Walker Natasha, Mackean Tamara, Longbottom Marlene, Coombes Julieann, Bennett-Brook Keziah, Clapham Kathleen, Ivers Rebecca, Hackett Maree, Redfern Julie, Cullen Patricia
School of Population Health, UNSW, Sydney, NSW, Australia.
The George Institute for Global Health, UNSW, Sydney, NSW, Australia.
Health Promot J Austr. 2021 Oct;32 Suppl 2:40-53. doi: 10.1002/hpja.417. Epub 2020 Oct 1.
It is demonstrated that primary health care (PHC) providers are sought out by women who experience violence. Given the disproportionate burden of violence experienced by Aboriginal and Torres Strait Islander women, it is essential there is equitable access to appropriate PHC services. This review aimed to analyse whether Australian PHC policy accounts for the complex needs of Aboriginal and Torres Strait Islander women experiencing violence and the importance of PHC providers responding to violence in culturally safe ways.
Using the Arskey and O'Malley framework, an iterative scoping review determined the policies for analysis. The selected policies were analysed against concepts identified as key components in responding to the needs of Aboriginal and Torres Strait Islander women experiencing violence. The key components are Family Violence, Violence against Aboriginal and Torres Strait Islander Women, Social Determinants of Aboriginal and Torres Strait Islander Health and Wellbeing, Cultural Safety, Holistic Health, Trauma, Patient-Centred Care and Trauma-and-Violence-Informed Care.
Following a search of Australian government websites, seven policies were selected for analysis. Principally, no policy embedded or described best practice across all key components.
The review demonstrates the need for a specific National framework supporting Aboriginal and Torres Strait Islander women who seek support from PHC services, as well as further policy analysis and review. SO WHAT?: Aboriginal and Torres Strait Islander women disproportionately experience more severe violence, with complex impact, than other Australian women. PHC policy and practice frameworks must account for this, together with the intersection of contemporary manifestations of colonialism and historical and intergenerational trauma.
研究表明，遭受暴力的女性会寻求初级卫生保健（PHC）提供者的帮助。鉴于原住民和托雷斯海峡岛民女性遭受暴力的负担过重，公平获得适当的初级卫生保健服务至关重要。本综述旨在分析澳大利亚的初级卫生保健政策是否考虑到了遭受暴力的原住民和托雷斯海峡岛民女性的复杂需求，以及初级卫生保健提供者以文化安全的方式应对暴力的重要性。
采用阿斯基和奥马利框架进行迭代式范围综述，以确定用于分析的政策。根据被确定为应对遭受暴力的原住民和托雷斯海峡岛民女性需求的关键组成部分的概念，对选定的政策进行分析。关键组成部分包括家庭暴力、针对原住民和托雷斯海峡岛民女性的暴力、原住民和托雷斯海峡岛民健康与福祉的社会决定因素、文化安全、整体健康、创伤、以患者为中心的护理以及创伤和暴力知情护理。
在搜索澳大利亚政府网站后，选择了七项政策进行分析。主要的是，没有一项政策涵盖或描述了所有关键组成部分的最佳实践。
该综述表明需要一个具体的国家框架来支持向初级卫生保健服务寻求帮助的原住民和托雷斯海峡岛民女性，以及进一步的政策分析和审查。那又如何？：与其他澳大利亚女性相比，原住民和托雷斯海峡岛民女性遭受更严重暴力且影响复杂的比例更高。初级卫生保健政策和实践框架必须考虑到这一点，以及殖民主义当代表现形式与历史和代际创伤的交织。
