Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia.
School of Medicine, Western Sydney University, Penrith, New South Wales, Australia.
J Child Health Care. 2021 Jun;25(2):194-211. doi: 10.1177/1367493520919305. Epub 2020 Apr 17.
Aboriginal and Torres Strait Islander children experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention from across the health, education and social service sectors is vital for improving outcomes, but families face a number of barriers to service access which impede intervention. This study aimed to inform ways to improve access to services for families of urban-dwelling Aboriginal children with a range of disabilities. A qualitative approach was taken to explore providers' perceptions of factors that either impeded or enabled families' access to services. In this research, the term 'provider' refers to individuals who are employed in a range of sectors to deliver a service involving assessment or management of an individual with a disability. Semi-structured in-depth interviews with 24 providers were conducted. Data analysis was informed by the general inductive approach and then applied deductively to the candidacy framework to generate additional insights. Candidacy focuses on how potential users access the services they need and acknowledges the joint negotiation between families and providers regarding such access. Our research identified that candidacy was influenced by the historical legacy of colonisation and its ongoing socio-cultural impact on Aboriginal people, as well as funding and current policy directives. Enacting culturally sensitive and meaningful engagement to better understand families' needs and preferences for support, as well as support for providers to develop their understanding of family contexts, will contribute to facilitating service access for Aboriginal children with a disability.
原住民和托雷斯海峡岛民儿童的残疾率和社会经济劣势比其他澳大利亚儿童更高。医疗、教育和社会服务部门的早期干预对于改善结果至关重要，但家庭在获得服务方面面临着许多障碍，这阻碍了干预的进行。本研究旨在为改善有各种残疾的城市居住的原住民儿童家庭获得服务的途径提供信息。本研究采用定性方法探讨了提供者对阻碍或促进家庭获得服务的因素的看法。在这项研究中，“提供者”一词是指受雇于一系列部门的个人，他们提供涉及残疾个体评估或管理的服务。对 24 名提供者进行了半结构化深入访谈。数据分析受一般归纳方法的启发，并随后应用于候选框架，以产生更多的见解。候选资格侧重于潜在用户如何获得他们所需的服务，并承认家庭和提供者就此类获取进行的联合谈判。我们的研究表明，候选资格受到殖民历史的遗留问题及其对原住民持续的社会文化影响的影响，以及资金和当前政策指令的影响。采取文化上敏感和有意义的方法来更好地了解家庭对支持的需求和偏好，以及支持提供者了解家庭背景，将有助于为残疾原住民儿童提供服务。
