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Dostie R, Dunn H, Marks WN, Camden C, Lovo S. Use of telehealth for paediatric rehabilitation needs of Indigenous children - a scoping review. Int J Circumpolar Health 2024; 83:2308944. [PMID: 38320112 PMCID: PMC10848996 DOI: 10.1080/22423982.2024.2308944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Telerehabilitation is proposed as a promising avenue to enhance service accessibility for Indigenous communities, yet its application for Indigenous children remains relatively unexplored. This scoping review followed the PRISMA-ScR framework to explore current knowledge on the use of telerehabilitation for Indigenous children. Ten scholarly databases, seven grey literature databases, reference searches, and expert consultations were utilised to identify relevant studies. Included articles discussed the use of telerehabilitation provided by rehabilitation professionals (e.g. occupational therapist (OT), physical therapist (PT), speech and language pathologist (SLP) to Indigenous children and/or caregivers. Seven studies were included. Telerehabilitation was explored in different ways, the most common being real-time videoconferencing by SLPs. While some studies explicitly acknowledged cultural responsiveness within both the research process and the intervention, most were not designed for Indigenous children and their caregivers; rather, these participants were included with non-Indigenous participants. Successful implementation and sustainability of telerehabilitation services requires addressing technological limitations, understanding, and respecting diverse worldviews, and co-developing services to meet the unique needs of Indigenous families. Telerehabilitation has been rarely used with Indigenous children and when it was, little attention was given to cultural considerations. These findings emphasise that future telerehabilitation interventions should be truly community-led to ensure cultural relevance.
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Affiliation(s)
- Rosalie Dostie
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Hailey Dunn
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
| | | | - Chantal Camden
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Stacey Lovo
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
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Nelson C, Mandrusiak A, Forbes R. Perceived preparedness and training needs of new graduate physiotherapists' working with First Nations Australians. Physiother Theory Pract 2024; 40:1537-1550. [PMID: 36809246 DOI: 10.1080/09593985.2023.2179382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION There is a considerable and ongoing health gap experienced by First Nations Australians. Physiotherapists play an integral role in the health care of this population; however, little is known about new graduate preparedness and training needs to work in a First Nations context. OBJECTIVE To explore the perceptions of new graduate physiotherapists regarding their preparedness and training needs for working with First Nation Australians. METHODS Qualitative telephone, semi-structured interviews of new graduate physiotherapists (n = 13) who have worked with First Nations Australians in the last two years. Inductive, reflexive thematic analysis was used. RESULTS Five themes were generated: 1) limitations of pre-professional training; 2) benefits of work integrated learning; 3) 'on the job' development; 4) intrapersonal factors and efforts; and 5) insights into improving training. CONCLUSION New graduate physiotherapists perceive that their preparedness to work in a First Nations health context is supported by practical and varied learning experiences. At the pre-professional level, new graduates benefit from work integrated learning and opportunities that evoke critical self-reflection. At the professional level, new graduates express a need for 'on the job' development, peer supervision, and tailored professional development, that focuses on the unique perspectives of the specific community in which they work.
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Affiliation(s)
- Curtley Nelson
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
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Nelson C, Mandrusiak A, Forbes R. Embarking on a cultural journey: a qualitative study of new graduate physiotherapists' experiences of working in First Nations Australian health settings. Physiother Theory Pract 2023:1-11. [PMID: 37585714 DOI: 10.1080/09593985.2023.2246547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/10/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Internationally, there is growing momentum in the physiotherapy profession to improve the cultural safety and capabilities of physiotherapists. In Australia, this is essential given the important role physiotherapists play in the delivery of healthcare to First Nations Australians. Understanding the experiences of the newest members of the profession who work with First Nations Australians is an important step in exploring the broader professions' cultural safety journey. OBJECTIVE To explore new graduate physiotherapists' experiences working in First Nations Australian health settings. METHODS The study used an interpretative phenomenological approach through semi-structured interviews to explore the experiences of seven new graduate physiotherapists, in their first 2 years of practice. All participants worked within a First Nations Australian health setting for some or all of their experience as a new graduate physiotherapist. RESULTS Three themes were generated: 1) enrichment through connection; 2) navigating challenges; and 3) a catalyst for self-reflection. CONCLUSION New graduate physiotherapists reported positive experiences when working within a First Nations Australian health setting, underpinned by building a strong therapeutic relationship through rapport building; navigating challenges alongside their clients; and delving into critical self-reflection.
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Affiliation(s)
- Curtley Nelson
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
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Bernardes CM, Ekberg S, Birch S, Claus A, Bryant M, Meuter R, Isua J, Gray P, Kluver JP, Malacova E, Jones C, Houkamau K, Taylor M, Lin I, Pratt G. Yarning about pain: Evaluating communication training for health professionals at persistent pain services in Queensland, Australia. Br J Pain 2023; 17:306-319. [PMID: 37342393 PMCID: PMC10278454 DOI: 10.1177/20494637221149831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Background Providing cultural education to health professionals is essential in improving the quality of care and outcomes for Aboriginal and Torres Strait Islander patients. This study reports the evaluation of a novel training workshop used as an intervention to improve communication with Aboriginal and Torres Strait Islander patients of persistent pain services. Methods In this single-arm intervention study, health professionals undertook a one-day workshop, which included cultural capability and communication skills training based on a clinical yarning framework. The workshop was delivered across three adult persistent pain clinics in Queensland. At the end of the training, participants completed a retrospective pre/post evaluation questionnaire (5 points Likert scale, 1 = very low to 5 = very high), to rate their perceived importance of communication training, their knowledge, ability and confidence to communicate effectively. Participants also rated their satisfaction with the training and suggested improvements for future trainings. Results Fifty-seven health professionals were trained (N = 57/111; 51% participation rate), 51 completed an evaluation questionnaire (n = 51/57; 90% response rate). Significant improvements in the perceived importance of communication training, knowledge, ability and confidence to effectively communicate with Aboriginal and Torres Strait Islander patients were identified (p < 0.001). The greatest increase was in the perceived confidence pre-training mean of 2.96 (SE = 0.11) to the post-training mean of 4.02 (SE = 0.09). Conclusion This patient-centred communication training, delivered through a novel model that combines cultural capability and the clinical yarning framework applied to the pain management setting, was highly acceptable and significantly improved participants' perceived competence. This method is transferrable to other health system sectors seeking to train their clinical workforce with culturally sensitive communication skills.
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Affiliation(s)
- Christina M Bernardes
- Aboriginal and Torres Strait Islander Health Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Stuart Ekberg
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Stephen Birch
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia
| | - Andrew Claus
- Tess Cramond Pain and Research Centre, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Matthew Bryant
- North Queensland Persistent Pain Management Service, Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Renata Meuter
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jermaine Isua
- Aboriginal and Torres Strait Islander Health Division, Cultural Capability Services, Queensland Health, Brisbane, QLD, Australia
| | - Paul Gray
- Tess Cramond Pain and Research Centre, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Joseph P Kluver
- Persistent Pain Clinic, Metro South Hospital and Health Service, Brisbane, QLD, Australia
| | - Eva Malacova
- Statistics Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Corey Jones
- Aboriginal and Torres Strait Islander Health Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Kushla Houkamau
- Aboriginal and Torres Strait Islander Health Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Marayah Taylor
- North Queensland Persistent Pain Management Service, Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health (WACRH), The University of Western Australia, Geraldton, WA, Australia
| | - Gregory Pratt
- Aboriginal and Torres Strait Islander Health Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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McPherson K, Nahon I. Culturally responsive women’s and men’s health physiotherapy for Indigenous people living in regional, rural, and remote Australia. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2152553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Kerstin McPherson
- Faculty of Health, University of Canberra, Canberra, Australia
- Faculty of Science, Charles Sturt University, Orange, Australia
| | - Irmina Nahon
- Faculty of Health, University of Canberra, Canberra, Australia
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Sehgal A, Barnabe C, Crowshoe L(L. Patient complexity assessment tools containing inquiry domains important for Indigenous patient care: A scoping review. PLoS One 2022; 17:e0273841. [PMID: 36044532 PMCID: PMC9432764 DOI: 10.1371/journal.pone.0273841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/16/2022] [Indexed: 11/21/2022] Open
Abstract
Patient complexity assessment tools (PCATs) are utilized to collect vital information to effectively deliver care to patients with complexity. Indigenous patients are viewed in the clinical setting as having complex health needs, but there is no existing PCAT developed for use with Indigenous patients, although general population PCATs may contain relevant content. Our objective was to identify PCATs that include the inquiry of domains relevant in the care of Indigenous patients with complexity. A scoping review was performed on articles published between 2016 and 2021 to extend a previous scoping review of PCATs. Data extraction from existing frameworks focused on domains of social realities relevant to the care of Indigenous patients. The search resulted in 1078 articles, 82 underwent full-text review, and 9 new tools were identified. Combined with previously known and identified PCATs, only 6 items from 5 tools tangentially addressed the domains of social realities relevant to Indigenous patients. This scoping review identifies a major gap in the utility and capacity of PCATs to address the realities of Indigenous patients. Future research should focus on developing tools to address the needs of Indigenous patients and improve health outcomes.
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Affiliation(s)
- Anika Sehgal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Cheryl Barnabe
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lynden (Lindsay) Crowshoe
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain: Needs and Preferences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031572. [PMID: 35162593 PMCID: PMC8835490 DOI: 10.3390/ijerph19031572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/03/2022]
Abstract
Poor communication is an important factor contributing to health disparity. This study sought to investigate clinicians’ perspectives about communicating with Aboriginal and Torres Strait Islander patients with pain. This multi-site and mixed-methods study involved clinicians from three pain management services in Queensland, Australia. Clinicians completed a survey and participated in focus groups. Clinicians rated the importance of communication training, their knowledge, ability, and confidence in communicating with Aboriginal and Torres Strait Islander patients using a 5-point Likert scale. Rating scores were combined into low (scores 1–2); moderate (score 3) and high (scores 4–5). Informed by an interpretive description methodology, thematic analysis of focus group data was used to identify the communication needs and training preferences of clinicians. Overall (N = 64), 88% of clinicians rated the importance of communication training when supporting Aboriginal and Torres Strait Islander patients as “high”. In contrast, far fewer clinicians rated as “high” their knowledge (28%), ability (25%) and confidence (28%) in effectively communicating with Aboriginal and Torres Strait Islander patients. Thematic analysis identified three areas of need: knowledge of Aboriginal and Torres Strait Islander cultures, health beliefs, and understanding cross-cultural cues. Communication skills can be learned and training, in the form of a tailored intervention to support quality engagement with Aboriginal and Torres Strait Islander patients, should combine cultural and communication aspects with biomedical knowledge.
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O'Brien P, Bunzli S, Lin I, Bessarab D, Coffin J, Dowsey MM, Choong PFM. Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action. ANZ J Surg 2021; 91:238-244. [PMID: 33506978 DOI: 10.1111/ans.16557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022]
Abstract
Aboriginal and Torres Strait Islander people continue to experience health inequity within the Australian health care system. Little research has examined how disparities in surgical care access and outcomes contribute to Aboriginal health. In this narrative review and call to action, we discuss five care points along the journey to high-quality surgical care: health care seeking, primary health care services, specialist services, surgery and surgical outcomes. We highlight barriers and disparities that exist along this journey, drawing examples from the field of joint replacement surgery. Finally, we present opportunities for change at the health system, health service and clinician level, calling upon researchers, clinicians and policy makers to confront the surgical disparities experienced by Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Penny O'Brien
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Juli Coffin
- Social and Emotional Wellbeing of Aboriginal Young People, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter F M Choong
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
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Introduction to special issue on new directions in physical rehabilitation of musculoskeletal pain conditions. Pain Rep 2020. [PMCID: PMC7808680 DOI: 10.1097/pr9.0000000000000852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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