Better cardiac care – the patient experience – a qualitative study

International Journal for Equity in Health

Research

Deborah Askew¹  Celestine Fisher²  Vivian Bryce²  Sonia Renouf²  Sean Grugan²  William Wang³  Sonya Egert⁴  Warren Jennings⁵ 

[1] General Practice Clinical Unit, The University of Queensland, Women’s Hospital, Level 8, Health Sciences Building, Royal Brisbane, 4029, Brisbane, Qld, Australia;Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, 4102, Woolloongabba, Qld, Australia;Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, 4102, Woolloongabba, Qld, Australia;Faculty of Medicine, The University of Queensland, 199 Ipswich Road, 4102, Woolloongabba, Qld, Australia;Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, 4077, Inala, Qld, Australia;Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, 4077, Inala, Qld, Australia;General Practice Clinical Unit, The University of Queensland, Women’s Hospital, Level 8, Health Sciences Building, Royal Brisbane, 4029, Brisbane, Qld, Australia;

关键词: Aboriginal and Torres Strait Islander people;    Indigenous;    Cultural competence;    Equity;    Health access;    Relationality;    Racism;    Health worker;    Yarning;    Qualitative;    Cardiac care.;   

DOI  :  10.1186/s12939-023-01931-5

 received in 2023-03-16, accepted in 2023-06-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn 2015, a Brisbane tertiary hospital’s cardiac unit implemented a new model of multidisciplinary care (Better Cardiac Care (BCC)) for Aboriginal and Torres Strait Islander patients. Since then, clinical indicators for Aboriginal and Torres Strait Islander cardiac patients have improved, but the recipients’ voices have not been heard. This research aimed to determine the acceptability and appropriateness, features of value, and opportunities for improvements in this model of care, from the perspective of patients and their family members.MethodsThis descriptive qualitative study employed a narrative methodology. BCC Health Workers contacted prospective participants; with consent, interested individuals were then contacted by the Aboriginal Research Officer (RO) who arranged yarning sessions and consent. Family members were also invited to share their stories of their loved ones’ hospitalisation. Two researchers conducted the interviews, using a yarning approach. Inductive narrative analysis, informed by Aboriginal and Torres Strait Islander ways of Being, Knowing, and Doing, focused on enabling participants’ stories to be heard and understood from their perspectives.ResultsRelationality was at the heart of the BCC model of care, particularly between patients and Aboriginal and Torres Strait Islander staff. The relationality included a responsibility for holistic care, extending beyond hospital discharge, although support and handover for family members required improvement. The Aboriginal and Torres Strait Islander staff understood the contextual and structural challenges faced by participants, including the disempowerment and racism experienced in healthcare. This understanding was shared with the BCC team who, in turn, protected, advocated for, and holistically supported participants through their cardiac health journeys.ConclusionsEmpowering (and employing) Aboriginal and Torres Strait Islander staff, and relating to patients as people, enabled BCC to meet Aboriginal and Torres Strait Islander patient’s needs and improve outcomes. The wider health system and health academia could benefit from exploring and valuing Aboriginal and Torres Strait Islander discourses of relationality.

【 授权许可】

CC BY   
© Crown 2023