‘It’s not easy’: Caring for Aboriginal clients with diabetes in remote Australia

Cribbes, Michelle; Glaister, Karen

doi:10.5172/conu.2007.25.1-2.163

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Many health professionals acknowledged the challenges faced by Indigenous Australians taking long-term medicines, but there were mixed views on patients’ attitudes to medicines and adherence [ 29 – 31 ]. No studies reported patients’ own perceptions of their adherence.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management

Dassel

Ralph

Cass

2017

BMC Health Serv Res

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BackgroundIndigenous Australians experience high rates of chronic conditions. It is often asserted Indigenous Australians have low adherence to medication; however there has not been a comprehensive examination of the evidence. This systematic literature review presents data from studies of Indigenous Australians on adherence rates and identifies supporting factors and impediments from the perspective of health professionals and patients.MethodsSearch strategies were used to identify literature in electronic databases and websites. The following databases were searched: Scopus, Medline, CINAHL Plus, PsycINFO, Academic Search Premier, Cochrane Library, Trove, Indigenous Health infonet and Grey Lit.org. Articles in English, reporting original data on adherence to long-term, self-administered medicines in Australia’s Indigenous populations were included.Data were extracted into a standard template and a quality assessment was undertaken.ResultsForty-seven articles met inclusion criteria. Varied study methodologies prevented the use of meta-analysis. Key findings: health professionals believe adherence is a significant problem for Indigenous Australians; however, adherence rates are rarely measured. Health professionals and patients often reported the same barriers and facilitators, providing a framework for improvement.ConclusionsThere is no evidence that medication adherence amongst Indigenous Australians is lower than for the general population. Nevertheless, the heavy burden of morbidity and mortality faced by Indigenous Australians with chronic conditions could be alleviated by enhancing medication adherence. Some evidence supports strategies to improve adherence, including the use of dose administration aids. This evidence should be used by clinicians when prescribing, and to implement and evaluate programs using standard measures to quantify adherence, to drive improvement in health outcomes.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2794-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…An issue reported by patients only was forgetting to take doses [ 31 , 40 , 45 , 46 ] and a few participants stated that their belief in God meant they did not need to take medicines [ 44 – 46 ]. In addition, health professionals reported that inadequate safe storage for medicines at home impaired adherence [ 30 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management

Dassel

Ralph

Cass

2017

BMC Health Serv Res

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2009

Understanding the Australian Health Care System

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Ontology based intercultural patient practitioner assistive communications from qualitative gap analysis

Forbes

Wongthongtham

2016

Information Technology &Amp; People

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Purpose – There is an increasing interest in using information and communication technologies to support health services. But the adoption and development of even basic ICT communications services in many health services is limited, leaving enormous gaps in the broad understanding of its role in health care delivery. The purpose of this paper is to address a specific (intercultural) area of healthcare communications consumer disadvantage; and it examines the potential for ICT exploitation through the lens of a conceptual framework. The opportunity to pursue a new solutions pathway has been amplified in recent times through the development of computer-based ontologies and the resultant knowledge from ontologist activity and consequential research publishing. Design/methodology/approach – A specific intercultural area of patient disadvantage arises from variations in meaning and understanding of patient and clinician words, phrases and non-verbal expression. Collection and localization of data concepts, their attributes and individual instances were gathered from an Aboriginal trainee nurse focus group and from a qualitative gap analysis (QGA) of 130 criteria-selected sources of literature. These concepts, their relationships and semantic interpretations populate the computer ontology. The ontology mapping involves two domains, namely, Aboriginal English (AE) and Type II diabetes care guidelines. This is preparatory to development of the Patient Practitioner Assistive Communications (PPAC) system for Aboriginal rural and remote patient primary care. Findings – The combined QGA and focus group output reported has served to illustrate the call for three important drivers of change. First, there is no evidence to contradict the hypothesis that patient-practitioner interview encounters for many Australian Aboriginal patients and wellbeing outcomes are unsatisfactory at best. Second, there is a potent need for cultural competence knowledge and practice uptake on the part of health care providers; and third, the key contributory component to determine success or failures within healthcare for ethnic minorities is communication. Communication, however, can only be of value in health care if in practice it supports shared cognition; and mutual cognition is rarely achievable when biopsychosocial and other cultural worldview differences go unchallenged. Research limitations/implications – There has been no direct engagement with remote Aboriginal communities in this work to date. The authors have initially been able to rely upon a cohort of both Indigenous and non-Indigenous people with relevant cultural expertise and extended family relationships. Among these advisers are health care practitioners, academics, trainers, Aboriginal education researchers and workshop attendees. It must therefore be acknowledged that as is the case with the QGA, the majority of the concept data is from third parties. The authors have also discovered that urban influences and cultural sensitivities tend to reduce the extent of, and opportunity to, witness AE usage, thereby limiting the ability to capture more examples of code-switching. Although the PPAC system concept is qualitatively well developed, pending future work planned for rural and remote community engagement the authors presently regard the work as mostly allied to a hypothesis on ontology-driven communications. The concept data population of the AE home talk/health talk ontology has not yet reached a quantitative critical mass to justify application design model engineering and real-world testing. Originality/value – Computer ontologies avail us of the opportunity to use assistive communications technology applications as a dynamic support system to elevate the pragmatic experience of health care consultations for both patients and practitioners. The human-machine interactive development and use of such applications is required just to keep pace with increasing demand for healthcare and the growing health knowledge transfer environment. In an age when the worldwide web, communications devices and social media avail us of opportunities to confront the barriers described the authors have begun the first construction of a merged schema for two domains that already have a seemingly intractable negative connection. Through the ontology discipline of building syntactically and semantically robust and accessible concepts; explicit conceptual relationships; and annotative context-oriented guidance; the authors are working towards addressing health literacy and wellbeing outcome deficiencies of benefit to the broader communities of disadvantage patients.

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‘It’s not easy’: Caring for Aboriginal clients with diabetes in remote Australia

Cited by 3 publications

References 5 publications

A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management

A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management

References

Ontology based intercultural patient practitioner assistive communications from qualitative gap analysis

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