School of Global and Population Health, University of Western Australia, Crawley, WA 6009, Australia.
Centre for Aboriginal Medical and Dental Health, University of Western Australia, Crawley, WA 6009, Australia.
Int J Environ Res Public Health. 2022 Apr 12;19(8):4650. doi: 10.3390/ijerph19084650.
Rheumatic heart disease (RHD) significantly impacts the lives of First Nations Australians. Failure to eliminate RHD is in part attributed to healthcare strategies that fail to understand the lived experience of RHD. To rectify this, a PhD study was undertaken in the Northern Territory (NT) of Australia, combining Aboriginal ways of knowing, being and doing with interviews (24 participants from clinical and community settings) and participant observation to privilege Aboriginal voices, including the interpretations and experiences of Aboriginal co-researchers (described in the adjunct article). During analysis, Aboriginal co-researchers identified three interwoven themes: maintaining good feelings; creating clear understanding (from good information); and choosing a good djalkiri (path). These affirm a worldview that prioritises relationships, positive emotions and the wellbeing of family/community. The findings demonstrate the inter-connectedness of knowledge, choice and behaviour that become increasingly complex in stressful and traumatic health, socioeconomic, political, historical and cultural contexts. Not previously heard in the RHD domain, the findings reveal fundamental differences between Aboriginal and biomedical worldviews contributing to the failure of current approaches to communicating health messages. Mitigating this, Aboriginal co-researchers provided targeted recommendations for culturally responsive health encounters, including: communicating to create positive emotions; building trust; and providing family and community data and health messages (rather than individualistic).
风湿性心脏病（RHD）严重影响了澳大利亚原住民的生活。未能消除 RHD 的部分原因是医疗保健策略未能理解 RHD 的生活体验。为了解决这个问题，澳大利亚北领地（NT）进行了一项博士研究，将原住民的认知、存在和行动方式与访谈（来自临床和社区环境的 24 名参与者）和参与式观察相结合，以赋予原住民声音特权，包括原住民共同研究者的解释和经验（在附属文章中描述）。在分析过程中，原住民共同研究者确定了三个相互交织的主题：保持良好的感觉；建立清晰的理解（来自好的信息）；并选择一个好的 djalkiri（路径）。这些主题肯定了一种优先考虑人际关系、积极情绪和家庭/社区福祉的世界观。研究结果表明，在充满压力和创伤的健康、社会经济、政治、历史和文化背景下，知识、选择和行为相互关联，变得越来越复杂。在 RHD 领域之前从未听说过，这些发现揭示了原住民和生物医学世界观之间的根本差异，这导致了当前沟通健康信息方法的失败。为了缓解这种情况，原住民共同研究者为文化上有回应的健康接触提供了有针对性的建议，包括：沟通以产生积极的情绪；建立信任；并提供家庭和社区数据和健康信息（而不是个人主义）。
