Exploring Aboriginal patients’ experiences of cardiac care at a major metropolitan hospital in Melbourne

Abstract

Objectives The aim of the present study was to explore Aboriginal patients' lived experiences of cardiac care at a major metropolitan hospital in Melbourne. Methods The study was a qualitative study involving in-depth interviews with a purposive sample of 10 Aboriginal patients who had been treated in the cardiology unit at the study hospital during 2012-13. A phenomenological approach was used to analyse the data. Results Eight themes emerged from the data, each concerning various aspects of participants' experiences: 'dislike of hospitals', 'system failures', 'engagement with hospital staff', 'experiences of racism', 'health literacy and information needs', 'self-identifying as Aboriginal', 'family involvement in care' and 'going home and difficulties adapting'. Most participants had positive experiences of the cardiac care, but hospitalisation was often challenging because of a sense of dislocation and disorientation. The stress of hospitalisation was greatly mediated by positive engagements with staff, but at times exacerbated by system failures or negative experiences. Conclusion Cardiac crises are stressful and hospital stays were particularly disorienting for Aboriginal people dislocated from their home land and community. What is known about the topic? Aboriginal people have higher mortality rates due to cardiovascular diseases compared with other Australians. Along with different factors contributing to the life expectancy gap, Aboriginal people also face significant barriers in the use of the healthcare system. What does this paper add? Aboriginal patients' lived experience of cardiac care at a major metropolitan hospital in Melbourne is explored in this paper. Different issues were revealed during their interaction with the hospital staff and the hospital system in conjunction with their cultural aspect of patient care. What are the implications for practitioners? Positive interactions with staff, ongoing support from family and community, culturally appropriate cardiac rehabilitation programs can improve the cardiac care experiences of Aboriginal patients.

Understanding Indigenous Australians’ experiences of cancer care: stakeholders’ views on what to measure and how to measure it

“…Reinforcing previous studies [7, 9], participants in our study commonly felt that coordination of care, particularly around the transition into primary health care, was unsatisfactory, and this requires more detailed exploration in future measurement activities for this patient group. The lack of awareness of post-discharge support services and the perceived lack of cultural safety of these services were commonly held concerns.…”

“…Access to an Indigenous care provider was commonly reported as a crucial, yet often lacking, aspect of care, echoing findings in previous studies [7, 9, 11, 13, 14]. Indigenous care providers promote culturally safe service delivery and help to bridge the cultural gap [17].…”

“…The findings of the current study are generally consistent with prior qualitative studies in this area. Previously reported issues relating to cross-cultural care were repeatedly raised by participants in this study, including: difficulties establishing trust given the historical context [4, 9, 12]; a lack of Indigenous staff [7, 11, 12]; communication difficulties with health staff [8, 11]; the intimidating nature of the health system [4, 12]; challenges in transitioning to primary care [14]; and the lack of understanding of cultural issues, such as being away from Country and the importance of family, as well as the importance of respect for the individual and his or her cultural perspective [8, 11, 12, 16]. A New South Wales Bureau of Health Information survey [38] of people who had been hospital inpatients found that Aboriginal respondents were less positive than non-Indigenous respondents about experiencing respect relating to culture, dignity and privacy, which is consistent with the current study.…”

“…Previous studies have identified a range of barriers to Indigenous Australians engaging with treatment and receiving optimal cancer care, including: alienation in the hospital environment [6, 7]; communication difficulties with health professionals [7, 8]; a lack of patient navigators [4, 9]; reduced health literacy [4, 7, 10]; lack of access to support from an Indigenous care provider [4, 11–13]; logistical impediments [14]; and inadequate linkages with primary care [4, 14–16]. Studies have also identified that respect for individual patients and their cultural perspectives is a key driver of Indigenous patients’ engagement with treatment [13, 14, 16, 17].…”

Indigenous cardiac patients’ and relatives’ experiences of hospitalisation: A narrative inquiry

“…One of the factors contributing to Indigenous health disparity lies in how Indigenous peoples experience hospitalisation in terms of their perception, expectation and interpretation of their healthcare encounters (Chapman, Smith, & Martin, 2014;Shahid, Finn, Bessarab, & Thompson, 2011;Worrall-Carter et al, 2016). These studies demonstrate that they are faced with common challenges when encountering health care, such as language barriers, the need to relocate to access services and cultural isolation.…”