Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, Australia.
The Society of Saint Hilarion, Adelaide, Australia.
Prim Health Care Res Dev. 2021 Oct 7;22:e50. doi: 10.1017/S1463423621000542.
To identify: 1) best practice aged care principles and practices for Aboriginal and Torres Strait Islander older peoples, and 2) actions to integrate aged care services with Aboriginal community-controlled primary health care.
There is a growing number of older Aboriginal and Torres Strait Islander peoples and an unmet demand for accessible, culturally safe aged care services. The principles and features of aged care service delivery designed to meet the unique needs of Aboriginal and Torres Strait Islander peoples have not been extensively explored and must be understood to inform aged care policy and primary health care planning into the future.
The research was governed by leaders from across the Aboriginal community-controlled primary health care sector who identified exemplar services to explore best practice in culturally aligned aged care. In-depth case studies were undertaken with two metropolitan Aboriginal community-controlled services. We conducted semi-structured interviews and yarning circles with 46 staff members to explore key principles, ways of working, enablers and challenges for aged care service provision. A framework approach to thematic analysis was undertaken with emergent findings reviewed and refined by participating services and the governance panel to incorporate national perspectives.
A range of principles guided Aboriginal community-controlled aged care service delivery, such as supporting Aboriginal and Torres Strait Islander identity, connection with elders and communities and respect for self-determination. Strong governance, effective leadership and partnerships, Aboriginal and Torres Strait Islander workforce and culturally safe non-Indigenous workforce were among the identified enablers of aged care. Nine implementation actions guided the integration of aged care with primary health care service delivery. Funding limitations, workforce shortages, change management processes and difficulties with navigating the aged care system were among the reported challenges. These findings contribute to an evidence base regarding accessible, integrated, culturally safe aged care services tailored to the needs of Aboriginal and Torres Strait Islander peoples.
确定：1）原住民和托雷斯海峡岛民老年人的最佳实践老年护理原则和实践，以及 2）将老年护理服务与原住民社区控制的初级卫生保健整合的措施。
原住民和托雷斯海峡岛民老年人的数量不断增加，对可及、文化安全的老年护理服务的需求尚未得到满足。旨在满足原住民和托雷斯海峡岛民独特需求的老年护理服务提供的原则和特点尚未得到广泛探讨，必须加以理解，以便为未来的老年护理政策和初级卫生保健规划提供信息。
该研究由原住民社区控制的初级卫生保健部门的领导人主导，他们确定了具有代表性的服务，以探索文化上一致的老年护理中的最佳实践。对两个大都市的原住民社区控制的服务进行了深入的案例研究。我们对 46 名工作人员进行了半结构化访谈和交谈，以探讨提供老年护理服务的关键原则、工作方式、促进因素和挑战。采用框架方法对主题分析进行了分析，参与的服务和治理小组对初步结果进行了审查和完善，以纳入国家观点。
一系列原则指导着原住民社区控制的老年护理服务的提供，例如支持原住民和托雷斯海峡岛民的身份、与老年人和社区的联系以及尊重自决。强有力的治理、有效的领导和伙伴关系、原住民和托雷斯海峡岛民劳动力以及文化安全的非原住民劳动力是老年护理的促进因素之一。九条实施措施指导着老年护理与初级卫生保健服务的整合。报告的挑战包括资金限制、劳动力短缺、变革管理流程以及在老年护理系统中导航的困难。这些发现有助于为可及、综合、文化安全的老年护理服务提供一个证据基础，以满足原住民和托雷斯海峡岛民的需求。
