Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, WA, Australia.
Respirology. 2020 Apr;25(4):383-392. doi: 10.1111/resp.13642. Epub 2019 Jul 25.
Chronic lung disease is prevalent among Australian Aboriginal children. Chronic wet cough is an early marker of disease but often goes undetected. Currently, no studies have examined health practitioner knowledge of chronic wet cough. We set out to examine health practitioner knowledge of chronic wet cough and chronic lung disease in Aboriginal children and to identify barriers and enablers to effective management.
A qualitative study, gathering data through individual semi-structured, in-depth interviews and focus groups to ascertain health practitioner knowledge about management of Aboriginal children with chronic wet cough in a regional Kimberley town and remote community.
Thirty-seven health practitioners participated. Key barriers identified were: (i) limited training in assessment and management of chronic wet cough; (ii) prioritization of acute presentations and competing complex chronic conditions; and (iii) normalization of cough in children by health practitioners. Key enablers were: (i) improving practitioners' knowledge and expertise in managing chronic wet cough; and (ii) health system changes to facilitate longitudinal patient care, improved cultural competence, improved chronic disease management and post-hospitalization follow-up.
Key barriers to effective management of chronic wet cough are limited training in chronic wet cough management combined with competing complexities of both acute and chronic healthcare needs for Aboriginal families. Early detection and management of chronic wet cough in Aboriginal children can be facilitated through health practitioner training, access to standardized management guidelines and a service model that allows longitudinal patient follow-up and resources to effectively prevent and manage chronic lung disease in children.
慢性肺部疾病在澳大利亚原住民儿童中较为常见。慢性湿咳是疾病的早期标志物，但往往未被发现。目前，尚无研究检查卫生保健从业者对慢性湿咳和原住民儿童慢性肺部疾病的了解程度。我们旨在检查卫生保健从业者对原住民儿童慢性湿咳和慢性肺部疾病的了解程度，并确定有效管理的障碍和促进因素。
这是一项定性研究，通过个人半结构化深入访谈和焦点小组收集数据，以确定区域金伯利镇和偏远社区中卫生保健从业者对管理患有慢性湿咳的原住民儿童的了解程度。
有 37 名卫生保健从业者参与了研究。确定的主要障碍包括：（i）评估和管理慢性湿咳的培训有限；（ii）急性发作和复杂慢性疾病的优先级；以及（iii）卫生保健从业者对儿童咳嗽的正常化。主要促进因素包括：（i）提高从业者管理慢性湿咳的知识和专业技能；以及（ii）卫生系统的改变，以促进纵向患者护理、提高文化能力、改善慢性疾病管理和住院后随访。
有效管理慢性湿咳的主要障碍是慢性湿咳管理方面的培训有限，再加上原住民家庭急性和慢性医疗保健需求的复杂性。通过卫生保健从业者培训、获得标准化管理指南以及允许纵向患者随访和资源的服务模式，可以促进原住民儿童慢性湿咳的早期发现和管理，从而有效预防和管理儿童慢性肺部疾病。
