School of Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia
Mawarnkarra Health Service, Roebourne, 6718 WA, Australia
Rural Remote Health. 2021 Jul;21(3):6485. doi: 10.22605/RRH6485. Epub 2021 Jul 5.
This research was undertaken to gain insight into what remote area nurses perceived were enablers and barriers to being involved in delivering care to an Aboriginal person with a terminal diagnosis passing away on their traditional lands. It is hoped that this gives remote area nurses, Aboriginal Australians and service providers a glimpse into what is happening in the remote areas of Australia. Remote area nurses often work in isolated and in extreme geographical locations. This also means that a significant proportion work alongside and with Aboriginal Australians. In addition, remote area nurses are often left to support people in the communities they work in under extreme and often under-resourced conditions.
A literature review was undertaken on this subject and a four-section questionnaire was then developed based on the literature. This included demographic questions and two sections using an ordinal Likert scale. The Likert scale questions asked remote area nurses about the skills they felt they used to deal with particular situations and the capacity of the health service to deal with the situations. The fourth section comprised open-ended questions. Thematic analysis was undertaken on the open-ended questions. Categories and themes were developed, and the results discussed. The four-part questionnaire was designed to be anonymous, and it formed part of the questionnaire distributed to students enrolled with the School of Indigenous and Remote Health Alice Springs, Flinders University by email, and to not-for-profit membership organisation CRANAplus for distribution through their networks.
Remote area nurses felt that the barriers to supporting an Aboriginal Australian with a terminal diagnosis passing away on their traditional lands were a lack of support around the delivery of culturally appropriate end-of-life care, lack of a stable workforce, insufficient cultural knowledge and understanding, and a lack of guidance and support from family. They felt the enablers were effective communication with the family and Aboriginal elders providing advice to staff and direction on how they can support the family, willingness of staff to participate in care, and input from Aboriginal health practitioners.
Remote area nurses perceived they lacked support and knowledge from several different areas, both from within their communities and outside of their communities. Despite the barriers, it was evident that remote area nurses can be very resourceful at enabling the processes of supporting Aboriginal people with a terminal diagnosis passing away on their traditional lands.
本研究旨在深入了解偏远地区护士在为传统土地上临终的原住民提供护理时，所面临的促进因素和障碍。希望这能让偏远地区护士、澳大利亚原住民和服务提供者了解澳大利亚偏远地区正在发生的事情。偏远地区护士通常在偏远和极端的地理位置工作。这也意味着很大一部分护士与澳大利亚原住民一起工作。此外，偏远地区护士经常在极端和资源匮乏的情况下，在他们工作的社区中支持人们。
对这一主题进行了文献回顾，并根据文献制定了四部分问卷。这包括人口统计问题和使用有序 Likert 量表的两个部分。Likert 量表问题询问了偏远地区护士他们认为自己在处理特定情况时使用的技能，以及卫生服务部门处理这些情况的能力。第四部分包括开放式问题。对开放式问题进行了主题分析。制定了类别和主题，并进行了讨论。四部分问卷旨在匿名，是分发给弗林德斯大学原住民和偏远健康学院学生的问卷的一部分，通过电子邮件发送，并由非营利性会员组织 CRANAplus 通过其网络分发。
偏远地区护士认为，在原住民传统土地上为临终原住民提供文化上适当的临终关怀时，存在的障碍是缺乏支持、劳动力不稳定、文化知识和理解不足，以及缺乏家庭的指导和支持。他们认为促进因素是与家属的有效沟通，以及提供建议的家属和长者，为工作人员提供支持家属的方向，工作人员愿意参与护理，以及原住民健康从业者的投入。
偏远地区护士认为他们在社区内外的几个不同领域都缺乏支持和知识。尽管存在障碍，但很明显，偏远地区护士在支持传统土地上临终的原住民方面非常有能力。
