Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T15:36:49.233Z Has data issue: false hasContentIssue false

Clinical profile of Aboriginal and Torres Strait Islander adults with stroke and traumatic brain injury at a regional Australian hospital: a retrospective chart audit

Published online by Cambridge University Press:  25 January 2021

Frances Cochrane*
Affiliation:
Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia College of Healthcare Sciences, James Cook University, Townsville, Australia
Samantha Siyambalapitiya
Affiliation:
Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia School of Allied Health Sciences, Griffith University, Brisbane, Australia
Petrea Cornwell
Affiliation:
Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia School of Allied Health Sciences, Griffith University, Brisbane, Australia
*
*Corresponding author. Email: frances.cochrane1@jcu.edu.au
Get access

Abstract

Background:

The clinical profile of Aboriginal and Torres Strait Islander adults admitted to hospital with neurological injury is not well documented. Understanding these profiles may enable health professionals to provide more culturally responsive health care for this patient group. This study aimed to report the clinical profile of Aboriginal and Torres Strait Islander adults admitted to a regional Queensland hospital due to stroke or traumatic brain injury (TBI).

Method:

A 2-year retrospective medical record review of Aboriginal and Torres Strait Islander adults (≥18 years) admitted to a regional Queensland hospital with principal diagnoses of stroke or TBI.

Results:

There were 132 Aboriginal and Torres Strait Islander adult stroke (51.5%) or TBI (48.5%) admissions. The mean ages were 56.7 years for stroke and 42.7 years for TBI. The majority of patients (83.3%) were of Aboriginal descent with others identifying as Torres Strait Islander only, or both Aboriginal and Torres Strait Islander. Patients were from 26 diverse home locations across northern Australia, primarily Outer Regional or Remote/Very Remote geographical locations. All patients’ language backgrounds were documented as English only. Over 90% of stroke and 50% of TBI patients presented with medical co-morbidities.

Conclusions:

Patients had diverse geographical locations and cultural backgrounds, with many likely impacted by dislocation from home and country, as well as potential delays in receiving treatment. Despite this diversity, English was documented in patients’ medical records as their only language. The majority of patients also presented with multiple medical co-morbidities. Health professionals should consider these factors to ensure patients receive optimum and culturally responsive health care.

Type
Articles
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

2M Language Services. (2019). Indigenous language interpreting. Retrieved from https://www.2m.com.au/interpreting-services/indigenous-language-interpreting/ Google Scholar
Armstrong, E., Coffin, J., McAllister, M., Hersh, D., Katzenellenbogen, J., Thompson, S., … Hayward, C. (2019). “I’ve got to row the boat on my own, more or less”: Aboriginal Australian experiences of traumatic brain injury. Brain Impairment, 20, 120136. doi: 10.1017/BrImp.2019.19 CrossRefGoogle Scholar
Aspin, C., Brown, N., Jowsey, T., Yen, L., & Leeder, S. (2012). Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic disease: A qualitative study. BMC Health Services Research, 12(143), 19. http://www.biomedcentral.com/1472-6963/12/143 CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics [ABS]. (2016a). The Australian Statistical Geography Standard (ASGS) remoteness structure. Retrieved from http://www.abs.gov.au/websitedbs/d3310114.nsf/home/remoteness+structure Google Scholar
Australian Bureau of Statistics [ABS]. (2016b). Australian Statistical Geography Standard (ASGS): Volume 1 - Main Structure and Greater Capital City Statistical Areas (cat. No. 1270.0.55.001). Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/mf/1270.0.55.001 Google Scholar
Australian Bureau of Statistics [ABS]. (2016c). Australian Statistical Geography Standard (ASGS): Volume 5 –Remoteness Structure (cat. No. 1270.0.55.005). Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/mf/1270.0.55.005 Google Scholar
Australian Bureau of Statistics [ABS]. (2018). Estimates of Aboriginal and Torres Strait Islander Australians. Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/mf/3238.0.55.001.Google Scholar
Australian Institute of Health and Welfare [AIHW]. (2008). Hospital separations due to traumatic brain injury 2004-05. Australian Government. Retrieved from https://www.aihw.gov.au/getmedia/61decf32-937b-4280-8571-dd66061c99bf/hsdttbia04-05.pdf.aspx?inline=tru Google Scholar
Australian Institute of Health and Welfare [AIHW]. (2018). Australia’s health 2018. Australian Government. Retrieved from https://www.aihw.gov.au/getmedia/fe037cf1-0cd0-4663-a8c0-67cd09b1f30c/aihw-aus-222.pdf.aspx?inline=true Google Scholar
Australian Institute of Health and Welfare [AIHW]. (2019). Hospitalised injury among Aboriginal and Torres Strait Islander people 2011-12 to 2015-16. Australian Government. Retrieved from https://www.aihw.gov.au/getmedia/89ae4b17-ad35-42da-958f-5c48ee209cf3/aihw-injcat-198.pdf.aspx?inline=true Google Scholar
Balabanski, A., Newbury, J., Leyden, J., Arima, H., Anderson, C., Castle, S., … Kleinig, T. (2018). Excess stroke incidence in young Aboriginal people in South Australia: Pooled results from two population-based studies. Journal of Stroke, 13(8), 811814. doi: 10.1177/1747493018778113 CrossRefGoogle ScholarPubMed
Barker-Collo, S., Jones, K., Theadom, A., Starkey, N., Dowell, A., McPherson, K., … behalf of the BIONIC Research Group. (2015). Neuropsychological outcome and its correlates in the first year after adult mild traumatic brain injury: A population-based New Zealand study. Brain Injury, 29(13–14), 16041616. doi: 10.3109/02699052.2015.1075143 CrossRefGoogle ScholarPubMed
Boufous, S., Ivers, R., Senserrick, T., & Martiniuk, A. (2010). Underlying causes and effects of injury in Australian Aboriginal populations: A rapid review. Sax Institute. https://www.saxinstitute.org.au/wp-content/uploads/14_Boufous-et-al.-FINAL-FOR-PUBLICATION.pdf.Google Scholar
Burnette, L., & Kickett, M. (2009). Dislocation and dialysis in Aboriginal Patients with renal failure. Aboriginal and Islander Health Workforce Journal, 33(4), 1013.Google Scholar
Cadilhac, D., Kilkenny, M., Levi, C., Lannin, N., Thrift, A., Kim, J., … Anderson, C. (2017). Risk-adjusted hospital mortality rates for stroke: Evidence from the Australian Stroke Clinical Registry (AuSCR). Medical Journal of Australia, 8, 345350. doi: 10.5694/mja16.00525 CrossRefGoogle Scholar
Esterman, A., Thompson, F., Fitts, M., Gilroy, J., Fleming, J., Maruff, P., … Bohanna, I. (2018). Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15-64 over the 9 year period 2007-2015 in North Queensland, Australia. Injury Epidemiology, 5(40), 17. doi: 10.1186/s40621.018.0172.9 CrossRefGoogle ScholarPubMed
Fitts, M., Bird, K., Gilroy, J., Fleming, J., Clough, A., Esterman, A., … Bohanna, I. (2019). A qualitative study on the transition support needs of Indigenous Australians following traumatic brain injury. Brain Impairment, 20, 137159. doi: 10.1017/BrImp.2019.24 CrossRefGoogle Scholar
Gearing, R., Mian, I., Barber, J., & Ickowicz, A. (2006). A methodology for conducting retrospective chart review research in child and adolescent psychiatry. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 15(3), 126134. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277255/pdf/ccap15_3p126.pdf Google ScholarPubMed
Helps, Y., Henley, G., & Harrison, J. (2008). Hospital separations due to traumatic brain injury, Australia 2004-2007. AIHW. Retrieved from https://www.aihw.gov.au/getmedia/61decf32-937b-4280-8571-dd66061c99bf/hsdttbia04-05.pdf.aspx?inline=true Google Scholar
Hersh, D., Armstrong, E., McAllister, M., Ciccone, N., Katzenellenbogen, J., Coffin, J., … Woods, D. (2019). General practitioners’ perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders. Patient Education and Counseling, 102, 23102317. doi: 10.1016/j.pec.2019.07.029 CrossRefGoogle ScholarPubMed
Jamieson, L., Harrison, J., & Berry, J. (2008). Hospitalisations for head injury due to assault among Indigenous and non-Indigenous Australians, July 1999 – June 2005. Medical Journal of Australia, 188, 576579.CrossRefGoogle ScholarPubMed
Katzenellenbogen, J., Atkins, E., Thompson, S., Hersh, D., Coffin, J., Flicker, L., … Armstrong, E. (2016). Missing voices: Profile and extent of acquired communication disorders in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia using linked administrative records. Journal of Stroke, 11(1), 103116. doi: 10.1177/1747493015607521 CrossRefGoogle ScholarPubMed
Katzenellenbogen, J., Atkins, E., Thompson, S., Hersh, D., Coffin, J., Flicker, L., … Armstrong, E. (2018). Missing voices: Profile, extent, and 12-month outcomes of nonfatal traumatic brain injury in Aboriginal and non-Aboriginal adults in Western Australia using linked administrative records. Journal of Head Trauma Rehabilitation, 33(6), 412423. doi: 10.1097/HTR.0000000000000371 CrossRefGoogle ScholarPubMed
Katzenellenbogen, J., Knuiman, M., Sanfilippo, F., Hobbs, M., & Thomson, S. (2014). Prevalence of stroke and coexistent conditions: Disparities between Indigenous and nonindigenous Western Australians. International Journal of Stroke, 9, 6168. doi: 10.111.ijs.12278 CrossRefGoogle ScholarPubMed
Katzenellenbogen, J., Sanfilippo, F., Hobbs, M., Knuiman, M., Bessarab, D., Durey, A., & Thompson, S. (2013). Voting with their feet - predictors of discharge against medical advice in Aboriginal and non-Aboriginal ischaemic heart disease patients in Western Australia: An analytic study using data linkage. BMC Health Services Research, 13(330), 110. doi: 10.1186/1472-6963-13-330 CrossRefGoogle ScholarPubMed
Katzenellenbogen, J., Vos, T., Somerford, P., Begg, S., Semmens, J., & Codde, J. (2011). Burden of Stroke in Western Australians: A study using data linkage. Stroke, 42, 15151521. doi: 10.1161/STROKEAHA.110.601799 CrossRefGoogle ScholarPubMed
Kelly, J., Dwyer, J., Pekarsky, B., Mackean, T., Willis, E., Battersby, M., & Glover, J. (2012). Managing two worlds together: Stage 2 - patient journey mapping tools. Flinders University. Retrieved from https://www.lowitja.org.au/page/services/resources/health-services-and-workforce/cultural-safety/M2WT-Stage-2-Mapping-Tools Google Scholar
Kelly, J., Dwyer, J., Willis, E., & Pekarsky, B. (2014). Travelling to the city for hospital care: Access factors in country Aboriginal patient journeys. Australian Journal of Rural Health, 22, 109113. doi: 10.1111/ajr.12094 CrossRefGoogle ScholarPubMed
López, L., Green, A., Tan-McGrory, A., King, R., & Betancourt, J. (2011). Bridging the digital divide in health care: The role of health information technology in addressing racial and ethnic disparities. Joint Commission Journal on Quality and Patient Safety, 37, 437445. doi: 10.1016/s1553-7250(11)37055-9 CrossRefGoogle ScholarPubMed
Morgan, D., Harris, T., Gidgup, R., & Whitely, M. (2019). Identifying the cultural heritage of patients during clinical handover and in hospital medical records. Medical Journal of Australia, 210(5), 220226. doi: 10.5694/mja2.12107 CrossRefGoogle ScholarPubMed
National Health and Medical Research Council. (2018). Ethical conduct in research with Aboriginal and Torres Strait Islander peoples and communities: Guidelines for researchers and stakeholders. Retrieved from https://www.nhmrc.gov.au/about-us/resources/ethical-conduct-research-aboriginal-and-torres-strait-islander-peoples-and-communities Google Scholar
Queensland Health. (2010). Aboriginal and Torres Strait Islander Cultural Capability Framework 2010-2033. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0014/156200/cultural_capability.pdf Google Scholar
Queensland Health. (2014). Aboriginal and Torres Strait Islander patient care guideline. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0022/157333/patient_care_guidelines.pdf Google Scholar
Queensland Government. (2017). Aboriginal and Torres Strait Islander peoples in Queensland, Census 2016. Retrieved from https://www.qgso.qld.gov.au/products/reports/atsi-pop-qld-c16/atsi-pop-qld-c16.pdf Google Scholar
Queensland Government. (2018). Townsville Hospital and Health Service Annual report 2017-2018. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0032/729608/thhs-annual-report-2017-18.pdf Google Scholar
Queensland Government. (2019). Appendix G: Language codes. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0030/853194/1920-append-g-v1.0.pdf Google Scholar
Ralph, A., Lowell, A., Murphy, J., Butler, D., Spain, B., Hughes, J., … Cass, A. (2017). Low uptake of Aboriginal interpreters in healthcare: exploration of current use in Australia’s Northern Territory. BMC Health Services Research, 17(733), 112. doi: 10.1186/s12913-017-2689-y CrossRefGoogle ScholarPubMed
State Library of Queensland. (2005). Torres Strait Islanders language. Queensland Government. Retrieved from https://iaha.com.au/wp-content/uploads/2013/03/000208_tsilanguages.pdf Google Scholar
Stroke Foundation. (2019). National stroke audit: Acute services report 2017. Retrieved from https://informme.org.au/-/media/7D1480925C2046BA914F3F66D392B83A.ashx?la=en Google Scholar
Taylor, K., & Guerin, P. (2014). Health care and Indigenous Australians: Cultural safety in practice (2nd ed.). Palgrave Macmillan.Google Scholar
Tiedeman, C., Suthers, B., Julien, B., Hackett, A., & Oakley, P. (2019). Management of stroke in the Australian Indigenous population: From hospitals to communities. Journal of Internal Medicine, 3, 125. doi: 10.1111/imj.14303 Google Scholar
Thomas, S., Wakerman, J., & Humphreys, J. (2015). Ensuring quality of access to primary health care in rural and remote Australia – what core services should be locally available? International Journal of Equity in Health, 14(111), 18. doi: 10.1186/s12939-015-0228-1 CrossRefGoogle Scholar
Vassar, M., & Holzmann, M. (2013). The retrospective chart review: Important methodological considerations. Journal Educational Evaluation for Health Professions, 10(12), 17. doi: 10.3352/jeehp.2013.10.12 CrossRefGoogle ScholarPubMed