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“必须坐下来共同解决”:澳大利亚原住民护理人员和服务提供者对改善澳大利亚原住民痴呆症护理方法的看法。

'Gotta be sit down and worked out together': views of Aboriginal caregivers and service providers on ways to improve dementia care for Aboriginal Australians.

作者信息

Smith Kate, Flicker Leon, Shadforth Geraldine, Carroll Emily, Ralph Naomi, Atkinson David, Lindeman Melissa, Schaper Frank, Lautenschlager Nicola T, LoGiudice Dina

机构信息

WA Centre for Health and Ageing, University of WA, Perth, Western Australia, Australia.

出版信息

Rural Remote Health. 2011;11(2):1650. Epub 2011 Jun 14.

Abstract

INTRODUCTION

Dementia is five-fold more prevalent among Aboriginal than non-Aboriginal Australians. Despite this, the quality of care available to people living with dementia in remote Aboriginal communities is poor. The objective of this study was to determine ways to overcome factors affecting the successful delivery of services to Aboriginal people with dementia living in remote communities, and to their families and communities.

METHODS

This qualitative research took place in the Kimberley Region of Western Australia. Data collection occurred in three stages: (1) interviews with service providers to identify the services available; (2) interviews with the caregivers of Aboriginal people living with dementia and community-based care workers; and (3) focus groups with community representatives and community care staff. Each stage was concluded when no new themes emerged. At each stage the transcribed information was analysed and joint interpretation identified common themes.

RESULTS

In total, 42 service providers, 31 caregivers and community-based care workers were interviewed and 3 focus groups were conducted. Obstacles to accessing quality care were mentioned and recommendations on ways to improve care were made. The key themes that emerged were caregiver role, perspectives of dementia, community and culturally-appropriate care, workforce, education and training, issues affecting remote communities and service issues. Detailed information on how each theme affects the successful delivery of dementia care is provided.

CONCLUSIONS

These research findings indicate that people living with dementia and their caregivers in remote Aboriginal communities are struggling to cope. They are requesting and require better community care. Implementing a culturally safe model of dementia care for remote Aboriginal communities that encompasses the recommendations made and builds on the strengths of the communities could potentially deliver the required improvements to dementia care for this population.

摘要

引言

澳大利亚原住民中痴呆症的患病率是非原住民的五倍。尽管如此,偏远原住民社区中痴呆症患者所获得的护理质量却很差。本研究的目的是确定克服影响向偏远社区中患有痴呆症的原住民及其家庭和社区成功提供服务的因素的方法。

方法

这项定性研究在西澳大利亚州的金伯利地区进行。数据收集分三个阶段进行:(1)与服务提供者进行访谈,以确定可用的服务;(2)与患有痴呆症的原住民的护理人员和社区护理工作者进行访谈;(3)与社区代表和社区护理人员进行焦点小组讨论。当没有新主题出现时,每个阶段结束。在每个阶段,对转录的信息进行分析,并通过联合解读确定共同主题。

结果

总共采访了42名服务提供者、31名护理人员和社区护理工作者,并进行了3次焦点小组讨论。提到了获得优质护理的障碍,并就改善护理的方法提出了建议。出现的关键主题包括护理人员角色、痴呆症观点、社区与文化适宜护理、劳动力、教育与培训、影响偏远社区的问题以及服务问题。提供了关于每个主题如何影响痴呆症护理成功提供的详细信息。

结论

这些研究结果表明,偏远原住民社区中患有痴呆症的人和他们的护理人员正在努力应对。他们要求并需要更好的社区护理。为偏远原住民社区实施一种文化安全的痴呆症护理模式,该模式包含所提出的建议并基于社区的优势,可能会为这一人群的痴呆症护理带来所需的改善。

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