D'Sylva Pamela, Walker Roz, Lane Mary, Chang Anne B, Schultz André
Child Health, School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
Kulunga Aboriginal Research Development Unit, Telethon Kids Institute, Perth, Western Australia, Australia.
J Paediatr Child Health. 2019 Jul;55(7):833-843. doi: 10.1111/jpc.14305. Epub 2018 Nov 15.
Chronic respiratory disease is common among Aboriginal Australians. Chronic wet cough is an early marker of chronic disease in children but often goes undetected due, in part, to delayed health seeking by families. Currently, no studies have examined the reasons for delayed health seeking for children's chronic cough. To identify the barriers to, and enablers for, seeking medical help for chronic wet cough in Aboriginal children.
This was a qualitative study, gathering data through individual semi-structured, in-depth interviews and focus groups to ascertain Aboriginal family knowledge, attitudes and beliefs about seeking health care for chronic wet cough in children in a regional Kimberley town, Western Australia between October 2017 and March 2018.
Forty Aboriginal community members participated. The three key barriers identified were: 'Cough normalisation', that is, 70% of participants considered chronic cough normal (with 53% of participants' previous interactions with doctors informing their understanding of chronic cough); the lack of health literacy information; and a sense of disempowerment (belief that no medical action would be taken and inability to challenge doctors). The key expressed enablers were provision of health literacy information and health practitioner training to assess and treat chronic wet cough in children. All participants reported that they would seek help for chronic wet cough once they were informed that it could signify underlying disease.
Results highlight the need for a culturally appropriate information and education to inform Aboriginal families and their health practitioners of the importance of chronic wet cough in children.
慢性呼吸道疾病在澳大利亚原住民中很常见。慢性湿性咳嗽是儿童慢性疾病的早期指标,但部分由于家庭延迟就医,常常未被发现。目前,尚无研究探讨儿童慢性咳嗽延迟就医的原因。旨在确定澳大利亚原住民儿童慢性湿性咳嗽寻求医疗帮助的障碍和促进因素。
这是一项定性研究,通过个人半结构化深度访谈和焦点小组收集数据,以确定2017年10月至2018年3月期间西澳大利亚州金伯利地区一个城镇的原住民家庭对儿童慢性湿性咳嗽寻求医疗保健的知识、态度和信念。
40名原住民社区成员参与。确定的三个主要障碍是:“咳嗽正常化”,即70%的参与者认为慢性咳嗽正常(53%的参与者之前与医生的互动影响了他们对慢性咳嗽的理解);缺乏健康素养信息;以及一种无权感(认为不会采取任何医疗行动且无法质疑医生)。表达出的主要促进因素是提供健康素养信息以及对医疗从业者进行评估和治疗儿童慢性湿性咳嗽的培训。所有参与者都表示,一旦得知慢性湿性咳嗽可能意味着潜在疾病,他们会寻求帮助。
研究结果凸显了开展具有文化适宜性的信息和教育的必要性,以便让原住民家庭及其医疗从业者了解儿童慢性湿性咳嗽的重要性。