Traumatic brain injury amongst indigenous people: a systematic review

Lakhani, Ali; Townsend, Clare; Bishara, Jason

doi:10.1080/02699052.2017.1374468

Cited by 31 publications

(24 citation statements)

References 37 publications

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“…In addition, the occurrence of TBI in NSW residents identifying as Aboriginal and Torres Strait Islander was 1.7 times the rate of the general population. This finding, supporting known ethnicity‐related disparities in TBI risk, 30 allows for a more accurate estimate of the magnitude of risk among Aboriginal and Torres Strait Islander peoples. There are only two studies providing data in this regard but these are limited to small, selected Australian cohorts, such as assault‐related TBI 12 and incarcerated young people 31 …”

Section: Discussionsupporting

confidence: 66%

Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population‐based study

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Rosenkoetter

et al. 2019

Australian and New Zealand Journal of Public Health

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Objective: To describe the population-based incidence and epidemiological characteristics of hospitalised traumatic brain injury (TBI) in New South Wales (NSW), Australia. Methods:One-year statewide hospital admission data from the NSW Department of Health were analysed. TBI cases were identified using a combination of TBI-related diagnostic and external cause codes from the International Classification of Diseases (ICD-10 th Revision). Sociodemographics, causes, associated factors, severity and medical details of hospitalisation were examined.Results: There were 6,827 hospitalised TBI cases that met review criteria. Incidence rate was 99.1/100,000 population. Incidence in persons older than 75 years of age and residents in remote areas was three times higher. Aboriginal and Torres Strait Islander peoples were 1.7 times more likely to sustain a TBI than the general population, and risk was greater for all NSW residents from areas that were remote and disadvantaged-socioeconomically. Older adults and those with severe injuries showed prolonged hospitalisation, higher morbidity and mortality. Conclusions:Overall TBI incidence in NSW is lower than international estimates. Nevertheless, groups with higher incidence rates and/or poor in-hospital outcomes were identified, highlighting directions for prevention and future research. Implications for public health:There is a need for identifying risk factors/barriers and assessing the impact of recent policies on these population groups.

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Section: Discussionsupporting

confidence: 66%

Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population‐based study

Pozzato

Tate

Rosenkoetter

et al. 2019

Australian and New Zealand Journal of Public Health

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“…However, none of the studies reviewed principally sought to investigate the transitional experiences of Indigenous Australians. A recent comprehensive systematic review of research focusing on TBI among Indigenous people generally found that almost half the studies were focused not on transition but on prevalence or incidence rate only (Lakhani, Townsend & Bishara, 2017). In health care generally, research indicates that Indigenous Australians experience differences in the health care they receive in hospital (Australian Health Ministers' Advisory Council, 2012;Paradies, Harris & Anderson, 2008).…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study on the Transition Support Needs of Indigenous Australians Following Traumatic Brain Injury

et al. 2019

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Objective:A growing body of qualitative literature globally describes post-hospital experiences during early recovery from a traumatic brain injury. For Indigenous Australians, however, little published information is available. This study aimed to understand the lived experiences of Indigenous Australians during the 6 months post-discharge, identify the help and supports accessed during transition and understand the gaps in service provision or difficulties experienced.Methods and Procedure:Semi-structured interviews were conducted at 6 months after hospital discharge to gain an understanding of the needs and lived experiences of 11 Aboriginal and Torres Strait Islander Australians who had suffered traumatic brain injury in Queensland and Northern Territory, Australia. Data were analysed using thematic analysis.Results:Five major themes were identified within the data. These were labelled ‘hospital experiences’, ‘engaging with medical and community-based supports’, ‘health and wellbeing impacts from the injury’, ‘everyday living’ and ‘family adjustments post-injury’.Conclusions:While some of the transition experiences for Indigenous Australians were similar to those found in other populations, the transition period for Indigenous Australians is influenced by additional factors in hospital and during their recovery process. Lack of meaningful interaction with treating clinicians in hospital, challenges managing direct contact with multiple service providers and the injury-related psychological impacts are some of the factors that could prevent Indigenous Australians from receiving the supports they require to achieve their best possible health outcomes in the long term. A holistic approach to care, with an individualised, coordinated transition support, may reduce the risks for re-admission with further head injuries.

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“…Changes related to social adjustment may not be immediately apparent but may continue to emerge over time (Olver, Ponsford & Curran, 2009;Salas, Casassus, Rowlands, Pimm & Flanagan, 2018), with personal and social circumstances like age, gender, incidence of depression and family support impacting on recovery, although to varying degrees (Alway, Gould, Johnston, McKenzie & Ponsford, 2016;Gauthier et al, 2018;Lewis & Horn, 2017;O'Reilly, Wilson & Peters, 2018). However, the overarching cultural context of the brain injury survivor, particularly that related to minority peoples with a history of colonisation and discrimination, has rarely been referred to in the research literature (see recent systematic review by Lakhani, Townsend and Bishara (2017)), despite profoundly influencing a person's recovery journey in significant ways, including access to services. In an Aboriginal 1 world view, for example, and consistent with Bronfenbrenner's socioecological model (1979), the individual is embedded in the family and community in a collectivist context, so that the effects/experience of a brain injury have immediate relevance and ramifications for that person's immediate and extended family, community and beyond, as well as for the person him/herself (see Fig.…”

Section: Introductionmentioning

confidence: 99%

‘I’ve got to row the boat on my own, more or less’: aboriginal australian experiences of traumatic brain injury

et al. 2019

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Background:The overarching cultural context of the brain injury survivor, particularly that related to minority peoples with a history of colonisation and discrimination, has rarely been referred to in the research literature, despite profoundly influencing a person’s recovery journey in significant ways, including access to services. This study highlights issues faced by Australian Aboriginal traumatic brain injury (TBI) survivors in terms of real-life consequences of the high incidence of TBI in this population, current treatment and long-term challenges.Method:A case study approach utilised qualitative interview and file review data related to five male Aboriginal TBI survivors diagnosed with acquired communication disorders. The five TBI survivors were from diverse areas of rural and remote Western Australia, aged between 19 and 48 years at the time of injury, with a range of severity.Case Reports:Common themes included: significant long-term life changes; short-term and long-term dislocation from family and country as medical intervention and rehabilitation were undertaken away from the person’s rural/remote home; family adjustments to the TBI including permanent re-location to a metropolitan area to be with their family member in residential care; challenges related to lack of formal rehabilitation services in rural areas; poor communication channels; poor cultural security of services; and lack of consistent follow-up.Discussion and Conclusion:These case reports represent some of the first documented stories of Aboriginal Australian TBI survivors. They supplement available epidemiological data and highlight different contexts for Aboriginal people after TBI, contributing to an overall profile that is relevant for rehabilitation service planning.

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Traumatic brain injury amongst indigenous people: a systematic review

Cited by 31 publications

References 37 publications

Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population‐based study

Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population‐based study

A Qualitative Study on the Transition Support Needs of Indigenous Australians Following Traumatic Brain Injury

‘I’ve got to row the boat on my own, more or less’: aboriginal australian experiences of traumatic brain injury

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