School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC 3010, Australia.
National Drug Research Institute, Curtin University, 7 Parker Place, Technology Park, Bentley, WA 6102, Australia.
Int J Environ Res Public Health. 2020 Nov 16;17(22):8480. doi: 10.3390/ijerph17228480.
Cultural security is a key element of accessible services for Indigenous peoples globally, although few studies have examined this empirically. We explored the scope, reach, quality, and cultural security of health and social services available to Aboriginal and/or Torres Strait Islander families in Western Australia (WA), from the point of view of staff from the services. We recruited staff from health and social services for Aboriginal people in the Perth, Kalgoorlie, Great Southern, and South West regions of WA between December 2015 and September 2017 to complete online surveys. We examined the proportions of participants that responded saying the service was culturally secure, the reasons for the response, and perceived factors related to a high-quality service. Sixty participants from 21 services responded to the survey. Seventy-three percent stated the service was culturally secure; however, only 36% stated that the staff employed at the service had sufficient knowledge on cultural security. Participants suggested having Aboriginal staff and better cultural awareness training as methods to improve cultural security within the service. Participants highlighted that staffing, funding for resources, and patient financial difficulties in accessing care as key areas for quality improvement. Much greater effort is required in improving knowledge through on-going training of staff in the practice of culturally safe care. Organisations must also be required to meet specific standards in cultural safety.
文化安全是全球原住民可及服务的一个关键要素，尽管很少有研究对此进行实证研究。我们从服务人员的角度探讨了西澳大利亚州（WA）原住民和/或托雷斯海峡岛民家庭可获得的卫生和社会服务的范围、覆盖范围、质量和文化安全性。我们于 2015 年 12 月至 2017 年 9 月期间招募了来自珀斯、卡尔古利、大南方和西南地区的原住民卫生和社会服务人员完成在线调查。我们调查了参与者中表示该服务具有文化安全性的比例、做出回应的原因以及与高质量服务相关的感知因素。来自 21 个服务机构的 60 名参与者对调查做出了回应。73%的人表示该服务具有文化安全性；但是，只有 36%的人表示服务机构的员工具有足够的文化安全知识。参与者建议，雇佣原住民员工和提供更好的文化意识培训是提高服务文化安全性的方法。参与者强调，人员配置、资源资金以及患者在获得护理方面的经济困难是提高服务质量的关键领域。需要通过对员工进行持续的文化安全护理实践培训来提高知识水平。还必须要求组织达到文化安全的具体标准。
