The First Nations experience of accessing rheumatology services in a metropolitan hospital: A qualitative study.
Objective: First Nations Australians experience a higher burden and severity of Rheumatic Disease with poorer outcomes than the general population. Despite a widely acknowledged need to improve health outcomes, there has been minimal research assessing existing models of care from a First Nations pe...
| Publicado en: | Health Expectations Vol. 27; no. 2; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176869885&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176869885 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13696513 EVY jtl: Health Expectations issn: 13696513 maglogo: Y pubinfo: dt: Apr2024 vid: 27 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 176869885 176869885 176869885 10.1111/hex.14049 176869885 ppf: 1 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The First Nations experience of accessing rheumatology services in a metropolitan hospital: A qualitative study. aug: au: Cullen, Taylor Griffith, Miki Damodaran, Arvin Lewis, Ebony McMillan, Faye Sammel, Anthony Honeysette, Rhiana Biles, Brett Beadman, Kim Nathan, Sally affil: School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, Australia sug: subj: Health Services Accessibility Rheumatology Hospitals, Urban First Nations of Australia Human Male Female Young Adult Adult Middle Age Aged Qualitative Studies Treatment Outcomes Semi-Structured Interview Telephone Thematic Analysis Telehealth Communication Aboriginal Australians Funding Source Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Objective: First Nations Australians experience a higher burden and severity of Rheumatic Disease with poorer outcomes than the general population. Despite a widely acknowledged need to improve health outcomes, there has been minimal research assessing existing models of care from a First Nations perspective in Australia. The objective of this study was to describe First Nations experiences and barriers and enablers to accessing a hospital‐based adult Rheumatology service in Sydney. Methods: A qualitative study using semi‐structured interviews was undertaken. Patients who self‐identified as First Nations attending the Prince of Wales Hospital Rheumatology Clinic in 2021 were invited to participate. Interviews were conducted face‐to‐face or by telephone using culturally‐appropriate Yarning methods with an Aboriginal Health Worker (AHW) at the request of participants. Thematic analysis was done in consultation with an Aboriginal Reference Group (ARG). Results: Four categories, which encapsulated 11 themes were identified. Participants reported barriers to care such as logistics of the referral process, not feeling culturally safe because of uncomfortable clinic environments and health worker behaviours, inadequate cultural support and community perceptions of the specialty. Enabling factors included family member involvement, AHW support and telehealth consultation. Conclusion: The current model of care perpetuates access challenges for First Nations Australians within rheumatology. Barriers to care include the delayed referral process, limited cultural responsivity in the clinic environment and poor cross‐cultural communication. There is a need for models of care that are co‐designed with First Nations Peoples to address these barriers. Patient and Public Contribution: Participants were First Nations Australians with lived experience attending the rheumatology clinic. All interviewees were offered the opportunity to review their transcripts to ensure trustworthiness of the data. Preliminary thematic analysis was conducted in partnership with the AHW who has over 20 years experience. Following preliminary coding, a list of themes were presented to the ARG for iterative discussion and refinement. The ARG provided community representation and ensured that First Nations voices were privileged in the analysis. It's intended that the findings of this study will support the upcoming co‐design of a First Nations health service for Rheumatology patients. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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