Turner Institute for Brain and Mental, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
Monash-Epworth Rehabilitation Research Centre, Richmond, VIC, Australia.
Health Promot J Austr. 2021 Jul;32(3):541-547. doi: 10.1002/hpja.389. Epub 2020 Aug 10.
Aboriginal and Torres Strait Islander populations are at a significantly higher risk of neurological and cognitive impairment from a range of aetiologies. In order to better identify and support Indigenous Australians with cognitive impairment, culturally appropriate screening, management and referral processes are critical. The primary aim of this study was to investigate the frequency of presentations and type of cognitive screening conducted with Indigenous Australians presenting to health services.
Hospital data for 30 Indigenous Australians presenting with neurological symptoms to Emergency Departments within a large metropolitan health service were compared with a group of 30 non-Indigenous, Australian-born, English-speaking, age-, gender- and diagnosis-matched individuals.
Only two individuals, one from each group, received cognitive screening. This was likely related to a surprisingly large proportion of Indigenous Australians presenting to hospital with headache and migraine. Significantly more Indigenous Australians (36.7%) were consulted by a member of the multidisciplinary team compared to 10% of the non-Indigenous group. No differences in follow-up referrals were observed.
Results indicated a lack of cognitive screening practices being undertaken in both groups. It was encouraging to see Indigenous Australians receiving consultations from multidisciplinary team members at a higher rate, with a similar follow-up pathway being observed. This study further highlights the need for adoption of screening practices in primary health care settings and the development and use of culturally appropriate cognitive screening measures. SO WHAT?: This study investigates the cognitive screening practices of a metropolitan health service and highlights the need for culturally appropriate cognitive screening methods to be developed and implemented to facilitate the identification of cognitive impairment in Indigenous Australians presenting for treatment.
由于多种病因，原住民和托雷斯海峡岛民群体在神经和认知功能损伤方面面临更高的风险。为了更好地识别和支持认知功能损伤的澳大利亚原住民，需要制定文化适宜的筛查、管理和转诊流程。本研究的主要目的是调查在向卫生服务机构就诊的原住民中，进行认知筛查的频率和类型。
对比了一家大型都市卫生服务机构急诊部门中出现神经症状的 30 名原住民和 30 名非原住民（澳大利亚出生、英语为母语、年龄、性别和诊断匹配）个体的住院数据。
仅有 2 名个体（每组各 1 名）接受了认知筛查。这可能与相当大比例的原住民因头痛和偏头痛而就诊有关。与非原住民组的 10%相比，有更多的原住民（36.7%）接受了多学科团队成员的咨询。在后续转诊方面没有差异。
结果表明两组都缺乏认知筛查实践。令人鼓舞的是，看到原住民接受多学科团队成员的咨询比例更高，并且观察到相似的后续途径。本研究进一步强调了在初级保健环境中采用筛查实践以及制定和使用文化适宜的认知筛查措施的必要性。
本研究调查了一家都市卫生服务机构的认知筛查实践，并强调需要制定和实施文化适宜的认知筛查方法，以促进识别接受治疗的澳大利亚原住民的认知功能损伤。
