Qualitative exploration of the perceived barriers and enablers to Aboriginal and Torres Strait Islander people accessing healthcare through one Victorian Emergency Department

Abstract

Aboriginal and Torres Strait Islander (ATSI) people experience challenges when accessing health care from the emergency department (ED). The aim of this project was to identify the perceived barriers and enablers to accessing health care at one Victorian Emergency Department for the local ATSI community. This qualitative explorative study collected data using focus groups or yarns to investigate the perceptions of the ATSI community presentations to the ED. Data were analysed following the standards of qualitative data analysis procedure. Three themes emerged organisational process, staff interactions and strategies for improvement. Information from this study will assist hospital and ED executives and practitioners to collaborate with the ATSI community in developing and implementing policy and practice changes that enable Aboriginal patients to be identified and receive culturally appropriate care.

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

“…There is a sense of vulnerability expressed in their descriptions of fear of the hospital, cultural discrepancies and the disempowering practices that made them feel dependent on, or at the mercy of, healthcare professionals (Tanner et al., ). Although displaying Indigenous flags and artwork has been promoted in other studies (Chapman et al., ) and was appreciated by participants, these were considered tokenistic, as their visibility in the hospital was in contrast with what happened at the bedside where a distinct lack of knowledge or acknowledgement of Indigenous culture was displayed by staff, and participants felt somewhat invisible. Unable to recognise any practices that were based on their beliefs or culture (Durey & Thompson, ), they felt unwelcome.…”

“…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, ; Shahid, Finn, Bessarab, & Thompson, ; Worrall‐Carter et al., ). 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.…”

Seldom heard voices: a meta-narrative systematic review of Aboriginal and Torres Strait Islander peoples healthcare experiences

“…Eighteen studies discussed the role of trust in systems in many Aboriginal and Torres Strait Islander’s patient experience and this was a significant and consistent finding across the traditions and their methodologies [ 34 , 37 , 42 , 44 , 46 , 50 , 52 – 54 , 56 , 58 , 63 , 70 , 71 , 76 , 79 , 81 , 83 ]. Findings indicted that Aboriginal or Torres Strait Islander patients’ sense of trust in a health service is formed from a complex layering of experiences.…”

“…Papers founded within the nursing research tradition were characterised by; a patient advocacy tone with an impetus on the need for action, authors having closer relationships with the participants, an awareness of patient experience differences between patient groups, and referral to the research participants as consumers, clients, or participants [ 44 , 50 , 51 ]. Patient experience was therefore conceptualised more broadly to include the care environment and the support around an individual.…”

“…Findings indicted that Aboriginal or Torres Strait Islander patients’ sense of trust in a health service is formed from a complex layering of experiences. At a basic level, the patient’s trust is informed by their experiences of current treatment in a particular health service, or more broadly the treatment of their current health complaint [ 27 , 34 , 44 , 46 , 50 , 52 , 53 , 70 , 79 , 81 , 83 ]. Many patients or carers also commented on the impact of historical traumas, particularly through the public health lens.…”