Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia.
First Peoples Health Unit, Griffith University, Gold Coast, QLD, 4215, Australia.
J Foot Ankle Res. 2022 Apr 4;15(1):25. doi: 10.1186/s13047-022-00524-9.
Aboriginal and Torres Strait Islander Peoples have high rates of diabetes-related foot disease including foot ulcer and amputation. There has been limited evaluation of foot care services for Aboriginal and Torres Strait Islander Peoples. This project aimed to evaluate an Aboriginal and Torres Strait Islander foot care service (the Buridja Clinic) for prevention and management of diabetes-related foot disease embedded in a university podiatry program from a Community perspective using culturally appropriate methods.
This mixed-methods study took place from March 2018 to April 2021 in the Buridja Clinic on the Central Coast of New South Wales, Australia, and included an audit of occasions of service (March 2018 to March 2020), and review of the Buridja Clinic via research yarns with Aboriginal and Torres Strait Islander clients of the clinic and a written 10-item customised clinic feedback survey. Research yarns were transcribed and analysed thematically. Descriptive analysis of quantitative occasions of use and survey data was undertaken, with the open-ended survey responses thematically analysed.
Total occasions of service across the review period was 548, with a total of 199 individual clients treated. Most common service types were general treatments (nail and skin care) and diabetes assessments. Nine participants who attended the Buridja Clinic were recruited to the two research yarns. An additional 52 participants who attended the clinic completed the customised clinic feedback survey. Specific clinic design elements, including yarning circles and group booking as well as student placement, were identified as strengths of the clinic. Participants reported difficulty with transport and restricted opening hours and encouraged increased Community engagement by clinic staff.
Evaluation of a foot care service for Aboriginal and Torres Strait Islander Peoples embedded in a university-based podiatry program demonstrated that the incorporation of specific service design elements, including yarning circles and group appointments as well as student placements, encouraged ongoing Community engagement with the service. Participants reported improved foot health, greater foot and self-care knowledge, and overall better general health and management as a result of attendance to the clinic. Consideration needs to be given to addressing limited access to transport and flexible operating hours when establishing similar services. Artist Jenni McEwen (Bundjalung) lives on Darkinjung Country. The story of her art shows people sitting in yarning circles sharing knowledges but looking outwards to connect with Country too, the Ochre of Wiradjuri Country around Wellington, and the Blue of Darkinjung Country around Central Coast. These are locations where podiatry service provision takes place. These are locations where everyone is sharing and learning. Students, teachers, patients, non-Indigenous people, and First Nations people, learning from each other, and learning from Country.
原住民和托雷斯海峡岛民的糖尿病相关足部疾病（包括足部溃疡和截肢）发病率较高。对于原住民和托雷斯海峡岛民的足部护理服务，评估工作十分有限。本项目旨在从社区角度，使用文化适宜的方法，对嵌入大学足部医学项目中的原住民和托雷斯海峡岛民足部护理服务（Buridja 诊所）进行糖尿病相关足部疾病的预防和管理进行评估。
本混合方法研究于 2018 年 3 月至 2021 年 4 月在澳大利亚新南威尔士州中部海岸的 Buridja 诊所进行，包括服务次数审核（2018 年 3 月至 2020 年 3 月），以及通过 Buridja 诊所的研究线对诊所的原住民和托雷斯海峡岛民客户进行回顾，并对诊所进行了书面的 10 项定制诊所反馈调查。研究线的转录内容进行了主题分析。对定量使用次数和调查数据进行了描述性分析，并对开放式调查回复进行了主题分析。
在审查期间，总服务次数为 548 次，共治疗了 199 名个体患者。最常见的服务类型是一般治疗（指甲和皮肤护理）和糖尿病评估。有 9 名参加 Buridja 诊所的参与者被招募参加了这两项研究线。另外 52 名参加诊所的参与者完成了定制诊所反馈调查。诊所的具体设计元素，包括研讨圈和团体预约以及学生实习，被确定为诊所的优势。参与者报告说交通不便和营业时间有限，并鼓励诊所工作人员增加社区参与。
对嵌入大学足部医学项目中的原住民和托雷斯海峡岛民足部护理服务的评估表明，纳入特定的服务设计元素，包括研讨圈和团体预约以及学生实习，鼓励服务的持续社区参与。参与者报告说，由于参加诊所，他们的足部健康状况得到改善，足部和自我护理知识得到提高，整体健康和管理状况得到改善。在建立类似服务时，需要考虑解决交通不便和灵活的营业时间问题。艺术家 Jenni McEwen（Bundjalung）生活在 Darkinjung 地区。她的艺术作品讲述了人们围坐在研讨圈中分享知识，但也向外望向威拉吉里国家的赭石色，以及中央海岸的 Darkinjung 国家的蓝色，这两个地方都提供足部医学服务。这些都是开展足部医学服务的地方。这些都是大家分享和学习的地方。学生、教师、患者、非原住民和原住民，相互学习，从他们所在的土地上学习。
