Sullivan Richard P, Bukulatjpi Sarah Mariyalawuy, Binks Paula, Hosking Kelly, Nundhirribala Patricia, Vintour-Cesar Emily, McKinnon Melita, Gurruwiwi George, Green Anna, Davis Joshua S, Davies Jane
Menzies School of Health Research, Charles Darwin University, Northern Territory (NT), Darwin, Australia.
Department of Infectious Diseases and Immunology, St George and Sutherland Hospital, School of Clinical Medicine, UNSW Medicine and Health, Sydney, New South Wales (NSW), Australia.
Arch Public Health. 2024 Sep 11;82(1):151. doi: 10.1186/s13690-024-01389-z.
The Aboriginal health workforce has unique insights given their healthcare experience and interactions with their communities. The aims of this project were to explore their perceptions of hepatitis B related shame and ways to improve hepatitis B care in Aboriginal and Torres Strait Islander communities of Northern Territory's Top End, Australia.
We conducted a qualitative study with guidance from the Menzies School of Health Research Infectious Diseases Indigenous Reference Group. The Aboriginal health workforce was asked to participate in semi-structured interviews exploring hepatitis B related shame and ways to improve hepatitis B care. Qualitative data were evaluated using reflexive thematic analysis.
There were fifteen semi-structured interviews with participants representing eight different communities. The experience of shame was reported by the Aboriginal health workforce to be common for individuals diagnosed with hepatitis B and comprised feelings of fear related to transmitting the virus, to being isolated, and to being at fault. Shame was mediated by poor health literacy, communication, the lack of culturally safe spaces and was perpetuated by intersecting stereotypes. Improvements in care can be achieved by utilising the Aboriginal health workforce more effectively, improving communication and the availability of culturally safe spaces, emphasising community connection, and reframing hepatitis B as a chronic condition.
Hepatitis B related shame was an important issue and impactful in Aboriginal and Torres Strait Islander communities in the Top End of the Northern Territory. There were many facets to shame in these communities and it was mediated by several factors. The Aboriginal health workforce has emphasised several pathways to improve care and diminish the impact of shame, such as improving communication and the availability of culturally safe spaces.
原住民卫生工作者凭借其医疗保健经验以及与社区的互动，拥有独特的见解。本项目的目的是探讨他们对乙型肝炎相关羞耻感的看法，以及改善澳大利亚北领地顶端地区原住民和托雷斯海峡岛民社区乙型肝炎护理的方法。
我们在孟席斯健康研究学院传染病原住民参考小组的指导下进行了一项定性研究。邀请原住民卫生工作者参与半结构化访谈，探讨与乙型肝炎相关的羞耻感以及改善乙型肝炎护理的方法。使用反思性主题分析对定性数据进行评估。
对代表八个不同社区的参与者进行了15次半结构化访谈。原住民卫生工作者报告称，被诊断为乙型肝炎的个人普遍有羞耻感，包括与传播病毒、被孤立以及感到自己有错相关的恐惧情绪。羞耻感因健康素养差、沟通不畅、缺乏文化安全空间而加剧，并因交叉的刻板印象而持续存在。通过更有效地利用原住民卫生工作者、改善沟通和提供文化安全空间、强调社区联系以及将乙型肝炎重新定义为慢性病，可以实现护理的改善。
在北领地顶端地区的原住民和托雷斯海峡岛民社区，与乙型肝炎相关的羞耻感是一个重要问题且影响深远。这些社区的羞耻感有很多方面，并且由多种因素介导。原住民卫生工作者强调了几条改善护理和减少羞耻感影响的途径，例如改善沟通和提供文化安全空间。
