and program coordination affected the uptake of secondary prophylaxis to a lesser extent. With regards to treatment uptake, individual patient factors inhibiting uptake of treatment were apparent in some cases, but treatment refusal was rare. Pain was not found to be a deterrent. No simple relationship was found between treatment compliance and biomedical knowledge of the disease. There was no simple relationship between patient passivity and sense of responsibility that guaranteed compliance.
This study demonstrated that the failure to achieve good uptake of prophylaxis for rheumatic fever related as much to factors of service provision as patient factors and that providing holistic care within a familiar and supportive framework is important to Yolngu patients. However, there are real difficulties for health services as they are currently structured to meet the expectations of patients and families.
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Ohtsuka, Thai, and thai_ohtsuka@hotmail com. "Impact of cultural change and acculturation on the health and help seeking behaviour of Vietnamese-Australians." Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20051013.095125.
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This study investigated the influence of cultural change and acculturation on
health-related help seeking behaviour of Vietnamese-Australians. Using convenience
sampling, 94 Vietnamese-Australians, 106 Anglo-Australians, and 49 Vietnamese in Vietnam participated in the study. Beliefs about health and health-related help-seeking behaviours were assessed through measures of common mental health symptoms, illness expression (somatisation, psychologisation), symptom causal attributions (environmental, psychological, biological), and choice of help seeking (self-help, family/friends, spiritual, mental health, Western medicine, Eastern medicine).Vietnamese-Australian data was compared with that of the Anglo-Australian and Vietnamese-in Vietnam. Results revealed that the help seeking behaviours and health related cognitions of Vietnamese-Australians, while significantly different from those of Anglo-Australians, were similar to those of Vietnamese in Vietnam. Specifically, both Vietnamese groups were less likely than Anglo-Australians to somatise and
psychologise or attribute the cause of symptoms to environmental, psychological or biological causes. However, the two Vietnamese groups were not different from each other in their style of illness expression or in their symptom causal attributions. The Vietnamese-Australians reported experiencing more mental health symptoms than the Vietnamese in Vietnam but fewer than the Anglo-Australians. In relation to help seeking, the Anglo-Australians chose self-help more than the Vietnamese, but there were few other differences between the cultural groups.
To investigate the influence of acculturation on health-related beliefs and help seeking behaviour, Vietnamese-Australians were compared according to their modes of acculturation (integration, assimilation, separation, and marginalisation). Generally, results showed a distinct pattern of response. Those with high levels of acculturation towards the Australian culture (the integration and the assimilation) were found to be most similar (in that they scored the highest in most areas measured) to the Anglo-Australians, while few differences were found between the separated and the
marginalised groups. Further, cultural orientation was a powerful predictor of help
seeking. In that, original cultural orientation predicted selection of help seeking from
Western and Eastern medicine, whereas, the host cultural orientation was a more robust predictor of the other variables. However, neither cultural orientation predicted preference for mental health help. Finally, the study found that, although the combination of symptom score, modes of illness expression, and symptom causal
attribution were strong predictors of choice of help seeking of Vietnamese-Australians,
acculturation scores further improved predictive power. The results were discussed in terms of the various limitations and constraints on interpretation of this complex data set.
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Stocks, Nigel. "Trachoma and visual impairment in the Anangu Pitjantjatjara of South Australia /." Title page, contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09MD/09mds865.pdf.
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Beale, B. L. "Maternity services for urban Aboriginal women : experiences of six women in Western Sydney /." View thesis, 1996. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030613.161127/index.html.
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Murphy, Mary Denise. "Living with asthma in Australia : an anthropological perspective on life with a chronic illness." University of Western Australia. School of Anatomy and Human Biology, 2005. http://theses.library.uwa.edu.au/adt-WU2005.0070.
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[Truncated abstract] In Australia, asthma is a common chronic illness, which often requires complex treatment regimens. This study used an anthropological perspective to explore the experience of people living with asthma, with the specific aim of contributing to the health care programs offered to people living with asthma. The study was conducted in an Australian city (Perth, Western Australia). The foci of the study were Australian lay people, from the general community, living with asthma, and a small number of non- English speaking Vietnamese-Australian migrants. Some spouses of the Australians and biomedical practitioners were also included. Questionnaires, and particularly indepth interviews, were used to explore the explanatory models of asthma for doctors and lay people with the condition. The explanatory models of the doctors focused primarily on assessing and treating the physiological dimension of asthma, and educating patients. The explanatory models for lay people with asthma reflected their everyday reality: in addition to its impact on their physical health, asthma affected their daily life, social roles and participation, and their personal identity. Placing the experience of asthma in this wider perspective showed that the Australians used practical reasoning to make a trade-off between using medication, such that they felt safe from `attacks? and could `do all they wanted to do?, and minimising their `dependence? on potentially harmful medications. Responding to acute episodes involved a risk assessment in which people weighing the health risk of waiting against the social risk of seeking help unnecessarily. For the Vietnamese- Australians, caring for asthma was strongly shaped by their social position as non- English speaking migrants. They lacked access to information about asthma and to specialist care. They had sufficient medication, but were ill-informed about how to use their medicines effectively and safely: in general, the Vietnamese people were overmedicated but under-serviced in the care of their asthma. Beyond explanatory models, the Australian participants (lay people and doctors) shared a cultural model of asthma as a chronic illness. This Australian cultural model shaped the experience and care of asthma. It included concepts such as framing the past as an adjustment process, and the present as `living normally? with asthma. Taking care of asthma was expressed as `taking control? of asthma, so a person could minimise the illness and still be healthy. The Vietnamese-Australians did not share this cultural model of asthma as a chronic illness, as reflected in their expression of the hardship asthma created in limiting their ability to work hard for their family, and how they expected a cure for their condition from biomedicine. The Australians also shared a cultural model of health that was derived, in part, from the health promotion messages that are targeted at lay people. These promotional messages were the basis of a morality in health: people shared an implicit understanding that a person deserved health, and assistance when ill, when he/she displayed the required self-discipline in performing health behaviours.
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Jewell, Trevor. "Martu tjitji pakani : Martu child rearing and its implications for the child welfare system." University of Western Australia. Social Work and Social Policy Discipline Group, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0147.
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In this research, I explore my belief that one the reasons for the continuing poor outcomes for Indigenous people was that State-wide and national programs ignored unique local Indigenous culture and did not actively involve local Indigenous people in the development of programs for their area. I chose to examine this perception through investigation of the tension between Indigenous culture and worldview and the dominant White values of the child welfare system (broadly defined), through description of Martu child rearing practices and beliefs in the remote Western Australian town of Wiluna. The Martu live in a remote environment of material poverty, high levels of unemployment, low levels of educational achievement and poor health outcomes. The research sponsored by the Ngangganawili Aboriginal Health Service and located in its Early Childhood Centre, uses an Indigenous research approach based on Brayboy's (2005) TribalCrit to explore Martu child rearing practices, beliefs and values. It uses the stories told by the Martu in Wiluna about the way they and their families were brought up and observations of Martu families to answer research questions around Martu definitions of children and families, their concerns for their children, ways of ensuring the well being of their children, and whether there is a Martu child welfare approach. The research then considers the implications of these Martu practices for the broadly defined child welfare system. The stories told by the Martu show that they have a unique way of bringing up their children that is different to those in the dominant White culture. This uniqueness is derived from a combination of the recent colonisation of the Martu, their culture and their post colonisation experiences. The implications of Martu child rearing for the child welfare system are based on the assumption that Martu are wholly dependent on poorly designed and targeted government provided or funded services, and the current ways of delivering these services is failing the Martu. The research concludes that the key to improving outcomes for Martu children and their families is for the agencies delivering these services to form close working relationships with the Martu; operate within, understand, appreciate, and respect Martu Law and culture; understand their (personal and agency) and Martu post colonisation histories; and allow for Martu control, definition of priorities and development of strategies to address the problems.
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Loff, Beatrice. "Health and human rights : case studies in the potential contribution of a human rights framework to the analysis of health questions." Monash University, Dept. of Epidemiology and Preventive Medicine, 2004. http://arrow.monash.edu.au/hdl/1959.1/5291.
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Gardner, Karen Louise. "Sustaining quality improvement in indigenous primary health care : a sociological analysis." Phd thesis, 2011. http://hdl.handle.net/1885/155965.
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Sustaining the delivery of effective chronic disease care is a major imperative for health systems worldwide. As the prevalence of chronic conditions continues to rise, health systems struggle to provide high quality care that meets the standards set out in practice guidelines. Reorientation of primary health care systems to support the delivery of prevention and management over long timeframes is required. Continuous quality improvement programs are increasingly being used to make and monitor progress towards meeting these objectives. They use participatory action methods to stimulate changes to clinical practice and to the systems that support it. Although research has demonstrated that these programs can be effective, little is known about how they are implemented and sustained, the mechanisms that underpin their impacts, or the influence of implementation processes and context on outcomes. There is a need for research approaches that are better informed by theory to help identify mechanisms and explain change processes or lack of them in different settings. This thesis uses a case study design to investigate factors associated with the sustainability of a large scale CQI program in Indigenous primary health care services in Australia. Drawing on sociological approaches, the study develops and applies a complexity perspective to conceptualise sustainability as the dynamic outcome of interactions between elements of programs and the broader health system and stakeholder environments. It brings together concepts from complex adaptive systems and actor network theory to conduct an in-depth examination of the processes through which participants were engaged in CQI, their use of the audit tools and processes and development of strategies to enact and sustain change. The study demonstrates that despite initial enthusiasm and a complex but broadly conducive environment for developing CQI, using the tools and processes was intensive and time consuming and changing practices to support improvement priorities required services to adapt and realign clinical and administrative processes within and between service systems. Processes of change were reflexive, operating in loops and feedbacks that produced results which were not always intended or predictable. Changes in one part of the system inevitably led to impacts in another. Partial engagement among the stakeholders, workforce shortage and turnover, inter{u00AD}professional relations, poorly aligned patient information systems, bureaucracy and competing priorities in the service environment impeded efforts. Services that were better able to address the impediments they faced had: organisational buy-in; supportive clinical and managerial leadership; someone at the health centre level to coordinate and drive CQI; resources to support team involvement and facilitation; internal communication and feedback; and decision making processes that allowed managers to enact change at the service level. The thesis makes recommendations for changes in practice at the local and regional levels, and in policy at the national level, that will be required to support the widespread adoption and sustained practice of CQI. These practical conclusions are founded in an enhanced theoretical repertoire developed by this thesis that furthers an understanding of implementation processes, and of the relationship between context and programme, in order to improve the sustainability of CQI programmes.
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Senior, Kate Adèle. "A Gudbala Laif? : health and wellbeing in a remote Aboriginal community - what are the problems and where lies responsibility?" Phd thesis, 2003. http://hdl.handle.net/1885/109708.
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The the sis is a study of a single community, its health, expectations and
aspirations. It is a study of understand in g and responsibility in the
context of dependence. The primarily ethnographic work for this thesis
was undertaken in Ngukurr over thirteen months between 1999 and
2002. Ngukurr is a remote town on the south east border of Arnhem Land in
Australia’s Northern Territory. Its long term residents are Aboriginal
people. The thesis presented here examines these people’s
understanding of health and illness in their community and their
attainment of a good life. My study focuses on issues around people’s
engagement with and disengagement from, the management of their
health and health service delivery.
My thesis is guided by the following questions:
• how do people assess their health status?
• how a republic health services perceived?
• what expectations does the community have about the type and
quality of the services provided ?
• do people seek an active role in the management of their
health ?
People’s attitudes to and expectations for their health are examined in
the context of a history of direct welfare dependence till the mid nineteen
seventies; followed by local self government in which fiscal and
administrative responsibility were held by Government or outside
individuals. The evidence for health status, morbidity, and mortality among the
remote indigenous population is significantly worse than non indigenous
Australians and h a s been the subject of extensive Commonwealth and
State health programs to little obvious effect.
The literature I survey shows that people in poor communities rate their
health more highly than the objective data suggests. Ngukurr residents
rate their health in a similar way, b u t their apparent satisfaction masks
complex beliefs about illness and concerns about health.
I demonstrate that the community believes that outside influences are
more important than personal actions as a cause of poor health, that
there is little respect for the community’s view of health or health
services, and in consequence there is little point in taking personal or
collective responsibility.
Ngukurr residents are not disinterested in health. They are acutely
aware of the patterns of morbidity and mortality in their community and
consider these to have a negative impact on their quality of life. Their
ability to bring about changes in these patterns is limited by different
paradigms of health and illness which sometimes appear as fatalism,
powerlessness in the non-Aboriginal domain, loss of confidence due to
poor communication with non indigenous providers, and consequent low
expectations with regard to personal and community health.
This creates a challenge for current policies to devolve management
responsibility for health services to local communities. Policy makers
should make considerable efforts to u n d e rs tan d local health beliefs and
value systems and ensure that changes are appropriate, rather than
making changes in health systems based on non-indigenous
understandings of needs.
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Kelly, Janet. "Moving forward together in Aboriginal women's health a participatory action research exploring knowledge sharing, working together and addressing issue collaboratively in urban primary health care settings /." 2008. http://catalogue.flinders.edu.au/local/adt/public/adt-SFU20090324.084222/index.html.
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Mills, David (Peter David Duncombe). "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia / David Mills." 2005. http://hdl.handle.net/2440/38374.
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Includes publications published as a result of ideas developed in this thesis, inserted at end."April 2005"
Includes bibliographical references (leaves 210-242)
242 leaves :
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Examines goal setting in people with diabetes as part of chronic disease management in a rural setting. The studies were performed in Eyre Peninsula with a significant (10-20%) Aboriginal population.
Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005
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Mills, David (Peter David Duncombe). "The role of goal setting in the diabetes case management of Aboriginal and non-Aboriginal populations in rural South Australia / David Mills." Thesis, 2005. http://hdl.handle.net/2440/38374.
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Includes publications published as a result of ideas developed in this thesis, inserted at end.Includes bibliographical references (leaves 210-242)
242 leaves
Examines goal setting in people with diabetes as part of chronic disease management in a rural setting. The studies were performed in Eyre Peninsula with a significant (10-20%) Aboriginal population.
Thesis (M.D.) -- University of Adelaide, Dept. of General Practice, 2005
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Lock, Mark John. "The participation of Indigenous people in national Indigenous health policy processes." 2008. http://repository.unimelb.edu.au/10187/6934.
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It is acknowledged that part of the failure to improve Indigenous health is due to the lack of participation of Indigenous people in national policy and decision making processes. In this three part study I investigated the nature of Indigenous people’s participation in national Indigenous health policy processes. I combined quantitative and qualitative methods through the perspective of policy networks.The first part of the study was directed at the prominence of informal networks in the evolution of Indigenous affairs policy. I aimed to determine and describe the structural location of Indigenous people in an informal network of influential people. I administered a network survey questionnaire during the period 2003/04. In a snowball nomination process influential people nominated a total of 227 influential people. Of these, 173 people received surveys of which 44 people returned surveys, a return rate of 25 per cent. I analysed the data to detect the existence of network groups; measure the degree of group interconnectivity; measure the characteristics of bonds between influential people; and I used demographic information to characterise the network and its groups. I found a stable pattern of relationships in the three features of the informal network: the whole network was diverse, and the Indigenous people were integrated and embedded in the network. It would not have existed without Indigenous people due to a combination of their greater number, their distribution throughout the network groups, and the interconnections between the groups. I argued that the findings showed that Indigenous people were fundamental in this informal network of influential people.
The second part of the study was directed at the role of national health committees in engaging with advice about Indigenous health. I aimed to describe the structural location of Indigenous people in national health committees. Using internet sites I identified 121 national health committees at the end of 2003, and obtained information from 77 committees or 64 per cent of all committees. I calculated the proportion of members who were Indigenous within each committee; the proportion of committees which were Indigenous health committees; and constructed a visual representation of the formal reporting relationship between all the committees and Cabinet. I then determined the importance of each committee in terms of a committee network using eigenvector centrality scores. Finally, I identified the linking people between the informal network and the national health committees. I found that in a traditional hierarchical view that Indigenous people and Indigenous health committees were small in number and distant from Cabinet. In contrast a network view assumes that the importance of a committee depends on the combination of the number of interlocks, comembership, and betweenness with other committees. In this network view, Indigenous health committees were similarly located to other committees. A small number of elite knowledge brokers linked the informal networks and the national health committees. I argued that the findings showed a formal systemic deficiency in the strategic location of Indigenous people.
The third part of the study was directed at the significance of inter-personal bonds between influential people in influencing policy processes. I aimed to describe the interpersonal relationships between influential people through a semi-structured interview. The interview questions were designed to elicit responses in the broad context of knowledge and influence in national Indigenous health policy processes. From a list of 47 potential interviewees I obtained 34 interviews (a response rate of 72 per cent), transcribed 32 interviews and coded them thematically. I found that underlying the episodic meetings of national health committees was the constant activities of informal networking. The influential non-Indigenous people had to pass some rules of entry in order to engage in and utilise informal processes. The interviewees demonstrated a value of connectedness in interpersonal relationships through agreement with principles such as social models of health. However, advice about Indigenous health issues may need to be continually rediscovered as it remains anchored to local contexts in a macro context where advice faces pathways that are confusing and convoluted. I argued that the findings indicated a meta-level vacuum in conceptualising the relationship between the concepts of participation and advice in national Indigenous health policy processes.
The findings from the three parts indicated three characteristics of an ongoing meta-process (informal network), absence of a meta-perspective (national health committees), and a meta-concept of participation (interviews). I suggest that they form a meta-frame of participation. In this frame the energy dispersed in the many efforts at improving Indigenous peoples‟ participation are unfocussed because of multiple and uncoordinated policy origins. Therefore I concluded that the nature of participation of Indigenous people in national Indigenous health policy processes is one of unfocussed energy.
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Her, Pey Shan, and 何佩珊. "The Study of Related Factors of Medical Care Utilization Between Aboriginal and Non-aboriginal Children." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/85189484821251604482.
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碩士高雄醫學院
公共衛生學研究所
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The purpose of this present study was to realized the difference ofmedical care existed between aboriginal and non- aboriginal children.The studyalso examined whether acculturation influenced the utilization of healthsevices. 896 children were included in the study,consisting of 316 aboriginal and580 non-aboriginal children.The survey was carried out among children bornafter 1983 from two communities.Aboriginal group lives in San-Di-Men community, and non- aboriginal group lives in a nearby community , Kao-Shu.The parentsof children filled out a questionnaire corcerning their socioenconomic status, medical belief, self-perception of their children''s health , and theirchildren''s medical behavior, physician utilization in the late month. The non- aboriginal children had 91.54% natinal health insurance coverage ,but the aboriginal children had lower proportion with 79.37%, but the coverageof national health insurance would not make difference on the utilization ofmedical service between the two groups.The non-aboriginal parents might choosemultiple medication including western , traditional , and folk medication fortheir children ,but the aboriginal parents might tend to only choose thewestern medication for their children .The proportion of aboriginal childrenwho preferred seeking medical care from providers practicing outside townshipwas higher than non-aboriginal children (p<0.01) with odds ratio of 10.35.Theaboriginal children also accepted more iatrogenic injection thannon-aboriginal children, when they had the physician consultation. In thestudy, the access to medical care might influence the number of physicianvisits between the two groups. The prevalence rate of children''s illness was 42% and the the mean numberof physician visit in one month per child was 0.81-0.83.There was nodifference between aboriginal and non-aboriginal on the prevalence rateof illness and the mean number of physician visit , but aboriginal childrenhad higher incidence rate of skin diseases and accident.The finding suggestedthat there was a little significant discrepancy between aboriginal andnon-aboriginal children on the medical service utilization and illnesspattern.But it seemed that there was no difference on the related factors ofmedical care utilization between the two groups.The impact of modernmedication on the medical service utilization was that the parentswould choose the proper medication for their c hildern when their children were ill.
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Mitchell, Jillian Mary Graham. "A matter of urgency! remote Aboriginal women's health : examining the transfer, adaptation and implementation of an established holistic Aboriginal Well Women's Health program from one remote community to another with similar needs and characteristics /." 2007. http://catalogue.flinders.edu.au/local/adt/public/adt-SFU20070725.112610/index.html.
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Lopez, Susan. "Indigenous self-determination and early childhood education and care in Victoria." 2008. http://repository.unimelb.edu.au/10187/8551.
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This thesis explores how Victoria’s early childhood community negotiates colonial constructions of Aboriginality around dualisms such as Indigenous/non Indigenous and intersecting constructions of the child as ignorant or innocent of race and power both in concert and conflict with the non Indigenous early childhood community. It found a need for a reconceptualisation of Aboriginality around complexity and multiplicity as well as continuity and uniformity. Such a reconceptualisation can better address those issues of race, culture, identity and racism that see Indigenous communities marginalised within non Indigenous early childhood programs.These negotiations around the colonial and the implications for Indigenous inclusion within the early childhood field are framed within post colonial theory which unites and connects major themes across tensions and contradictions. These themes act as a basis for each data chapter.
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McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective / Laurence James McNamara." Thesis, 1997. http://hdl.handle.net/2440/19142.
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Bibliography: p. 493-562.iv, 562 p. ; 30 cm.
Provides a philosophical and theological analysis of health care for aged persons, exploring the ways in which Roman Catholic moral theory might contribute to the development of just health care for aged Australians.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 1998?
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Parslow, Ruth Adeline. "A study of Australians' access to health services for common mental health problems." Phd thesis, 2002. http://hdl.handle.net/1885/146160.
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Harrington, Zinta. "B cell antigen D8/17 as a marker of susceptibility to rheumatic fever in Australians and The sharp end of the needle : rheumatic fever prophylaxis and concepts of care for Yolngu patients /." 2005. http://catalogue.flinders.edu.au/local/adt/public/adt-SFU20060219.200649/index.html.
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Landrie, Marty E. V. "Best practices does it mean the same thing in the Aboriginal community as it does in the health authorities when it comes to diabetes care? /." 2009. http://hdl.handle.net/10048/1029.
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Thesis (M.Sc.)--University of Alberta, 2010.A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Population Health, School of Public Health. Title from pdf file main screen (viewed on March 18, 2010). Includes bibliographical references.
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Devitt, Rebecca. "'Sweat and tears' : stolen generations activism and the National Inquiry into the separation of Aboriginal and Torres Strait Islander children from their families." Phd thesis, 2008. http://hdl.handle.net/1885/149903.
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Lovett, Raymond William. "Mob and country : a role for identity in alcohol screening for Indigenous Australians living in the ACT and region." Phd thesis, 2013. http://hdl.handle.net/1885/150701.
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Risky alcohol consumption is responsible for seven per cent of all Indigenous deaths in Australia and is a precursor to many diseases. Despite high rates of risky consumption, screening is not routine practice in primary health care and the validity of screening instruments (other than the Indigenous Risk Impact Screen) have not been performed for Indigenous peoples. Enquiring about risky alcohol use can cause discomfort for health practitioners and clients. One way of overcoming this is to create an environment free from a number of social contexts. My first aim was to assess the reliability and validity of commonly used alcohol screening instruments. This then provided an opportunity to assess the level of risky alcohol use in the study population, my second aim. My third aim was to assess whether a culturally mediated alcohol screen could improve reporting of risky alcohol consumption. It involved starting the interview with questions about the participant's 'mob and country'. My fourth aim was to determine whether the socio-cultural factors or acculturation stress reflected determinants of drinking for the study population. My final aim was to examine facilitators and moderators of risky drinking. I conducted a computer-assisted cross-sectional survey of Indigenous people (n=121) in the primary survey and 45 participants completed a re-test survey (for test re-test reliability). The surveys were conducted among Aboriginal and Torres Strait Islander people living in the Australian Capital Territory (ACT) region from July 2010 to August 2011. Participants were randomised into a 'mob-ask' screening group (n=53) and a 'screening as usual' group (n=69). Five alcohol screening instruments were administered. A modified Vancouver Index of Acculturation (VIA) were used to examine how Indigenous people viewed their participation in heritage and dominant society cultures, the Drinking Motives Questionnaire (DMQ) to examine motives for drinking and the Kessler 10 (K10) to examine psychological distress. All alcohol screening instruments were reliable, but shorter screening instruments were as reliable and valid as existing instruments. Half the participants were drinking above recommended guideline limits and the mean age of initiation to alcohol was 14 years, 13 years for males and 15 years for females. Being male, living in a dependent household situation and being excluded from education were associated with risk-taking behaviour and risky alcohol consumption. Alcohol screening instrument mean scores were higher in the 'mob-ask' screen group compared to the control group. Participants were highly integrated (had a positive association with both heritage and dominant society culture) and, as anticipated, socio-cultural factors, rather than acculturation stress, predicted risky alcohol use. Health gains achieved through reducing consumption and drinking in specific situations (particularly around children and family members) moderated drinking. Family members were also identified by participants as facilitators to drinking and risk-taking behaviour. Screening approaches for risky drinking do not require major modification but do need to be focused on younger people (from 13 years) and screening needs to be routine.
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Burnett, Kristin. "The healing work and nursing care of Aboriginal women, female medical missionaries, nursing sisters, public health nurses, and female attendants in Southern Alberta First Nations communities, 1880-1930 /." 2006. http://proquest.umi.com/pqdweb?index=2&did=1251850601&SrchMode=1&sid=4&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1195659877&clientId=5220.
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Thesis (Ph.D.)--York University, 2006. Graduate Programme in History.Typescript. Includes bibliographical references (leaves 261-280). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://proquest.umi.com/pqdweb?index=2&did=1251850601&SrchMode=1&sid=4&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1195659877&clientId=5220
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Martin, Leah J. "Outcomes of antiretroviral therapy in northern Alberta the impact of Aboriginal ethnicity and injection drug use /." Phd thesis, 2009. http://hdl.handle.net/10048/574.
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Thesis (Ph.D.)--University of Alberta, 2009.A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Department of Public Health Sciences. Title from pdf file main screen (viewed on September 20, 2009). Includes bibliographical references.