Kendall Elizabeth, Barnett Leda
a Griffith Health Institute , Griffith University , Meadowbrook , Australia.
Ethn Health. 2015;20(5):437-52. doi: 10.1080/13557858.2014.921897. Epub 2014 Jul 4.
To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being.
We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians.
Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health.
Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.
为了提高原住民对主流医疗服务的参与度，有必要了解影响医疗服务使用的因素。这些知识有助于开发尊重原住民生活方式、符合文化习俗的医疗服务。
我们采用基于社区的参与式方法，来探究澳大利亚原住民未充分利用医疗服务的原因。
通过对农村、地区和城市环境中的原住民医疗专业人员、领导者及社区成员进行三场焦点小组讨论和18次访谈，我们确定了影响医疗服务使用的五个因素，包括（1）负面的历史经历，（2）文化能力不足，（3）沟通不当，（4）集体健康观念，以及（5）更全面的健康观念。
鉴于这些因素塑造了原住民对健康干预措施的负面反应，它们很可能是产生更合适解决方案的原则。尽管这些原则直观上合理且广为人知，但非原住民医疗系统对其理解甚少，实施得更少。我们已将这些原则概念化为共情医疗系统的基础。没有共情，澳大利亚乃至国际上的医疗系统将继续面临构建有效服务以改善所有少数族裔健康状况的挑战。
