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让每一位澳大利亚人都被重视:国家残疾保险计划(NDIS)面临的挑战以及无家可归的患有神经认知障碍的原住民和托雷斯海峡岛民的平等包容问题。

Making every Australian count: challenges for the National Disability Insurance Scheme (NDIS) and the equal inclusion of homeless Aboriginal and Torres Strait Islander Peoples with neurocognitive disability.

作者信息

Townsend Clare, White Paul, Cullen Jennifer, Wright Courtney J, Zeeman Heidi

机构信息

Synapse, 1/262 Montague Road, West End, Qld 4101, Australia. Email:.

Queensland Government Department of Communities, Child Safety and Disability Services, Specialist Disability Services Assessment and Outreach Team, Russell Street, South Brisbane, Qld 4101, Australia. Email.

出版信息

Aust Health Rev. 2018 Apr;42(2):227-229. doi: 10.1071/AH16229.

Abstract

This article highlights the dearth of accurate evidence available to inform the National Disability Insurance Scheme (NDIS) regarding the extent and nature of neurocognitive disability amongst homeless Aboriginal and Torres Strait Islander people. Without accurate prevalence rates of neurocognitive disability, homeless Aboriginal and Torres Strait Islander people are in danger of not being counted by the NDIS and not receiving supports to which they are entitled. Addressing this knowledge gap is challenged by a range of factors, including: (1) the long-term effect of profound intergenerational disenfranchisement of Aboriginal and Torres Strait Islander people; (2) Aboriginal and Torres Strait Islander cultural perspectives around disability; (3) the generally unrecognised and poorly understood nature of neurocognitive disability; (4) the use of research methods that are not culturally safe; (5) research logistics; and (6) the absence of culturally appropriate assessment tools to identify prevalence. It is argued that an accurate evidence base that is informed by culturally safe research methods and assessment tools is needed to accurately guide the Commonwealth government and the National Disability Insurance Agency about the expected level of need for the NDIS. Research within this framework will contribute to the realisation of a truly inclusive NDIS.

摘要

本文强调,在为国家残疾保险计划(NDIS)提供信息时,缺乏关于无家可归的原住民和托雷斯海峡岛民中神经认知残疾的程度和性质的准确证据。由于缺乏神经认知残疾的准确患病率,无家可归的原住民和托雷斯海峡岛民面临不被NDIS统计且无法获得应有支持的风险。一系列因素给填补这一知识空白带来了挑战,这些因素包括:(1)原住民和托雷斯海峡岛民长期遭受的严重代际剥夺公民权的影响;(2)原住民和托雷斯海峡岛民关于残疾的文化观念;(3)神经认知残疾通常未被认识且了解甚少的性质;(4)使用不符合文化安全的研究方法;(5)研究后勤;以及(6)缺乏用于确定患病率的符合文化习惯的评估工具。有人认为,需要一个基于文化安全的研究方法和评估工具的准确证据基础,以便为联邦政府和国家残疾保险局准确指导NDIS的预期需求水平提供依据。在此框架内开展的研究将有助于实现一个真正包容的NDIS。

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