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与患有痴呆症或认知障碍的原住民和托雷斯海峡岛民及其护理人员共同绘制患者旅程地图:方案

Developing patient journey maps with Aboriginal and Torres Strait Islander peoples living with dementia or cognitive impairment and their carers: protocol.

作者信息

O'Brien Penny, Sinclair Craig, Kinsey India, Zanker Jesse, Juhrmann Madeleine, Smith Robyn, Thompson Sandra, Bessarab Dawn, Lo Giudice Dina

机构信息

Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.

School of Psychology, University of New South Wales, Randwick, New South Wales, Australia.

出版信息

BMJ Open. 2025 May 8;15(5):e090672. doi: 10.1136/bmjopen-2024-090672.

Abstract

INTRODUCTION

Although Aboriginal and Torres Strait Islander peoples are increasingly living healthier and longer lives, they continue to experience a high prevalence and incidence of dementia and cognitive impairment. Navigating dementia care services is challenging, and there is limited availability of flexible, culturally secure health and community care services. The aim of this study is to use a culturally adapted patient journey mapping methodology to examine the lived experiences of Aboriginal and Torres Strait Islander Aboriginal peoples living with dementia/cognitive impairment and their carers navigating their care journeys.

METHODS AND ANALYSIS

The overarching principle guiding this project is cultural security, referring to the incorporation of processes such that the research will not compromise the cultural rights, values and expectations of Aboriginal and Torres Strait Islander peoples. In this three-phase participatory action research study, we will (1) formalise relationships with health and home care services as recruitment sites; (2) conduct research yarns (a culturally secure qualitative data collection tool) with Aboriginal and Torres Strait Islander peoples living with dementia or cognitive impairment and their carers about their experiences of healthcare including perceived barriers and enablers to high-quality care. Data collected in research yarns will be analysed using a modified framework approach to map patient journeys and; (3) make recommendations for improving care identified by participants to be discussed and refined with stakeholder groups and to inform best practice guideline development.

ETHICS AND DISSEMINATION

This project follows the National Health and Medical Research Council's guidelines for ethical conduct in research with Aboriginal and Torres Strait Islander communities and has been designed with active involvement and governance by Aboriginal and Torres Strait Islander peoples. The results will be disseminated through community feedback sessions, newsletters, conference presentations, peer-reviewed publications and best practice guidelines. Dissemination will also be guided by an established Aboriginal Reference Group.

摘要

引言

尽管原住民和托雷斯海峡岛民的生活越来越健康长寿,但他们仍面临着痴呆症和认知障碍的高患病率和发病率。在痴呆症护理服务中进行导航具有挑战性,而且灵活的、具有文化安全性的健康和社区护理服务的可获得性有限。本研究的目的是使用一种经过文化调整的患者旅程映射方法,来考察患有痴呆症/认知障碍的原住民和托雷斯海峡岛民及其护理人员在护理旅程中的生活经历。

方法与分析

指导该项目的总体原则是文化安全,即纳入相关流程,使研究不会损害原住民和托雷斯海峡岛民的文化权利、价值观和期望。在这个分为三个阶段的参与式行动研究中,我们将:(1)与健康和家庭护理服务机构建立正式关系,作为招募地点;(2)与患有痴呆症或认知障碍的原住民和托雷斯海峡岛民及其护理人员进行研究访谈(一种具有文化安全性的定性数据收集工具),了解他们的医疗保健经历,包括高质量护理的感知障碍和促进因素。将使用一种经过修改的框架方法对研究访谈中收集的数据进行分析,以绘制患者旅程图;(3)就参与者确定的改善护理的建议提出建议,与利益相关者群体进行讨论和完善,并为最佳实践指南的制定提供信息。

伦理与传播

本项目遵循澳大利亚国家卫生与医学研究委员会关于与原住民和托雷斯海峡岛民社区进行研究的伦理行为指南,并在原住民和托雷斯海峡岛民的积极参与和管理下进行设计。研究结果将通过社区反馈会议、时事通讯、会议报告、同行评审出版物和最佳实践指南进行传播。传播工作也将由一个既定的原住民参考小组进行指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa1e/12067768/428e1ebfdfbe/bmjopen-15-5-g001.jpg

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