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探索医疗服务提供者对促进原住民和托雷斯海峡岛民青年获得初级卫生保健的因素的看法:昆士兰州东南部的一项定性研究

Exploring healthcare providers' perspectives on the factors that facilitate primary health care access among Aboriginal and Torres Strait Islander young people: a qualitative study in Southeast Queensland.

作者信息

Harfield Stephen, Dean Judith A, Azzopardi Peter, Mishra Gita D, Ward James

机构信息

UQ Poche Centre for Indigenous Health, University of Queensland, St Lucia, Australia.

School of Public Health, University of Queensland, Brisbane, Australia.

出版信息

BMC Prim Care. 2025 Aug 19;26(1):257. doi: 10.1186/s12875-025-02959-y.

Abstract

BACKGROUND

Aboriginal and Torres Strait Islander young people aged 15-24 years of age often encounter challenges accessing and utilising primary health care (PHC). Providing health care responsive to the needs of Aboriginal and Torres Strait Islander young people requires the active involvement of healthcare providers (HCPs), who play a central role in healthcare delivery. This study explored perspectives of HCPs working in urban Aboriginal and Torres Strait Islander Community-Controlled Health Organisations (ATSICCHOs) on the factors that facilitate Aboriginal and Torres Strait young people accessing and utilising PHC services.

METHODS

Thirteen research yarns were conducted with HCPs in urban southeast Queensland (SEQ), Australia. Inductive thematic analysis was used to identify factors facilitating health care access and utilisation and were mapped to a social-ecological framework model.

RESULTS

Three overarching strength-based themes that facilitate access to health care were common across research yarns: (1) The ATSICCHO model of care addresses the needs of Aboriginal and Torres Strait Islander young people; (2) Family and community play a key role in facilitating Aboriginal and Torres Strait Islander young people's access to healthcare services; and (3) The characteristics of Aboriginal and Torres Strait Islander young people that support health-seeking behaviour. Specific factors identified included targeted programs and initiatives specifically for Aboriginal and Torres Strait Islander young people; equitable access to holistic, comprehensive and culturally safe PHC; characteristics and skills of the ATSICCHO workforce that support young people's engagement and access; and young people's motivation to be healthy and to seek care. Barriers contrasting these themes were also identified.

CONCLUSION

HCPs from urban ATSICCHOs provide a unique perspective on the healthcare experience of Aboriginal and Torres Strait Islander young people and the factors that facilitate and/or challenge their access to PHC services. Improving PHC access among Aboriginal and Torres Strait Islander young people should focus on multilevel strategies across all three levels of the social-ecological model, with a particular focus on increasing opportunities for equitable access to PHC services for young people, enhancing target programs and initiatives for young people, and supporting the knowledge, skills and capacity of HCPs to delivery appropriate, culturally safe and holistic care.

摘要

背景

15至24岁的原住民和托雷斯海峡岛民年轻人在获得和利用初级卫生保健(PHC)方面常常面临挑战。提供符合原住民和托雷斯海峡岛民年轻人需求的卫生保健需要医疗服务提供者(HCPs)的积极参与,他们在卫生保健服务提供中发挥着核心作用。本研究探讨了在城市原住民和托雷斯海峡岛民社区控制卫生组织(ATSICCHOs)工作的医疗服务提供者对促进原住民和托雷斯海峡岛民年轻人获得和利用初级卫生保健服务的因素的看法。

方法

在澳大利亚昆士兰州东南部城市(SEQ)与医疗服务提供者进行了13次研究访谈。采用归纳主题分析法确定促进卫生保健获得和利用的因素,并将其映射到社会生态框架模型。

结果

在所有研究访谈中,有三个基于优势的总体主题促进了卫生保健的获得:(1)ATSICCHO护理模式满足了原住民和托雷斯海峡岛民年轻人的需求;(2)家庭和社区在促进原住民和托雷斯海峡岛民年轻人获得卫生保健服务方面发挥着关键作用;(3)支持寻求健康行为的原住民和托雷斯海峡岛民年轻人的特征。确定的具体因素包括专门针对原住民和托雷斯海峡岛民年轻人的目标项目和举措;公平获得全面、综合和文化上安全的初级卫生保健;支持年轻人参与和获得服务的ATSICCHO工作人员的特征和技能;以及年轻人保持健康和寻求护理的动机。还确定了与这些主题形成对比的障碍。

结论

城市ATSICCHOs的医疗服务提供者对原住民和托雷斯海峡岛民年轻人的卫生保健经历以及促进和/或挑战他们获得初级卫生保健服务的因素提供了独特的视角。改善原住民和托雷斯海峡岛民年轻人获得初级卫生保健的机会应侧重于社会生态模型所有三个层面的多层次战略,特别关注增加年轻人公平获得初级卫生保健服务的机会,加强针对年轻人的目标项目和举措,以及支持医疗服务提供者提供适当、文化上安全和全面护理所需的知识、技能和能力。

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