Keightley Michelle, Kendall Victoria, Jang Shu-Hyun, Parker Cindy, Agnihotri Sabrina, Colantonio Angela, Minore Bruce, Katt Mae, Cameron Anita, White Randy, Longboat-White Claudine, Bellavance Alice
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
Brain Inj. 2011;25(2):142-52. doi: 10.3109/02699052.2010.541898.
To explore the barriers and enablers surrounding the transition from health care to home community settings for Aboriginal clients recovering from acquired brain injuries (ABI) in northwestern Ontario.
Participatory research design using qualitative methods.
Focus groups conducted with clients with ABI, their caregivers and hospital and community health-care workers. The Framework Method of analysis was used to uncover emerging themes.
Six main categories emerged: ABI diagnosis accuracy, acute service delivery and hospital care, transition from hospital to homecare services, transition from hospital to community services, participant suggestions to improve service delivery and transition, and views on traditional healing methods during recovery.
A lack of awareness, education and resources were acknowledged as key challenges to successful transitioning by clients and healthcare providers. Geographical isolation of the communities was highlighted as a barrier to accessibility of services and programmes, but the community was also regarded as an important source of social support. The development of educational and screening tools and needs assessments of remote communities were identified to be strategies that may improve transitions.
Findings demonstrate that the structure of rehabilitation and discharge processes for Aboriginal clients living on reserves or in remote communities are of great concern and warrants further research.
探讨安大略省西北部从后天性脑损伤（ABI）中康复的原住民患者从医疗保健过渡到家庭社区环境的障碍和促进因素。
采用定性方法的参与式研究设计。
对ABI患者、他们的护理人员以及医院和社区医护人员进行焦点小组访谈。采用框架分析法来揭示新出现的主题。
出现了六个主要类别：ABI诊断准确性、急性服务提供和医院护理、从医院到家庭护理服务的过渡、从医院到社区服务的过渡、参与者对改善服务提供和过渡的建议，以及对康复期间传统治疗方法的看法。
缺乏认识、教育和资源被认为是患者和医疗服务提供者成功过渡的关键挑战。社区的地理隔离被强调为服务和项目可及性的障碍，但社区也被视为社会支持的重要来源。开发教育和筛查工具以及对偏远社区进行需求评估被确定为可能改善过渡的策略。
研究结果表明，居住在保留地或偏远社区的原住民患者的康复和出院流程结构令人高度关注，值得进一步研究。
