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Emden, Carolyn, Inge Kowanko, Charlotte de Crespigny, and Helen Murray. "Better medication management for Indigenous Australians: findings from the field." Australian Journal of Primary Health 11, no. 1 (2005): 80. http://dx.doi.org/10.1071/py05011.
Повний текст джерелаАнотація:
This paper reports findings from interviews and focus groups conducted within a multi-dimensional action research project concerning medication management among Indigenous Australians. Participants were Aboriginal people with mental health problems, carers and family members, and health and social service workers from different regions in South Australia. A meta-analysis of findings from each regional project component was conducted, and major themes conceptualised and developed into a coherent summary. The findings revealed problems of a magnitude not previously realised - mental health problems (including alcohol and drug problems) and medication management among Aboriginal people clearly are major issues requiring immediate and sustained attention if the health and welfare of the Australian Indigenous population are to be improved. Findings concerned eight major areas: social and emotional wellbeing issues; stressors on Aboriginal health services and providers; training for the Aboriginal health workforce; mainstream health services for Aboriginal people; trust and confidentiality within Aboriginal health services; English language literacy and numeracy skills of Aboriginal clients; remote living arrangements for many Aboriginal people; problems with alcohol use; and institutionalised and individual racism in the community at large.
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Puszka, Stefanie, Kylie M. Dingwall, Michelle Sweet, and Tricia Nagel. "E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services." JMIR Mental Health 3, no. 3 (September 19, 2016): e43. http://dx.doi.org/10.2196/mental.5837.
Повний текст джерелаАнотація:
Background Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. Objective This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians. Methods Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services. Results The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment). Conclusions There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies, implementation planning and organizational and government investment.
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Wright, Michael, Alex Brown, Patricia Dudgeon, Rob McPhee, Juli Coffin, Glenn Pearson, Ashleigh Lin, et al. "Our journey, our story: a study protocol for the evaluation of a co-design framework to improve services for Aboriginal youth mental health and well-being." BMJ Open 11, no. 5 (May 2021): e042981. http://dx.doi.org/10.1136/bmjopen-2020-042981.
Повний текст джерелаАнотація:
IntroductionMainstream Australian mental health services are failing Aboriginal young people. Despite investing resources, improvements in well-being have not materialised. Culturally and age appropriate ways of working are needed to improve service access and responsiveness. This Aboriginal-led study brings Aboriginal Elders, young people and youth mental health service staff together to build relationships to co-design service models and evaluation tools. Currently, three Western Australian youth mental health services in the Perth metropolitan area and two regional services are working with local Elders and young people to improve their capacity for culturally and age appropriate services. Further Western Australian sites will be engaged as part of research translation.Methods and analysisRelationships ground the study, which utilises Indigenous methodologies and participatory action research. This involves Elders, young people and service staff as co-researchers and the application of a decolonising, strengths-based framework to create the conditions for engagement. It foregrounds experiential learning and Aboriginal ways of working to establish relationships and deepen non-Aboriginal co-researchers’ knowledge and understanding of local, place-based cultural practices. Once relationships are developed, co-design workshops occur at each site directed by local Elders and young people. Co-designed evaluation tools will assess any changes to community perceptions of youth mental health services and the enablers and barriers to service engagement.Ethics and disseminationThe study has approval from the Kimberley Aboriginal Health Planning Forum Kimberley Research Subcommittee, the Western Australian Aboriginal Health Ethics Committee, and the Curtin University Human Research Ethics Committee. Transferability of the outcomes across the youth mental health sector will be directed by the co-researchers and is supported through Aboriginal and non-Aboriginal organisations including youth mental health services, peak mental health bodies and consumer groups. Community reports and events, peer-reviewed journal articles, conference presentations and social and mainstream media will aid dissemination.
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Westerman, Tracy. "Engaging Australian Aboriginal youth in mental health services." Australian Psychologist 45, no. 3 (September 2010): 212–22. http://dx.doi.org/10.1080/00050060903451790.
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Butler, Tony, Stephen Allnutt, Azar Kariminia, and David Cain. "Mental Health Status of Aboriginal and Non-Aboriginal Australian Prisoners." Australian & New Zealand Journal of Psychiatry 41, no. 5 (May 2007): 429–35. http://dx.doi.org/10.1080/00048670701261210.
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Objective: To compare the mental health of Aboriginal and non-Aboriginal prisoners in New South Wales. Methods: The sample consisted of a cross-sectional random sample of sentenced prisoners, and a consecutive sample of reception prisoners. The sample was drawn from 29 correctional centres (27 male, two female) across New South Wales. Overall, 1208 men (226 Aboriginal), and 262 women (51 Aboriginal) participated in the study. Mental illness was detected using the Composite International Diagnostic Interview (CIDI-A) and a number of other screening measures incorporated into the programme. Results: No differences were detected in mental illness between Aboriginal and non-Aboriginal men, apart from depression, which was lower in the latter group. Aboriginal woman were more likely than non-Aboriginal women to screen positive for symptoms of psychosis in the prior 12 months and have a higher 1 month and 12 month prevalence of affective disorder; they also had higher psychological distress scores. Suicidal thoughts and attempts were the same in both groups. Conclusions: These findings confirm that the demand for mental health services in prisons is considerable, and that Aboriginal women are one of the most vulnerable groups. Services and programmes providing an alternative to incarceration are needed, as are culturally sensitive approaches to treatment.
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Titov, Nickolai, Carlie Schofield, Lauren Staples, Blake F. Dear, and Olav Nielssen. "A comparison of Indigenous and non-Indigenous users of MindSpot: an Australian digital mental health service." Australasian Psychiatry 27, no. 4 (July 30, 2018): 352–57. http://dx.doi.org/10.1177/1039856218789784.
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Objective: To report on Aboriginal and Torres Strait Islander (Indigenous) users of MindSpot, a national service for the remote assessment and treatment of anxiety and depression. Methods: The characteristics and treatment outcomes of Indigenous patients who registered with MindSpot between January 2015 and December 2016, were compared with non-Indigenous users. Changes in psychological distress, depression and anxiety were measured using the Kessler 10-Item (K-10), Patient Health Questionnaire 9-Item (PHQ-9), and Generalised Anxiety Disorder Scale 7-Item (GAD-7), respectively. Results: Of 23,235 people who completed a MindSpot assessment between 1 January 2015 and 31 December 2016, 780 (3.4%) identified as Indigenous Australian. They had higher symptom scores, were more likely to live in a remote location, and a third reported no previous contact with mental health services. Fewer Indigenous patients enrolled in a treatment course, but those who did had similar rates of completion and similar reductions in symptoms to non-Indigenous patients. Conclusions: MindSpot treatments were effective in treating anxiety and depression in Indigenous Australians, and outcomes were similar to those of non-Indigenous patients. Services like MindSpot are a treatment option that can help overcome barriers to mental health care for Indigenous Australians.
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Dudgeon, Pat, Maddie Boe, and Roz Walker. "Addressing Inequities in Indigenous Mental Health and Wellbeing through Transformative and Decolonising Research and Practice." Research in Health Science 5, no. 3 (August 10, 2020): p48. http://dx.doi.org/10.22158/rhs.v5n3p48.
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Aim: This paper discusses the current mental health and social and emotional wellbeing in Indigenous Australian mental health and wellbeing, the gaps in research, the need for transformative and decolonising research and practice, and the opportunities and recommendations to address existing mental health inequities. Method: This paper reviews key mental health and social and wellbeing policy documents and frameworks, and examines relevant literature documenting current decolonising strategies to improve programs, services and practice. It also draws on the key findings of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP) and Transforming Indigenous Mental Health and Wellbeing research projects. In addition this work builds on the substantial work of the national Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) which outlines a range of solutions to reduce the causes, prevalence, and impact of Indigenous suicide by identifying, translating, and promoting the adoption of evidenced based best practice in Indigenous specific suicide prevention activities. Discussion and Conclusion: This paper details the challenges as well as the promise and potential of engaging in transformative and decolonising research and practice to address the existing health service inequities. Acknowledging and addressing these health inequities is an urgent and critical task given the current COVID-19 pandemic and potential for further increasing the adverse mental health and wellbeing gap for Indigenous Australians.
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de Crespigny, Charlotte, Inge Kowanko, Helen Murray, Carolyn Emden, and Scott Wilson. "Improving Indigenous health through better medication management: an overview." Australian Journal of Primary Health 11, no. 1 (2005): 17. http://dx.doi.org/10.1071/py05003.
Повний текст джерелаАнотація:
This paper provides an overview of a major South Australian research project with implications for the health of all Indigenous Australians. The researchers set out to explore the medication needs of Aboriginal people with mental health problems and found that most Aboriginal people have to deal with profound challenges to social and emotional wellbeing with significant medication implications. No previous research had investigated the problem of medication use by Aboriginal people in metropolitan, rural and remote locations to the depth and extent of this project. The research therefore is of widespread relevance and holds interest for many Indigenous and non-Indigenous individuals and groups, consumers, service providers and policy-makers. As a research team comprising Indigenous and non-Indigenous members, we were committed to implementing strategies in the course of the project with immediate benefit to project participants as well as longer-term impact on improved use of medications. The design of the project enabled these strategic interventions and we are pleased to promote this model to other researchers. Recommendations from the project concern services, coordination of care, carers and family members, workforce education, and community development. Readers are advised where the project report and other published papers can be accessed. The project was funded by the Commonwealth Department of Health and Ageing.
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Ames, David. "Australia (Melbourne)." Psychiatric Bulletin 16, no. 9 (September 1992): 552–54. http://dx.doi.org/10.1192/pb.16.9.552.
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Australia is a unique, geologically ancient island continent. Its flora and fauna are unlike those found anywhere else and the same may be said of its people, politics and health services. The population of 17.3 millions represents a multicultural mix, with an anglo-celtic core conflated by sustained post-war immigration from southern Europe, Turkey, southeast Asia and south America. One in five current Australians was born elsewhere, one in ten comes from a non-English speaking background, and a quarter of those born here have a parent who was born overseas. Aboriginals and Torres Strait Islanders form 1.4% of the total population. They have third world mortality figures but die of first world diseases, their life expectancy being 20 years less than that of other Australians. Two hundred and four years after what they see as the British invasion, their standard of living lags far behind all other socio-cultural groups in the country. Most members of the Aboriginal community do not live long enough to develop Alzheimer's disease, but it and other age-related diseases are emerging as the major determinants of health costs as Australia moves towards the 21st century.
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Liddelow-Hunt, Shakara, Ashleigh Lin, James Hector Laurent Hill, Kate Daglas, Braden Hill, Yael Perry, Mirella Wilson, and Bep Uink. "Conceptualising Wellbeing for Australian Aboriginal LGBTQA+ Young People." Youth 3, no. 1 (January 12, 2023): 70–92. http://dx.doi.org/10.3390/youth3010005.
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It is likely that young people who are both Aboriginal and Torres Strait Islander and LGBTQA+ would be at increased risk for poor mental health outcomes due to the layered impacts of discrimination they experience; however, there is very little empirical evidence focused on the mental health and wellbeing of Aboriginal and Torres Strait Islander LGBTQA+ young people. The current study represents a qualitative exploration of wellbeing among Aboriginal LGBTQA+ young people. This study consisted of semi-structured interviews and focus groups with Aboriginal LGBTQA+ young people aged 14–25 years old in the Perth metropolitan area of Western Australia. Thematic analysis identified seven major themes that were significant to participants’ wellbeing: identity, family, community, visibility, services, stigma and navigating.
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Lima, Fernando, Carrington Shepherd, Janice Wong, Melissa O’Donnell, and Rhonda Marriott. "Trends in mental health related contacts among mothers of Aboriginal children in Western Australia (1990–2013): a linked data population-based cohort study of over 40 000 children." BMJ Open 9, no. 7 (July 2019): e027733. http://dx.doi.org/10.1136/bmjopen-2018-027733.
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ObjectiveThis study examines the scale of maternal mental health related contacts among Australian Aboriginal children over time, and associations with socio-economic characteristics, geographical remoteness and maternal age.DesignA retrospective cohort study of the prevalence of maternal mental health related contacts among Aboriginal children born in Western Australia between 1990 and 2013.SettingPopulation of Western Australia with de-identified linked administrative data from the Western Australian Department of Health.ParticipantsAll Aboriginal children born in Western Australia between 1990 and 2013 and their mothers.Primary outcome measurePrevalence of maternal mental health related contacts among Aboriginal children born between 1990 and 2013. Mental health related contacts were identified using mental health related inpatient hospitalisations and outpatient contacts.ResultsAlmost 30% of cohort children were born to a mother with at least one mental health contact in the 5 years prior to birth, with 15% reported in the year prior to birth and the year post birth. There was a distinct increase in the prevalence of maternal mental health contacts between 1990 and 2013 (4–5% per year, with a peak in 2007). Maternal mental health contacts were associated with living in more disadvantaged areas and major cities, and having a mother aged over 20 years at birth.ConclusionsThe study affirms that mental health issues place a considerable burden on Aboriginal Australia, and suggests that many of the mental health issues that women develop earlier in life are chronic at the time of conception, during pregnancy and at birth. Early intervention and support for women in the earliest stages of family planning are required to alleviate the burden of mental health problems at birth and after birth. There is a clear need for policies on the development of a holistic healthcare model, with a multisector approach, offering culturally appropriate services for Aboriginal people.
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Katzenellenbogen, Judith M., Laura J. Miller, Peter Somerford, Suzanne McEvoy, and Dawn Bessarab. "Strategic information for hospital service planning: a linked data study to inform an urban Aboriginal Health Liaison Officer program in Western Australia." Australian Health Review 39, no. 4 (2015): 429. http://dx.doi.org/10.1071/ah14102.
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Objectives The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. Methods A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006–11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. Results There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital re-admissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. Conclusions Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes. What is known about the topic? The health gap between Aboriginal and non-Aboriginal Australians is well documented. Aboriginal people have significantly higher hospital utilisation rates, as well as higher rates of complications, comorbidities and discharges against medical advice (DAMA). Aboriginal patients receive most of their specialist services in hospital; however, detailed person-based analyses are limited and planning is often based on crude data. What does this paper add? This is the first analysis of linked data focusing on Aboriginal patient flows and volume and 28-day health system outcomes following hospital admission for all causes in a large metropolitan setting. Because the data were linked, admissions belonging to a single episode of care were combined, ensuring that transfers were not counted as re-admissions. Linkage also allowed follow up across time. The results highlight the main disease groups for which Aboriginal patients are admitted, how this varies by age and the high proportion of patients returning to (any) hospital within 28 days, either through EDs or as booked (pre-arranged) admissions. These data aid in the planning of hospital-based Aboriginal health liaison services. What are the implications for practitioners? The paper outlines the complexity with which many Aboriginal patients present to hospital and the risk of DAMA and re-admission. Clinical and organisational strategies can be put in place in hospitals to address these risks and ensure improved continuity of care with community-based primary health services. The Western Australian South Metropolitan Health Service is reviewing these data and will monitor the impact of the hospital-based AHLO program.
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Titov, Nickolai, Blake F. Dear, Lauren G. Staples, James Bennett-Levy, Britt Klein, Ronald M. Rapee, Gerhard Andersson, Carol Purtell, Greg Bezuidenhout, and Olav B. Nielssen. "The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives." Australian & New Zealand Journal of Psychiatry 51, no. 12 (October 12, 2016): 1227–39. http://dx.doi.org/10.1177/0004867416671598.
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Objective: The MindSpot Clinic provides online mental health services to Australian adults with anxiety and depression. This paper describes users of MindSpot between January 2013 and June 2015. Outcomes are considered against three key objectives: improving access to mental health services, improving public awareness of how to access services and providing evidence-based treatments. Method: Website traffic data were examined to determine patterns of use. Demographic characteristics, past service utilisation and reasons for contacting MindSpot were analysed. Outcomes for patients enrolled in a MindSpot treatment course were also analysed. Primary outcomes were scores on the 9-Item Patient Health Questionnaire, Generalised Anxiety Disorder 7-Item, Yale–Brown Obsessive Compulsive Scale and Post-Traumatic Stress Disorder Checklist–Civilian Version, administered at assessment, post-treatment and 3-month follow-up. Results: The website was visited by almost 500,000 Australians, of which 33,990 adults started assessments, and 25,469 people completed assessment and were eligible for analysis. Mean age was 36.4 years (standard deviation = 13.3 years; range = 18–94 years), and 72% were female. The proportion living in rural or remote regions and who identified as Aboriginal and Torres Strait Islander closely matched national statistics. The majority (82%) reported that they were not currently in contact with mental health services. Most patients sought an assessment, information about treatment options, or referral to another service, and only 24% of those completing an assessment commenced a MindSpot treatment course. Of these, large clinical effects ( d: 0.7–2.4; average symptom reductions: 25.5% to 61.6%) were found from assessment to follow-up on all outcome measures. Deterioration ranged from 1.0% to 4.3%. Conclusion: Based on the number of website visits, completed assessments and treatment outcomes, MindSpot achieved its three programme objectives. This model of service provision has considerable value as a complement to existing services, and is proving particularly important for improving access for people not using existing services.
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Jabran, S., S. Smith, Y. Fatima, and S. King. "O007 Sleep health promotion in Aboriginal and Torres Strait Islander communities: untapped potential of Indigenous youth workers as sleep coaches." SLEEP Advances 2, Supplement_1 (October 1, 2021): A4. http://dx.doi.org/10.1093/sleepadvances/zpab014.006.
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Abstract Purpose The lack of culturally appropriate sleep health programs and community-led support services are significant barriers to sleep health promotion in Indigenous communities. This project offers Australia’s first-ever training and upskilling program for Indigenous youth workers (IYWs) to work as “Sleep Coaches” in Indigenous communities. Methods Key stakeholders, i.e., community elders, service providers, Indigenous youth and sleep scientists, were consulted to develop a training program for IYWs. Stakeholder consultations ensured community ownership of the program, facilitated co-design of educational and training activities, and integrated traditional and scientific sleep health knowledge for developing sleep health resources. Results Consultations with the advisory group (n=48) identified the need for a multipronged approach for IYWs capacity building. The education and training activities are centred around sleep and include cultural training to cover Indigenous Australians’ understanding and interpretation of sleep health, youth mental health first aid training, and participation in youth alcohol and drug education workshops. For sleep education, two blocks of activities, i.e., foundation and advanced level, are offered to cover triaging, sleep education/support and monitoring. An interactive tool for diabetes education in Indigenous communities (FeltMan/FeltMum) has been adapted to offer culturally appropriate sleep education. Conclusion IYWs’ capacity building as sleep coaches is an innovative way to empower Indigenous communities to embrace sleep health. Going forward, the program will engage with youth mental health services to evaluate the program effectiveness and transferability to other Indigenous communities. There is a need to define the scope of practice and certification to ensure compliance with industry standards.
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McNamara, Bridgette, Lina Gubhaju, Louisa Jorm, David Preen, Jocelyn Jones, Grace Joshy, Carrington Shepherd, Daniel McAullay, and Sandra Eades. "Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)." BMJ Open 8, no. 3 (March 2018): e021236. http://dx.doi.org/10.1136/bmjopen-2017-021236.
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IntroductionEmpirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years.Methods and analysisThe study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA.Ethics and disseminationEthics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.
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Pearson (Eastern Kuku‐Yalanji and Torres Strait Islander), Odette, Tracy Air, Greer Humphrey, Clare Bradley, Noeleen Tunny, Alex Brown (Yuin Nation), Steven L. Wesselingh, Maria C. Inacio, and Gillian E. Caughey. "Aged care service use by Aboriginal and Torres Strait Islander people after aged care eligibility assessments, 2017–2019: a population‐based retrospective cohort study." Medical Journal of Australia 221, no. 1 (July 2024): 31–38. http://dx.doi.org/10.5694/mja2.52353.
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AbstractObjectiveTo characterise the socio‐demographic characteristics, aged and health care needs, and aged care services used by older Aboriginal and Torres Strait Islander people assessed for aged care service eligibility.Study designPopulation‐based retrospective cohort study; analysis of Registry of Senior Australians (ROSA) National Historical Cohort data.Setting, participantsAboriginal and Torres Strait Islander people aged 50 years or older who were first assessed for aged care service eligibility (permanent residential aged care, home care package, respite care, or transition care) during 1 January 2017 – 31 December 2019.Major outcome measuresSocio‐demographic and aged care assessment characteristics; health conditions and functional limitations recorded at the time of the assessment; subsequent aged care service use.ResultsThe median age of the 6209 people assessed for aged care service eligibility was 67 years (interquartile range [IQR], 60–75 years), 3626 were women (58.4%), and 4043 lived in regional to very remote areas of Australia (65.1%). Aboriginal health workers were involved in 655 eligibility assessments (10.5%). The median number of health conditions was six (IQR, 4–8); 6013 (96.9%) had two or more health conditions, and 2592 (41.8%) had seven or more. Comorbidity was most frequent among people with mental health conditions: 597 of 1136 people with anxiety (52.5%) and 1170 of 2416 people with depression (48.5%) had seven or more other medical conditions. Geriatric syndromes were recorded for 2265 people (36.5%); assistance with at least one functional activity was required by 6190 people (99.7%). A total of 6114 people (98.5%) were approved for at least one aged care service, 3218 of whom (52.6%) subsequently used these services; the first services used were most frequently home care packages (1660 people, 51.6%).ConclusionDespite the high care needs of older Aboriginal and Torres Strait Islander people, only 52% used aged care services for which they were eligible. It is likely that the health and aged care needs of older Aboriginal and Torres Strait Islander people are not being adequately met.
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Hunter, Ernest. "‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs." Australian & New Zealand Journal of Psychiatry 36, no. 5 (October 2002): 575–84. http://dx.doi.org/10.1046/j.1440-1614.2001.01040.x.
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Objective: A shortened version of a presentation to the Australian Institute of Aboriginal and Torres Strait Islander Studies, this paper raises questions regarding policy and program directions in Indigenous affairs with consequences for Indigenous health. Method: The author notes the inadequate Indigenous mental health database, and describes contemporary conflicts in the arena of Indigenous mental health, drawing on personal experience in clinical service delivery, policy and programme development. Results: Medicalized responses to the Stolen Generations report and constructions of suicide that accompanied the Royal Commission into Aboriginal Deaths in Custody are presented to demonstrate unforeseen health outcomes. Examples are also given of wellintentioned social interventions that, in the context of contemporary Indigenous society appear to be contributing to, rather than alleviating, harm. Problems of setting priorities that confront mental health service planners are considered in the light of past and continuing social disadvantage that informs the burden of mental disorder in Indigenous communities. Conclusions: The importance of acknowledging untoward outcomes of initiatives, even when motivated by concerns for social justice, is emphasized. The tension within mental health services of responding to the underpinning social issues versus providing equity in access to proven mental health services for Indigenous populations is considered.
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Bohanna, India, Michelle S. Fitts, Katrina Bird, Jennifer Fleming, John Gilroy, Adrian Esterman, Paul Maruff, and Alan R. Clough. "The Transition from Hospital to Home: Protocol for a Longitudinal Study of Australian Aboriginal and Torres Strait Islander Traumatic Brain Injury (TBI)." Brain Impairment 19, no. 3 (December 2018): 246–57. http://dx.doi.org/10.1017/brimp.2018.1.
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Background: Traumatic brain injury (TBI) is a leading cause of disability in Australia. Evidence shows that multidisciplinary rehabilitation and support in the six months following TBI is important for successful independent living and social re-integration. Despite this, access to services and supports during this period is often limited by environmental, socio-economic, geographic and cultural factors. Australian studies on outcomes after brain injury have reported primarily on non-Indigenous people. This study will investigate key sentinel events during the transition from hospital to home after a TBI in the first longitudinal study with Indigenous Australians.Method: Indigenous Australians admitted to one of three major trauma hospitals in northern Australia with a TBI, and their care givers, will be recruited. Clinical and brain injury risk factor information, along with measures of cognitive function, transition events, mental health and community re-integration will be collected at three time points prior to hospital discharge, and at three and six months post-discharge. Qualitative interviews will also be conducted. Data will be analysed using regression methods for the quantitative component, and situational analysis for the qualitative component. Annual rates of brain injury will be calculated for patients admitted to tertiary hospital facilities in the study region with a diagnosis of TBI.Discussion: Understanding the experience and events which shape the transition period is critical to determining the services and supports that may enhance transition outcomes, and ensure that such services are culturally appropriate and endorsed by Indigenous families and communities.
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Gould, Gillian S., Renee Bittoun, and Marilyn J. Clarke. "A Pragmatic Guide for Smoking Cessation Counselling and the Initiation of Nicotine Replacement Therapy for Pregnant Aboriginal and Torres Strait Islander Smokers." Journal of Smoking Cessation 10, no. 2 (March 31, 2014): 96–105. http://dx.doi.org/10.1017/jsc.2014.3.
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Smoking prevalence of pregnant Aboriginal and Torres Strait Islander women is quadruple that of pregnant women in the Australian population, and is associated with significant adverse outcomes in pregnancy. While cessation is a priority, there is as yet little evidence for effective interventions. This paper provides a pragmatic approach to addressing the complexities of smoking in pregnant Aboriginal and Torres Strait Islander peoples and informs clinicians about the initiation of nicotine replacement therapy (NRT) in pregnancy. Experts agree that nicotine replacement is safer than continuing to smoke in pregnancy. Although a pharmacotherapy-free attempt is initially recommended, if abstinence is not able to be achieved in the first few days, the women should be offered an accelerated option of NRT starting with oral forms and then, if required, progressing to nicotine patch or combined oral and transdermal therapy. Support should be offered for at least 12 weeks and post-partum. Offering counselling and cessation support to partners and family is also important, as is linking the woman in with appropriate social and community support and Aboriginal specific services. As long as oral forms of NRT are not included in the Pharmaceutical Benefit Scheme for Aboriginal and Torres Strait Islander women a significant and inequitable barrier will remain.
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Chan, Ai Wen, Petra Skeffington, Corinne Reid, and Rhonda Marriott. "Research protocol for the exploration of experiences of Aboriginal Australian mothers and healthcare professionals when using the Edinburgh Postnatal Depression Scale: a process-oriented validation study using triangulated participatory mixed methods." BMJ Open 8, no. 10 (October 2018): e022273. http://dx.doi.org/10.1136/bmjopen-2018-022273.
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IntroductionAdopting a process-oriented framework for test validation can help to establish whether this tool has the potential to be an acceptable, valid and reliable indicator of depression for mothers and mothers-to-be. This mixed-methods research protocol seeks to explore the views and experiences of Aboriginal mothers and healthcare professionals in relation to the Edinburgh Postnatal Depression Scale (EPDS), and is intended to highlight potential barriers in perinatal mental health conceptualisation, engagement and response style.Methods and analysisThematic analysis will be applied to interview transcripts of Aboriginal Australian mothers (n=6+) and healthcare professionals (n=6+) to identify key themes. The process-focused validation model will use narratives about experiences of using the EPDS as the priority point of analysis. Item-level data and process-level (experience) data are key phenomenological data. The interview-based narratives will be then compared with EPDS scores to check for points of congruence and divergence. This will be done at two time points, antenatally and postnatally, to assess changes in assessment processes and perceptions. Bridging evidence-based research with clinical practice in an Aboriginal Australian context will be facilitated by an investigation of the perceived cultural relevance and likely clinical effectiveness of EPDS. Such evidence is critical to understanding whether the EPDS fulfils its intended purpose. The guiding principles in designing this research protocol is to benefit the well-being of young Aboriginal families and communities through partnership with Aboriginal women.Ethics and disseminationEthics approval was obtained from Human Research Ethics Committee of Murdoch University and from Western Australian Aboriginal Health Ethics Committee (WAAHEC). Participating healthcare sites and services have provided letters of support. Results of this study will be submitted for publication in a peer-reviewed journal.
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Charlson, Fiona, Bruce Gynther, Karin Obrecht, Ed Heffernan, Michael David, Jesse T. Young, and Ernest Hunter. "Incarceration among adults living with psychosis in Indigenous populations in Cape York and the Torres Strait." Australian & New Zealand Journal of Psychiatry 55, no. 7 (January 21, 2021): 678–86. http://dx.doi.org/10.1177/0004867420985247.
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Objective: The relationship between psychosis and contact with the criminal justice system for Indigenous people living in rural and remote areas is not well understood. In this study, the authors examine patterns of incarceration among Indigenous people living with psychosis in Cape York and the Torres Strait over two decades. Methods: Data were collated from a clinical database of complete psychiatric records from 1992 to 2015, extracted for all Indigenous patients with a psychotic disorder from the Remote Area Mental Health Service, and linked to the Queensland Corrections Service database. Descriptive statistics were calculated to compare characteristics between those incarcerated and those not incarcerated during the study period and to quantify patterns of incarceration including types of offences, time spent in custody and frequency of incarceration. Multivariate Cox regression analysis was used to assess associations between reported variables and ‘first incarceration’. Results: Forty-five percent of Aboriginal patients ( n = 116) were incarcerated compared with 31% of Torres Strait Islanders ( n = 41) ( p = 0.008), and the proportion of males incarcerated (51%, n = 141) was approximately twice that of females (24%, n = 35; p = 0.001). A cluster of first incarcerations were observed in close time proximity to diagnosis of psychosis. Individuals who had a history of both alcohol and cannabis use had approximately two times higher risk of being incarcerated following positive diagnosis compared to those without a history of substance use (hazard ratio = 1.85; 95% confidence interval: [1.08, 3.17]; p = 0.028). Males accounted for approximately 85% ( n = 328) of sentences. The most common most serious offence was causing physical harm to others (assault – n = 122, 31%). Conclusion: Our study found that for Aboriginal and Torres Strait Islander people with a psychotic disorder in North Queensland, criminal justice responses with resultant incarceration occurs frequently. Access to appropriate mental health services and diversion options for Indigenous Australians with psychosis should be a key public health and justice priority.
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Callander, Emily, Sarah Larkins, and Lisa Corscadden. "Variations in out-of-pocket costs for primary care services across Australia: a regional analysis." Australian Journal of Primary Health 23, no. 4 (2017): 379. http://dx.doi.org/10.1071/py16127.
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The aim of this study is to describe average out-of-pocket costs across different regions of Australia, as defined by Primary Health Network (PHN) boundaries, and assess the association between population characteristics and out-of-pocket costs for selected primary care services. A combination of descriptive and regression analysis was undertaken using administrative data from the Australian Department of Human Services reporting on the health services used across PHNs in Australia. Those in regional areas paid significantly more for Allied Health services than those in capital cities (A$5.68, P=0.006). The proportion of an area’s population aged 65 years and over was inversely related to out-of-pocket charges for Allied Mental Health (–A$79.12, P=0.029). Some areas had both high charges and disadvantaged populations: Country South Australia, Northern Queensland, Country Western Australia, Tasmania and Northern Territory, or populations with poor health: Northern Territory and Tasmania. Although there was a large amount of variation in out-of-pocket charges for primary care services between PHNs in Australia, there was little evidence of inequality based on health, age and socioeconomic characteristics of a population or the proportion of Aboriginal and Torres Strait Islander people.
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Batchelor, Madeleine, Stephanie J. Brown, Karen Glover, and Deirdre Gartland. "A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand." International Journal of Environmental Research and Public Health 18, no. 23 (December 1, 2021): 12669. http://dx.doi.org/10.3390/ijerph182312669.
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While much is known about the health implications of low birthweight for infants and adults, there is limited information about the health implications in childhood, particularly for Indigenous children. The aim of this systematic review was to assess associations between low birthweight (LBW) and/or small for gestational age (SGA) and the developmental, physical or mental health outcomes for Australian, Canadian and New Zealand Indigenous children (5–12 years), including the potential mediating role of cultural connections. The review was guided by an Aboriginal Advisory Group established to guide the Aboriginal Families Study. Four databases were investigated with pre-determined inclusion/exclusion criteria. The search identified 417 articles after independent screening by two authors. Eight studies assessing six child outcomes were included. The review identified limited evidence, although the review suggested possible links between LBW and/or SGA and childhood asthma, lower body mass index (BMI) and poorer academic performance. Links between LBW, SGA and disability, global health and developmental vulnerability were inconclusive. One study identified cultural-based resilience as protective against perinatal adversity. In summary, research on the relationship between adverse birth outcomes and Indigenous children’s health and development is limited. Further investigation and collaboration with Indigenous communities is required to drive optimised health and social services responses and equitable system reform.
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McCalman, Janya Robyn, Ruth Fagan, Tina McDonald, Semara Jose, Paul Neal, Ilse Blignault, Deborah Askew, and Yvonne Cadet-James. "The Availability, Appropriateness, and Integration of Services to Promote Indigenous Australian Youth Wellbeing and Mental Health: Indigenous Youth and Service Provider Perspectives." International Journal of Environmental Research and Public Health 20, no. 1 (December 26, 2022): 375. http://dx.doi.org/10.3390/ijerph20010375.
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Concerns about the complexity, fragmentation and inefficiency of Australia’s current youth mental health service systems have led policy makers to seek improvements through a shift to community-based solutions. However, there is little evidence of how communities can make this shift. This paper examines the efforts of one Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) community—Yarrabah in north Queensland—to develop strategies for mental health and wellbeing service system improvements for school-aged youth (5–18 years). The research was co-designed with Yarrabah’s community-controlled health service and explores the perceptions of Yarrabah youth and service providers. Iterative grounded theory methods were used to collect and analyse data from 32 youth aged 11–24 years and 24 service providers. Youth were reluctant to seek help, and did so only if they felt a sense of safety, trust, relationality and consistency with providers. Young people’s four suggestions for improvement were access to (1) information and awareness about mental health; (2) youth facilities, spaces and activities; (3) safe and available points of contact; and (4) support for recovery from mental illness. Service providers highlighted an appetite for youth-guided community change and recommended five improvement strategies: (1) listening to youth, (2) linking with community members, (3) providing wellbeing promotion programs, (4) intervening early, and (5) advocating to address the determinants of youth mental health. Overall, both groups realised a disjunct between youth need and service provision, but a willingness to work together for systems change. This study demonstrates the importance of community-driven efforts that harness both youth and service providers’ perspectives, and suggests a need for ongoing dialogue as the basis for co-designing and implementing improvements to wellbeing supports and mental health services for Indigenous youth.
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Perdacher, Elke, David Kavanagh, Jeanie Sheffield, Karyn Healy, Penny Dale, and Edward Heffernan. "Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study." JMIR Formative Research 6, no. 4 (April 8, 2022): e32157. http://dx.doi.org/10.2196/32157.
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Background The gap between mental health needs and resources for Aboriginal and Torres Strait Islander people, the Indigenous people of Australia, is most marked in the prison population. Indigenous people are overrepresented in Australian prisons. In prison, this group experiences mental disorders to a greater degree than non-Indigenous prisoners. This group has also been found to experience mental disorder at a higher rate than Indigenous people in the community. In addition to pre-existing determinants of poor mental health, these high prevalence rates may reflect poor engagement in mainstream interventions or the efficacy of available interventions. In community populations, the use of digital mental health resources may help to increase access to well-being support. However, culturally appropriate digital tools have not been available to Indigenous people in prisons. The absence of feasibility and efficacy studies of these tools needs to be addressed. Objective The aim of this study is to determine the feasibility of the Stay Strong app as a digital well-being and mental health tool for use by Indigenous people in prison. Methods Dual government agency (health and corrective services) precondition requirements of implementation were identified and resolved. This was essential given that the Stay Strong app was to be delivered by an external health agency to Indigenous prisoners. Then, acceptability at a practice level was tested using postuse qualitative interviews with clients and practitioners of the Indigenous Mental Health Intervention Program. All Indigenous Mental Health Intervention Program practitioners (10/37, 27%) and client participants who had completed their second follow-up (review of the Stay Strong app; 27/37, 73%) during the study period were invited to participate. Results Owing to the innovative nature of this project, identifying and resolving the precondition requirements of implementation was challenging but provided support for the implementation of the app in practice. Acceptability of the app by clients and practitioners at a practice level was demonstrated, with nine themes emerging across the interviews: satisfaction with the current Stay Strong app, supported client goal setting, increased client self-insight, improved client empowerment, cultural appropriateness, enhanced engagement, ease of use, problems with using an Android emulator, and recommendations to improve personalization. Conclusions The Stay Strong Custody Project is a pioneering example of digital mental health tools being implemented within Australian prisons. Using the app within high-security prison settings was found to be feasible at both strategic and practice levels. Feedback from both clients and practitioners supported the use of the app as a culturally safe digital mental health and well-being tool for Aboriginal and Torres Strait Islander people in prison.
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Conigrave, James H., Kristie H. Harrison, K. S. Kylie Lee, Timothy A. Dobbins, Beth Hummerston, Noel Hayman, Jimmy Perry, et al. "Support can increase use of the AUDIT‐C in Australian Aboriginal Community Controlled Health Services: a cluster randomized trial." Addiction 116, no. 9 (February 17, 2021): 2304–15. http://dx.doi.org/10.1111/add.15428.
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Doyle, Kerrie. "Measuring cultural appropriateness of mental health services for Australian Aboriginal peoples in rural and remote Western Australia: a client/clinician's journey." International Journal of Culture and Mental Health 5, no. 1 (April 2012): 40–53. http://dx.doi.org/10.1080/17542863.2010.548915.
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Allan, Julaine, and Michele Campbell. "Improving Access to Hard-to-Reach Services: A Soft Entry Approach to Drug and Alcohol Services for Rural Australian Aboriginal Communities." Social Work in Health Care 50, no. 6 (July 2011): 443–65. http://dx.doi.org/10.1080/00981389.2011.581745.
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Lawler, Kate, Mithilesh Dronavalli, Andrew Page, Evelyn Lee, Hannah Uebel, Barbara Bajuk, Lucinda Burns, et al. "‘Joining the Dots: Linking Prenatal Drug Exposure to Childhood and Adolescence’ – research protocol of a population cohort study." BMJ Paediatrics Open 8, no. 1 (April 2024): e002557. http://dx.doi.org/10.1136/bmjpo-2024-002557.
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IntroductionPrenatal drug exposure (PDE) is one of the most important causes of child harm, but comprehensive information about the long-term outcomes of the families is difficult to ascertain. TheJoining the Dotscohort study uses linked population data to understand the relationship between services, therapeutic interventions and outcomes of children with PDE.Methods and analysisInformation from routinely collected administrative databases was linked for all births registered in New South Wales (NSW), Australia between 1 July 2001 and 31 December 2020 (n=1 834 550). Outcomes for seven mutually exclusive groups of children with varying prenatal exposure to maternal substances of addiction, including smoking, alcohol, prescription/illicit drugs and neonatal abstinence syndrome will be assessed. Key exposure measures include maternal drug use type, maternal social demographics or social determinants of health, and maternal physical and mental health comorbidities. Key outcome measures will include child mortality, academic standardised testing results, rehospitalisation and maternal survival. Data analysis will be conducted using Stata V.18.0.Ethics and disseminationApprovals were obtained from the NSW Population and Health Services Research Ethics Committee (29 June 2020; 2019/ETH12716) and the Australian Capital Territory Health Human Research Ethics Committee (11 October 2021; 2021-1231, 2021-1232, 2021-1233); and the Aboriginal Health and Medical Research Council (5 July 2022; 1824/21), and all Australian educational sectors: Board of Studies (government schools), Australian Independent Schools and Catholic Education Commission (D2014/120797). Data were released to researchers in September 2022. Results will be presented in peer-reviewed academic journals and at international conferences. Collaborative efforts from similar datasets in other countries are welcome.
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Williams, Robyn, and Dorothy E. Badry. "Aboriginal Kinship Carers and Children with Fetal Alcohol Spectrum Disorder in Western Australia: Advancing Knowledge from an Indigenous and Disability Lens." First Peoples Child & Family Review 18, no. 1 (February 20, 2024): 60–80. http://dx.doi.org/10.7202/1109655ar.
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Children and youth with fetal alcohol spectrum disorder (FASD) have limited access to assessment, diagnostic, and treatment resources – a distinct disadvantage in meeting their care needs in Australia. Limited knowledge exists on the intersection of FASD, Indigeneity, racism, trauma, and child welfare involvement. Notably, the lack of support for children with FASD increases the risk of adverse outcomes, including incarceration, homelessness, mental health problems, and early mortality. Children with FASD are often cared for in the child protection system by kinship carers, many without a diagnosis or the benefits of FASD informed care. Rarely considered is the Australian response to FASD or the Aboriginal worldview on disability. Qualitative research was utilized to conduct semi-structured interviews with six carers of Indigenous children with FASD–three foster carers and three relative or kinship carers. Seven core themes identified by carers included: FASD awareness, caregiver health, advocacy for the child, mothers of the children with FASD, loss and grief experienced by the carer, social costs, and children in child protection care. Carers identified that limited resources existed to address the disabilities and care needs of children, including training and respite. Financial disparity exists with relative carers receiving less income than foster carers. Carers demonstrated advocacy, resiliency, and resourcefulness in providing care. A lack of knowledge of FASD and core resources in child welfare services were identified as major challenges in providing care. This research examined the caregiving experiences of foster and Aboriginal kinship carers, caring for children with FASD in child protection.
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Nancarrow, Susan A., Alison Roots, Sandra Grace, and Vahid Saberi. "Models of care involving district hospitals: a rapid review to inform the Australian rural and remote context." Australian Health Review 39, no. 5 (2015): 494. http://dx.doi.org/10.1071/ah14137.
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Objectives District hospitals are important symbolic structures in rural and remote communities; however, little has been published on the role, function or models of care of district hospitals in rural and remote Australia. The aim of the present study was to identify models of care that incorporate district hospitals and have relevance to the Australian rural and remote context. Methods A systematic, rapid review was conducted of published peer-reviewed and grey literature using CINAHL, Medline, PsychInfo, APAIS-Health, ATSI health, Health Collection, Health & Society, Meditext, RURAL, PubMed and Google Scholar. Search terms included ‘rural’, ‘small general and district hospitals’, ‘rural health services organisation & administration’, ‘medically underserved area’, ‘specific conditions, interventions, monitoring and evaluation’, ‘regional, rural and remote communities’, ‘NSW’, ‘Australia’ and ‘other OECD countries’ between 2002 and 2013. Models of teaching and education, multipurpose services centres, recruitment and/or retention were excluded. Results The search yielded 1626 articles and reports. Following removal of duplicates, initial screening and full text screening, 24 data sources remained: 21 peer-reviewed publications and three from the grey literature. Identified models of care related specifically to maternal and child health, end-of-life care, cancer care services, Aboriginal health, mental health, surgery and emergency care. Conclusion District hospitals play an important role in the delivery of care, particularly at key times in a person’s life (birth, death, episodes of illness). They enable people to remain in or near their own community with support from a range of services. They also play an important role in the essential fabric of the community and the vertical integration of the health services. What is known about the topic? Little has been published on the function of small-to-medium district hospitals in rural and remote Australia, and almost nothing is known about models of care that are relevant to these settings. What does this paper add? District hospitals form an important part of vertically integrated models of care in Australia. Effective models of care aim to keep health services close to home. There is scope for networked models of care that keep health care within the community supported by hub-and-spoke models of service delivery. What are the implications for practitioners? This review found limited evidence on the skill mix required in district hospitals; however, the skill mix underpins the extent of service and speciality that can be provided locally, particularly with regard to the provision of surgery and emergency services. International evidence suggests that providing surgical services locally can help increase the sustainability of smaller hospitals because they typically provide high return, short episodes of care; however, this depends on the funding model being used. Similarly, the skill mix of staff required to sustain a functioning emergency department brings a skill base that supports a higher level of expertise across the hospital.
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Luke, Carly R., Katherine Benfer, Leeann Mick-Ramsamy, Robert S. Ware, Natasha Reid, Arend F. Bos, Margot Bosanquet, and Roslyn N. Boyd. "Early detection of Australian Aboriginal and Torres Strait Islander infants at high risk of adverse neurodevelopmental outcomes at 12 months corrected age: LEAP-CP prospective cohort study protocol." BMJ Open 12, no. 1 (January 2022): e053646. http://dx.doi.org/10.1136/bmjopen-2021-053646.
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IntroductionNeurodevelopmental disorders (NDD), including cerebral palsy (CP), autism spectrum disorder (ASD) and foetal alcohol spectrum disorder (FASD), are characterised by impaired development of the early central nervous system, impacting cognitive and/or physical function. Early detection of NDD enables infants to be fast-tracked to early intervention services, optimising outcomes. Aboriginal and Torres Strait Islander infants may experience early life factors increasing their risk of neurodevelopmental vulnerability, which persist into later childhood, further compounding the health inequities experienced by First Nations peoples in Australia. The LEAP-CP prospective cohort study will investigate the efficacy of early screening programmes, implemented in Queensland, Australia to earlier identify Aboriginal and Torres Strait Islander infants who are ‘at risk’ of adverse neurodevelopmental outcomes (NDO) or NDD. Diagnostic accuracy and feasibility of early detection tools for identifying infants ‘at risk’ of a later diagnosis of adverse NDO or NDD will be determined.Methods and analysisAboriginal and/or Torres Strait Islander infants born in Queensland, Australia (birth years 2020–2022) will be invited to participate. Infants aged <9 months corrected age (CA) will undergo screening using the (1) General Movements Assessment (GMA); (2) Hammersmith Infant Neurological Examination (HINE); (3) Rapid Neurodevelopmental Assessment (RNDA) and (4) Ages and Stages Questionnaire-Aboriginal adaptation (ASQ-TRAK). Developmental outcomes at 12 months CA will be determined for: (1) neurological (HINE); (2) motor (Peabody Developmental Motor Scales 2); (3) cognitive and communication (Bayley Scales of Infant Development III); (4) functional capabilities (Paediatric Evaluation of Disability Inventory-Computer Adaptive Test) and (5) behaviour (Infant Toddler Social and Emotional Assessment). Infants will be classified as typically developing or ‘at risk’ of an adverse NDO and/or specific NDD based on symptomology using developmental and diagnostic outcomes for (1) CP (2) ASD and (3) FASD. The effects of perinatal, social and environmental factors, caregiver mental health and clinical neuroimaging on NDOs will be investigated.Ethics and disseminationEthics approval has been granted by appropriate Queensland ethics committees; Far North Queensland Health Research Ethics Committee (HREC/2019/QCH/50533 (Sep ver 2)-1370), the Townsville HHS Human Research Ethics Committee (HREC/QTHS/56008), the University of Queensland Medical Research Ethics Committee (2020000185/HREC/2019/QCH/50533) and the Children’s Health Queensland HHS Human Research Ethics Committee (HREC/20/QCHQ/63906) with governance and support from local First Nations communities. Findings from this study will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberACTRN12619000969167.
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Laugharne, Jonathan. "Poverty and mental health in Aboriginal Australia." Psychiatric Bulletin 23, no. 6 (June 1999): 364–66. http://dx.doi.org/10.1192/pb.23.6.364.
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When the Australian Governor General, Sir William Deane, referred in a speech in 1996 to the “appalling problems relating to Aboriginal health” he was not exaggerating. The Australia Bureau of Statistics report on The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples (McLennan & Madden, 1997) outlines the following statistics. The life expectancy for Aboriginal Australians is 15 to 20 years lower than for non-Aboriginal Australians, and is lower than for most countries of the world with the exception of central Africa and India. Aboriginal babies are two to three times more likely to be of lower birth weight and two to four times more likely to die at birth than non-Aboriginal babies. Hospitalisation rates are two to three times higher for Aboriginal than non-Aboriginal Australians. Death rates from infectious diseases are 15 times higher among Aboriginal Australians than non-Aboriginal Australians. Rates for heart disease, diabetes, injury and respiratory diseases are also all higher among Aboriginals – and so the list goes on. It is fair to say that Aboriginal people have higher rates for almost every type of illness for which statistics are currently recorded.
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Durey, A., D. McAullay, B. Gibson, and L. M. Slack-Smith. "Oral Health in Young Australian Aboriginal Children." JDR Clinical & Translational Research 2, no. 1 (September 27, 2016): 38–47. http://dx.doi.org/10.1177/2380084416667244.
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Despite dedicated government funding, Aboriginal Australians, including children, experience more dental disease than other Australians, despite it being seen as mostly preventable. The ongoing legacy of colonization and discrimination against Aboriginal Australians persists, even in health services. Current neoliberal discourse often holds individuals responsible for the state of their health, rather than the structural factors beyond individual control. While presenting a balanced view of Aboriginal health is important and attests to Indigenous peoples’ resilience when faced with persistent adversity, calling to account those structural factors affecting the ability of Aboriginal people to make favorable oral health choices is also important. A decolonizing approach informed by Indigenous methodologies and whiteness studies guides this article to explore the perceptions and experiences of Aboriginal parents ( N = 52) of young children, mainly mothers, in Perth, Western Australia, as they relate to the oral health. Two researchers, 1 Aboriginal and 1 non-Aboriginal, conducted 9 focus group discussions with 51 Aboriginal participants, as well as 1 interview with the remaining individual, and independently analyzed responses to identify themes underpinning barriers and enablers to oral health. These were compared, discussed, and revised under key themes and interpreted for meanings attributed to participants’ perspectives. Findings indicated that oral health is important yet often compromised by structural factors, including policy and organizational practices that adversely preclude participants from making optimal oral health choices: limited education about prevention, prohibitive cost of services, intensive marketing of sugary products, and discrimination from health providers resulting in reluctance to attend services. Current government intentions center on Aboriginal–non-Aboriginal partnerships, access to flexible services, and health care that is free of racism and proactively seeks and welcomes Aboriginal people. The challenge is whether these good intentions are matched by policies and practices that translate into sustained improvements to oral health for Aboriginal Australians. Knowledge Transfer Statement: Slow progress in reducing persistent oral health disparities between Aboriginal and non-Aboriginal Australians calls for a new approach to this seemingly intractable problem. Findings from our qualitative research identified that structural factors—such as cost of services, little or no education on preventing oral disease, and discrimination by health providers—compromised Aboriginal people’s optimum oral health choices and access to services. The results from this study can be used to recommend changes to policies and practices that promote rather than undermine Aboriginal health and well-being and involve Aboriginal people in decisions about their health care.
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Daws, Karen, Amanda Punch, Michelle Winters, Sonia Posenelli, John Willis, Andrew MacIsaac, Muhammad Aziz Rahman, and Linda Worrall-Carter. "Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care." Australian Health Review 38, no. 5 (2014): 552. http://dx.doi.org/10.1071/ah13211.
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Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients’ admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. What is known about the topic? Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome. This may contribute to the life expectancy gap between Aboriginal and non-Aboriginal Australians. What does this paper add? This paper describes a model of care involving an Aboriginal Hospital Liaisons Officer and a specialist cardiac nurse working together to improve hospital care and attendance at cardiac rehabilitation services for Aboriginal Australians with acute coronary syndrome. What are the implications for practitioners? The working together model of care could be implemented across mainstream health services where Aboriginal people attend for specialist care.
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Gwynne, Kylie, Thomas Jeffries Jr, and Michelle Lincoln. "Improving the efficacy of healthcare services for Aboriginal Australians." Australian Health Review 43, no. 3 (2019): 314. http://dx.doi.org/10.1071/ah17142.
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Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.
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Henderson, Scott, and GA Broe. "Dementia in Aboriginal Australians." Australian & New Zealand Journal of Psychiatry 44, no. 10 (October 2010): 869–71. http://dx.doi.org/10.3109/00048674.2010.514858.
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Street, Gillian. "The HOP Pilot: A collaboration to develop an integrated person-centred model for vulnerable people to feel safe accessing health support." International Journal of Integrated Care 23, S1 (December 28, 2023): 499. http://dx.doi.org/10.5334/ijic.icic23186.
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Introduction: Using a partner-development framework, 29 government, private, educational, and not-for-profit organisations, across two West Australian Local Governments, developed a person-centred model to tackle barriers experienced by vulnerable community members for accessing treatment and health programs.
Target group: “Vulnerable” is a broad term that includes disability, mental health issues, Aboriginal, other cultural diversity, elderly, and low socio-economic status. Those with the highest health needs are often least likely to access services. Challenges for engagement include ignorance, lack of understanding by both service-providers and consumers, and absence of inter-sectoral collaboration. Trust and relationship-building can take years.
Stakeholders: As the pilot timeframe was short, the insights of identified community champions and those working closely with vulnerable communities were sought to facilitate a supportive person-centred model, tailored to identified local needs. Partners included State and Local Government departments, not-for-profit agencies, universities, and the private sector. (Links for partner details are available at: https://cihealth.com.au/the-hop-healthy-outreach-program/)
Collaborative Development of Participant Journey Model: The HOP, chosen for its lively sound rather than the acronym of Healthy Outreach Program, was resourced by the Western Australian Primary Health Alliance (WAPHA) to adapt Cockburn Integrated Health’s existing healthy lifestyle service to meet the needs of neighbouring local government areas. The partnering process was:
Review of extant models > snowball organisation recruitment > one-to-one stakeholder interviews > mapping of strengths, gaps and opportunities > draft for proposed participant journey model > a full-day workshop to finalise the model, culminating in program-naming and signing of “The Coalition of the Willing”.
Results of Collaboration: Consultation and collaboration elucidated several service gaps and barriers to engagement. In many cases, immediate solutions were discovered through coordinated networking. For example, one park’s usual activities of fights, drug deals, and drinking were replaced for one day a week with exercise sessions, on-demand psychological help, and displays created by supervised nutrition students with free (donated) fruit and customised resources. By offering health-enablers in settings already attended by vulnerable people, a supportive environment became accessible. Peer mentors and outreach workers (known as “HOP Guides”) received interactive training to augment engagement and sustained participation. A recommendation for choice inspired a hierarchy for levels of health assessment and commitment to participation: HOP to Good, HOP to Better, and HOP to Best. Resource-sharing of a colour-in wellness wheel allowed an icebreaking, appealing self-assessment tool.
Learning: Tailoring and integration of services to meet local needs, peer mentorship, and dedicated networking opportunities were similar to the five-year-old Cockburn service. Differences included greater vulnerabilities and higher needs of HOP participants, short timeframe of the pilot, and HOP Guide training. The dedicated coordinator role was deemed essential to the partnership success. The inclusive consultation process resulted in a sense of ownership for participating stakeholders and is recommended as a framework for similar partnership development initiatives.
Next Steps: Two-and-a half-years post-workshop, in March 2023, HOP partners will be re-interviewed to assess sustained outcomes of the pilot program. These strengths will be disseminated to interested parties to inform future program planning.
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Shahid, Shaouli, Lizzie Finn, Dawn Bessarab, and Sandra C. Thompson. "'Nowhere to room … nobody told them': logistical and cultural impediments to Aboriginal peoples' participation in cancer treatment." Australian Health Review 35, no. 2 (2011): 235. http://dx.doi.org/10.1071/ah09835.
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Background. Cancer mortality among Indigenous Australians is higher compared to the non-Indigenous population and attributed to poor access to cancer detection, screening, treatment and support services. A large proportion of Indigenous Australians live in rural and remote areas which makes access to cancer treatment services more challenging. Factors, such as transport, accommodation, poor socio-economic status and cultural appropriateness of services also negatively affect health service access and, in turn, lead to poor cancer outcomes. Design, setting and participants. Qualitative research with 30 in-depth interviews was conducted with Aboriginal people affected by cancer from across WA, using a variety of recruitment approaches. Results. The infrastructure around the whole-of-treatment experience affected the decision-making and experiences of Aboriginal patients, particularly affecting rural residents. Issues raised included transport and accommodation problems, travel and service expenses, displacement from family, concerns about the hospital environment and lack of appropriate support persons. These factors are compounded by a range of disadvantages already experienced by Aboriginal Australians and are vital factors affecting treatment decision-making and access. Conclusion. To improve cancer outcomes for Aboriginal people, logistical, infrastructure and cultural safety issues must be addressed. One way of ensuring this could be by dedicated support to better coordinate cancer diagnostic and treatment services with primary healthcare services. What is known about the topic? Cancer is a major cause of death among Indigenous Australians who are generally diagnosed later with their disease, have poorer continuity of care and lower uptake and completion of cancer treatment. For cancer diagnosis at an equivalent stage of cancer, Aboriginal people have poorer outcomes. What does this paper add? This study documents Aboriginal perspectives on basic infrastructure and logistical problems which impede their accessing hospital-based cancer treatments: transport, accommodation, preparation for the experience of hospital and cancer treatment, service affordability and the certainty of support services. What are the implications for practitioners? There are difficulties for practitioners in addressing the geographic, socioeconomic and cultural differences that Aboriginal people face in accessing cancer treatment. System level changes to ensure cultural safety, social support and better coordination with primary healthcare are essential to improve outcomes of Aboriginal people with cancer.
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Wettasinghe, Pamela Ming, Wendy Allan, Gail Garvey, Alison Timbery, Sue Hoskins, Madeleine Veinovic, Gail Daylight, et al. "Older Aboriginal Australians’ Health Concerns and Preferences for Healthy Ageing Programs." International Journal of Environmental Research and Public Health 17, no. 20 (October 10, 2020): 7390. http://dx.doi.org/10.3390/ijerph17207390.
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While there is strong evidence of the need for healthy ageing programs for older Aboriginal Australians, few are available. It is important to understand older Aboriginal Australians’ perspectives on healthy ageing in order to co-design culturally-appropriate programs, including views on technology use in this context. Semi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ health concerns, preferences for healthy ageing programs, and receptiveness to technology. Qualitative data were analyzed using a grounded theory approach. This study found that older Aboriginal Australians are concerned about chronic health conditions, social and emotional well-being, and difficulties accessing health services. A range of barriers and enablers to participation in current health programs were identified. From the perspective of older Aboriginal people, a successful healthy ageing program model includes physical and cognitive activities, social interaction, and health education. The program model also provides culturally safe care and transport for access as well as family, community, cultural identity, and empowerment regarding ageing well as central tenets. Technology could also be a viable approach for program delivery. These findings can be applied in the implementation and evaluation of culturally-appropriate, healthy ageing programs with older Aboriginal people.
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Phillips, Christine B., Mahomed S. Patel, and Yolanda Cabaron. "Utilisation of health services by Aboriginal Australians with diabetes." Diabetes Research and Clinical Practice 20, no. 3 (June 1993): 231–39. http://dx.doi.org/10.1016/0168-8227(93)90083-h.
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DiGiacomo, Michelle L., Sandra C. Thompson, Julie S. Smith, Kate P. Taylor, Lynette A. Dimer, Mohammed A. Ali, Marianne M. Wood, Timothy G. Leahy, and Patricia M. Davidson. "'I don't know why they don't come': barriers to participation in cardiac rehabilitation." Australian Health Review 34, no. 4 (2010): 452. http://dx.doi.org/10.1071/ah09803.
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Objectives. To describe health professionals’ perceptions of Aboriginal people’s access to cardiac rehabilitation (CR) services and the role of institutional barriers in implementing the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander peoples. Design. Qualitative study. Setting. Metropolitan and rural tertiary and community-based public CR services and Aboriginal health services in WA. Participants. Thirty-eight health professionals working in the CR setting. Method. Semistructured interviews were undertaken with 28 health professionals at public CR services and 10 health professionals from Aboriginal Medical Services in WA. The participants represented 17 services (10 rural, 7 metropolitan) listed in the WA Directory of CR services. Results. Emergent themes included (1) a lack of awareness of Aboriginal CR patients’ needs; (2) needs related to cultural awareness training for health professionals; and (3) Aboriginal health staff facilitate access for Aboriginal patients. Conclusions. Understanding the institutional barriers to Aboriginal participation in CR is necessary to recommend viable solutions. Promoting cultural awareness training, recruiting Aboriginal health workers and monitoring participation rates are important in improving health outcomes. What is already known about this subject? Significant health and social inequity exists for Aboriginal Australians. Despite the persisting high rates of morbidity and mortality related to cardiovascular disease in Aboriginal Australians, participation rates in cardiac rehabilitation remain low. What does this paper add? Despite widespread dissemination of NHMRC guidelines, there remains a disconnect between CR health professionals’ understandings and practices and the needs of Aboriginal people in WA. Increasing the volume and quality of cultural awareness training as well as access to Aboriginal health professionals are crucial in addressing this disparity. What are the implications for practitioners? Increasing the number and support of Aboriginal people trained as health professionals will assist the system to respond better to the needs of communities. Collaborative partnership models where Aboriginal and non-Aboriginal health professionals work together to increase mutual understanding are warranted.
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GRACEY, MICHAEL. "Substance misuse in Aboriginal Australians." Addiction Biology 3, no. 1 (January 1998): 29–46. http://dx.doi.org/10.1080/13556219872326.
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Rege, Sanil. "State of indigenous mental health in Australia - a colonial legacy?" International Psychiatry 6, no. 4 (October 2009): 98–100. http://dx.doi.org/10.1192/s1749367600000801.
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The Aboriginal culture of Australia is one of the oldest cultures on earth, dating back 50 000 years. The Aboriginal and Torres Strait Islander (ATSI) people are the indigenous inhabitants of Australia, constituting 2.4% of the population. The health status of these ‘First Australians’ has been described as a source of national shame, with the life expectancy approximately 17 years lower than that of other Australians (Eades, 2000). This gap in life expectancy is also significantly larger than that of other countries with indigenous populations and a history of colonisation, such as the USA, Canada and New Zealand (Ring & Firman, 1998). This paper offers an overview of the impact of colonisation and its subsequent influence on the social and emotional well-being of ATSI people.
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Gentile, Victoria, Adrian Carter, and Laura Jobson. "Examining the Associations Between Experiences of Perceived Racism and Drug and Alcohol Use in Aboriginal Australians." Journal of the Australian Indigenous HealthInfoNet 3, no. 1 (2022): 1–18. http://dx.doi.org/10.14221/aihjournal.v3n1.3.
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Objective This study aimed to explore the relationships between experiences of perceived racism, mental health and drug and alcohol use among Aboriginal Australians. Method Sixty-two Aboriginal Australians, ranging in age from 19-64 years (Mage = 33.71, SD = 12.47) and residing in Victoria completed an online questionnaire containing measures of perceived racism, alcohol use, substance use and mental health. Results First, 66% of the sample reported experiencing interpersonal racism, with the highest proportion of reported experiences occurring in health settings, educational/academic settings and by staff of government agencies. Second, perceived racism was significantly associated with poorer mental health and well-being. Finally, while perceived racism was not significantly associated with substance use, there was an indirect pathway from perceived racism to substance use through mental health concerns. Conclusions The current research indicates that racism is still frequently experienced by Aboriginal Australians and is directly associated with poorer mental health, and indirectly with substance use through poorer mental health. The findings demonstrate a clear need for further research in this area.
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Wotherspoon, Craig, and Cylie M. Williams. "Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service." Australian Health Review 43, no. 2 (2019): 217. http://dx.doi.org/10.1071/ah17096.
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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.
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Alexander, Jacob, and Adriana Lattanzio. "Utility of telepsychiatry for Aboriginal Australians." Australian & New Zealand Journal of Psychiatry 43, no. 12 (December 2009): 1185. http://dx.doi.org/10.3109/00048670903279911.
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Carman, William, Marie Ishida, Justin S. Trounson, Stewart W. Mercer, Kanya Anindya, Grace Sum, Gregory Armstrong, Brian Oldenburg, Barbara McPake, and John Tayu Lee. "Epidemiology of physical–mental multimorbidity and its impact among Aboriginal and Torres Strait Islander in Australia: a cross-sectional analysis of a nationally representative sample." BMJ Open 12, no. 10 (October 2022): e054999. http://dx.doi.org/10.1136/bmjopen-2021-054999.
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ObjectivesThis study aimed to examine the differences in multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity.SettingCross-sectional sample of the Household, Income and Labour Dynamics in Australia wave 17.ParticipantsA nationally representative sample of 16 749 respondents aged 18 years and above.Outcome measuresMultimorbidity prevalence and pattern, self-reported health, health service use and employment productivity by Indigenous status.ResultsAboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared with non-Indigenous Australians (20.7%), and the prevalence of mental–physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity pattern varies significantly among the Aboriginal and non-Indigenous Australians. Multimorbidity was associated with higher health service use (any overnight admission: adjusted OR=1.52, 95% CI=1.46 to 1.58), reduced employment productivity (days of sick leave: coefficient=0.25, 95% CI=0.19 to 0.31) and lower perceived health status (SF6D score: coefficient=−0.04, 95% CI=−0.05 to −0.04). These associations were found to be comparable in both Aboriginal and non-Indigenous populations.ConclusionsMultimorbidity prevalence was significantly greater among Aboriginal and Torres Strait Islanders compared with the non-Indigenous population, especially mental–physical multimorbidity. Strategies are required for better prevention and management of multimorbidity for the aboriginal population to reduce health inequalities in Australia.
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Raeburn, Toby, Kayla Sale, Paul Saunders, and Aunty Kerrie Doyle. "Aboriginal Australian mental health during the first 100 years of colonization, 1788–1888: a historical review of nineteenth-century documents." History of Psychiatry 33, no. 1 (December 13, 2021): 3–20. http://dx.doi.org/10.1177/0957154x211053208.
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Past histories charting interactions between British healthcare and Aboriginal Australians have tended to be dominated by broad histological themes such as invasion and colonization. While such descriptions have been vital to modernization and truth telling in Australian historical discourse, this paper investigates the nineteenth century through the modern cultural lens of mental health. We reviewed primary documents, including colonial diaries, church sermons, newspaper articles, medical and burial records, letters, government documents, conference speeches and anthropological journals. Findings revealed six overlapping fields which applied British ideas about mental health to Aboriginal Australians during the nineteenth century. They included military invasion, religion, law, psychological systems, lunatic asylums, and anthropology.
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Nolan-Isles, Davida, Rona Macniven, Kate Hunter, Josephine Gwynn, Michelle Lincoln, Rachael Moir, Yvonne Dimitropoulos, et al. "Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia." International Journal of Environmental Research and Public Health 18, no. 6 (March 15, 2021): 3014. http://dx.doi.org/10.3390/ijerph18063014.
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Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Importance of prioritizing health services by Aboriginal people; (5) Importance of reliable, affordable and sustainable services; (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.