Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Broadway, P,O, Box 123, Broadway, Australia 2007.
BMC Health Serv Res. 2013 Aug 19;13:326. doi: 10.1186/1472-6963-13-326.
Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability.
Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community.
Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people.
Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services.Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability.
尽管残疾的发病率很高，但澳大利亚原住民获得残疾服务的比例却低于残疾的非原住民。原住民残疾儿童的需求尤其得不到充分理解。他们可能会经历长时间的治疗延迟，这可能会对其发育产生不利影响。本研究旨在确定影响澳大利亚原住民残疾儿童获得服务和支持的因素。
采用焦点小组方法，在澳大利亚新南威尔士州悉尼大都市区的一个原住民社区控制的健康服务机构（ACCHS）举办了两次社区论坛，一次是针对卫生和服务提供者，另一次是针对残疾原住民儿童的照顾者。对定性数据应用了框架分析，以阐明与获取框架维度相关的关键问题。对分析的一致性进行了独立的编码检查，并由整个研究团队（其中一些代表当地的原住民社区）对分析结果达成了共识。
2011 年 9 月至 10 月，17 名卫生和社会服务提供者代表地方政府和非政府资助的卫生和社会服务组织以及 5 名照顾者参加了两个单独的论坛。尽管距离拥有大量卫生基础设施的主要大都市区较近，但两组都对服务意识不足和服务可用性不足感到担忧。照顾者提到了种族主义、服务不足或不存在以及需要增强 ACCHS 和 AHW 在残疾支持服务中的作用。提供者强调了后勤障碍以及对原住民服务产生影响的文化和历史问题。
尽管在一个城市社区有专门的残疾服务，但地理位置的接近并不能减轻对支持的认识不足和可用性不足的问题。本文列举了在澳大利亚城市原住民社区提供残疾服务时需要考虑的一些问题，包括在原住民卫生工作者职位和服务中建立专业知识和专业能力。提高对服务的认识、促进联系和转介、消除获取支持的复杂性以及在弹性和赋权的框架内与家庭和原住民社区组织合作，以确保建立一个相关且可接受的模式，这些都是改善对残疾原住民儿童的支持和护理的必要步骤。
