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从照顾原住民儿童的角度出发,确定有效诊断和提供中耳炎初级保健的障碍和促进因素。

Identifying barriers and facilitators for the effective diagnosis and provision of primary health care for otitis media from the perspective of carers of Aboriginal children.

机构信息

Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia.

Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.

出版信息

J Paediatr Child Health. 2024 Oct;60(10):505-510. doi: 10.1111/jpc.16626. Epub 2024 Jul 20.

Abstract

AIM

To identify the barriers and facilitators for timely detection and optimal management of otitis media (OM) in Aboriginal children in a primary care setting from the perspective of carers of Aboriginal children.

METHODS

A qualitative, Aboriginal co-designed, participatory action research study with interviews and focus groups in a large town in the Kimberley, Western Australia. The Consolidated Framework for Implementation Research informed stakeholder group identification and interview framework development. Data underwent thematic analysis using NVivo software.

RESULTS

Thirty-two carers of Aboriginal children participated. Key barriers identified for the detection of OM were limited information about OM provided to carers and carers feeling disempowered to express their concerns. Key facilitators identified were the provision of health information through health promotion and the use of culturally secure resources. Having a culturally secure clinical environment was identified as essential, with Aboriginal Health Workers playing a vital role in clinical care. No barriers to management of OM in primary care were reported. Facilitators included health care practitioners (HCPs) emphasising the importance of completing antibiotic course and the clinic providing necessary medications.

CONCLUSIONS

A culturally secure health promotion strategy with health promotion teams, campaigns and resources is needed to increase community awareness of OM signs and symptoms and facilitate appropriate health seeking. It is essential that the local Aboriginal community co-lead and co-develop these initiatives to ensure the unique wisdom and knowledge of Aboriginal people are captured. HCPs and the clinic effectively facilitate management of OM by providing medications and emphasising completion of antibiotics.

摘要

目的

从照顾原住民儿童的照顾者的角度出发,确定原住民儿童在初级保健环境中及时发现和最佳管理中耳炎(OM)的障碍和促进因素。

方法

这是一项在西澳大利亚金伯利地区一个大城镇进行的定性、原住民共同设计的参与式行动研究,采用访谈和焦点小组的方法。实施研究综合框架为利益相关者小组的确定和访谈框架的制定提供了信息。数据使用 NVivo 软件进行主题分析。

结果

共有 32 名原住民儿童的照顾者参与了研究。发现的 OM 检测的主要障碍包括向照顾者提供的 OM 信息有限,以及照顾者感到无力表达自己的担忧。确定的主要促进因素包括通过健康促进提供健康信息和使用文化安全资源。有一个文化安全的临床环境被认为是至关重要的,原住民卫生工作者在临床护理中发挥着重要作用。在初级保健中,没有发现 OM 管理的障碍。促进因素包括医疗保健从业者(HCPs)强调完成抗生素疗程的重要性,以及诊所提供必要的药物。

结论

需要制定一种文化安全的健康促进策略,包括健康促进团队、运动和资源,以提高社区对 OM 体征和症状的认识,并促进适当的寻求健康。至关重要的是,当地的原住民社区共同领导和共同制定这些倡议,以确保原住民人民的独特智慧和知识得到体现。HCPs 和诊所通过提供药物和强调完成抗生素疗程,有效地促进了 OM 的管理。

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