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澳大利亚西部偏远原住民社区儿童皮肤感染卫生服务利用的障碍和促进因素。

Barriers and Enablers of Health Service Utilisation for Childhood Skin Infections in Remote Aboriginal Communities of Western Australia.

机构信息

Telethon Kids Institute, University of Western Australia, Perth WA 6009, Australia.

IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), University of Technology Sydney, Sydney NSW 2007, Australia.

出版信息

Int J Environ Res Public Health. 2020 Jan 28;17(3):808. doi: 10.3390/ijerph17030808.

Abstract

In Australia, children living in remote Aboriginal communities experience high rates of skin infections and associated complications. Prompt presentation to primary care health services is crucial for early diagnosis and treatment. We performed a qualitative study in four remote Aboriginal communities in the Pilbara region of Western Australia to explore factors that affected health service utilisation for childhood skin infections in this setting. The study consisted of semistructured interviews and focus group discussions with parents and carers ( = 16), healthcare practitioners ( = 15) and other community service providers ( = 25). We used Andersen's health service utilisation model as an analytical framework. Our analysis captured a wide range of barriers that may undermine timely use of health services for childhood skin infections. These included general factors that illustrate the importance of cultural competency amongst healthcare providers, patient-centred care and community engagement. Relating specifically to health service utilisation for childhood skin infections, we identified their apparent normalisation and the common use of painful benzathine penicillin G injections for their treatment as important barriers. Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections, actively engaging parents and carers in consultation and treatment processes and strengthening community involvement in health service activities.

摘要

在澳大利亚,生活在偏远原住民社区的儿童皮肤感染率和相关并发症很高。及时向初级保健卫生服务机构就诊对于早期诊断和治疗至关重要。我们在西澳大利亚皮尔巴拉地区的四个偏远原住民社区进行了一项定性研究,以探讨影响该环境下儿童皮肤感染卫生服务利用的因素。该研究包括对父母和照顾者(= 16)、医疗保健从业者(= 15)和其他社区服务提供者(= 25)进行半结构化访谈和焦点小组讨论。我们使用安德森卫生服务利用模型作为分析框架。我们的分析捕捉到了一系列可能破坏儿童皮肤感染及时使用卫生服务的障碍。其中包括说明了医疗保健提供者文化能力重要性的一般因素、以患者为中心的护理和社区参与。具体涉及儿童皮肤感染的卫生服务利用,我们发现其明显的常态化和普遍使用疼痛的苄星青霉素 G 注射治疗是重要的障碍。通过提高对儿童皮肤感染重要性的普遍认识、积极让父母和照顾者参与咨询和治疗过程以及加强社区对卫生服务活动的参与,可以改善该环境中的卫生服务利用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6206/7037003/5a08e2947de5/ijerph-17-00808-g001.jpg

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