“People like numbers”: a descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory

BMC Psychiatry

Melissa A Lindeman³  Jennifer Pinkerton¹  Kylie M Dingwall² 

[1] Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia;Menzies School of Health Research, PO Box 4066, Alice Springs, 0870, Australia;Centre for Remote Health, Flinders University, Alice Springs, Australia

关键词: Aboriginal;    Indigenous;    Testing;    Cross-cultural;    Assessment;    Cognition;   

Others  :  1124151
DOI  :  10.1186/1471-244X-13-42

 received in 2012-09-03, accepted in 2013-01-29,  发布年份 2013

【 摘 要 】

Background

Achieving culturally fair assessments of cognitive functioning for Aboriginal people is difficult due to a scarcity of appropriately validated tools for use with this group. As a result, some Aboriginal people with cognitive impairments may lack fair and equitable access to services. The objective of this study was to examine current clinical practice in the Northern Territory regarding cognitive assessment for Aboriginal people thereby providing some guidance for clinicians new to this practice setting.

Method

Qualitative enquiry was used to describe practice context, reasons for assessment, and current practices in assessing cognition for Aboriginal Australians. Semi-structured interviews were conducted with 22 clinicians working with Aboriginal clients in central and northern Australia. Results pertaining to assessment methods are reported.

Results

A range of standardised tests were utilised with little consistency across clinical practice. Nevertheless, it was recognised that such tests bear severe limitations, requiring some modification and significant caution in their interpretation. Clinicians relied heavily on informal assessment or observations, contextual information and clinical judgement.

Conclusions

Cognitive tests developed specifically for Aboriginal people are urgently needed. In the absence of appropriate, validated tests, clinicians have relied on and modified a range of standardised and informal assessments, whilst recognising the severe limitations of these. Past clinical training has not prepared clinicians adequately for assessing Aboriginal clients, and experience and clinical judgment were considered crucial for fair interpretation of test scores. Interpretation guidelines may assist inexperienced clinicians to consider whether they are achieving fair assessments of cognition for Aboriginal clients.

【 授权许可】

   
2013 Dingwall et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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