Experiences of Aboriginal and Torres Strait Islander people admitted for a cardiac event in Australian public hospitals: a systematic review protocol

Katharine McBride, Janet Kelly, Elaine Kite, Wendy Keech, Amanda Rischbieth, Alex Brown

Research output: Contribution to journalArticle

Abstract

Review question/objective: The objective of the systematic literature review is to identify the experiences of Aboriginal and Torres Strait Islander people admitted for a cardiac event in Australian public hospitals, and ascertain the factors which shape these experiences. The specific review question to be addressed is: What are the factors which shape the experiences of Aboriginal and Torres Islander people who have been admitted for a cardiac event in Australia?

Background: Cardiovascular disease (CVD) is the leading cause of death for Aboriginal and Torres Strait Islander people; accounting for a quarter of all deaths.1 Aboriginal and Torres Strait Islander people are more likely to have multiple risk factors for and experience early onset of CVD, with significant differentials in outcomes, which are particularly notable in younger age groups.2,3 Aboriginal and Torres Strait Islander people also experience hospitalization for heart attack at significantly higher rates (males: 2.2 times, females: 3.1 times). However, national data demonstrates that Aboriginal and Torres Strait Islander people are significantly less likely to receive angiography; coronary angioplasty; and coronary bypass surgery when compared to other Australians.4 Furthermore, their in‐hospital mortality is 2.2 times that of non‐Indigenous people.5

Once admitted to hospital, a range of clinical, health system and individual patient factors may contribute to poorer experiences and worse outcomes for Aboriginal and Torres Strait Islander people who have been admitted for a cardiac event. The health of Aboriginal and Torres Strait Islander people, such as the greater presence of diabetes, comorbidities and more diffuse coronary disease, may influence both the level of treatment received and the experience of hospitalization.6,7 Health systems factors may also influence the patient's experience. In particular, racism and disrespectful treatment, poor communication, a sense of being invisible, and a disengagement of family structure have been identified as barriers to appropriate care and detrimental to long‐term health outcomes.8 Other factors, such as lack of access to follow‐up care, assumptions around “compliance” and adherence, and language barriers are also believed to influence the care received by Aboriginal and Torres Strait Islander people, and their experience of hospitalization.6

A search of the literature on existing systematic reviews was conducted. Whilst there are systematic reviews which focus on the experiences of Indigenous peoples in seeking hospital care, none have specifically considered what factors shape these experiences for Aboriginal and Torres Strait Islander peoples with CVD in Australia.

This systematic review will therefore focus on: the experiences of Aboriginal and Torres Strait Islander people receiving hospital care for a cardiac event within the Australian public hospital system, and; the individual, clinical and system factors which shape these experiences.

The systematic review will center on the experience of Aboriginal and Torres Strait Islander people from their perspective and that of their families and communities. It is also recognized that the perspective of health care providers and policy makers may provide a valuable, and potentially alternative perspective, of the experiences of patients and the factors which shape these experiences. These will also be explored.

This systematic review will bring together recent qualitative and text/opinion literature to provide an understanding of the factors which impact the experiences of Aboriginal and Torres Strait Islander people, potentially supporting the development of strategies to improve the Aboriginal and Torres Strait Islander experience of cardiac hospital care.

Outcomes from this systematic review will provide health care providers and system administrators with a foundation to overcome barriers to positive experiences and improve access and quality of care for Aboriginal and Torres Strait Islander people accessing care for cardiac events in hospitals.
LanguageEnglish
Pages45-57
Number of pages12
JournalJBI Database of Systematic Reviews and Implementation Reports
Volume12
Issue number9
DOIs
Publication statusPublished - Sep 2014

Cite this

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abstract = "Review question/objective: The objective of the systematic literature review is to identify the experiences of Aboriginal and Torres Strait Islander people admitted for a cardiac event in Australian public hospitals, and ascertain the factors which shape these experiences. The specific review question to be addressed is: What are the factors which shape the experiences of Aboriginal and Torres Islander people who have been admitted for a cardiac event in Australia?Background: Cardiovascular disease (CVD) is the leading cause of death for Aboriginal and Torres Strait Islander people; accounting for a quarter of all deaths.1 Aboriginal and Torres Strait Islander people are more likely to have multiple risk factors for and experience early onset of CVD, with significant differentials in outcomes, which are particularly notable in younger age groups.2,3 Aboriginal and Torres Strait Islander people also experience hospitalization for heart attack at significantly higher rates (males: 2.2 times, females: 3.1 times). However, national data demonstrates that Aboriginal and Torres Strait Islander people are significantly less likely to receive angiography; coronary angioplasty; and coronary bypass surgery when compared to other Australians.4 Furthermore, their in‐hospital mortality is 2.2 times that of non‐Indigenous people.5Once admitted to hospital, a range of clinical, health system and individual patient factors may contribute to poorer experiences and worse outcomes for Aboriginal and Torres Strait Islander people who have been admitted for a cardiac event. The health of Aboriginal and Torres Strait Islander people, such as the greater presence of diabetes, comorbidities and more diffuse coronary disease, may influence both the level of treatment received and the experience of hospitalization.6,7 Health systems factors may also influence the patient's experience. In particular, racism and disrespectful treatment, poor communication, a sense of being invisible, and a disengagement of family structure have been identified as barriers to appropriate care and detrimental to long‐term health outcomes.8 Other factors, such as lack of access to follow‐up care, assumptions around “compliance” and adherence, and language barriers are also believed to influence the care received by Aboriginal and Torres Strait Islander people, and their experience of hospitalization.6A search of the literature on existing systematic reviews was conducted. Whilst there are systematic reviews which focus on the experiences of Indigenous peoples in seeking hospital care, none have specifically considered what factors shape these experiences for Aboriginal and Torres Strait Islander peoples with CVD in Australia.This systematic review will therefore focus on: the experiences of Aboriginal and Torres Strait Islander people receiving hospital care for a cardiac event within the Australian public hospital system, and; the individual, clinical and system factors which shape these experiences.The systematic review will center on the experience of Aboriginal and Torres Strait Islander people from their perspective and that of their families and communities. It is also recognized that the perspective of health care providers and policy makers may provide a valuable, and potentially alternative perspective, of the experiences of patients and the factors which shape these experiences. These will also be explored.This systematic review will bring together recent qualitative and text/opinion literature to provide an understanding of the factors which impact the experiences of Aboriginal and Torres Strait Islander people, potentially supporting the development of strategies to improve the Aboriginal and Torres Strait Islander experience of cardiac hospital care.Outcomes from this systematic review will provide health care providers and system administrators with a foundation to overcome barriers to positive experiences and improve access and quality of care for Aboriginal and Torres Strait Islander people accessing care for cardiac events in hospitals.",
author = "Katharine McBride and Janet Kelly and Elaine Kite and Wendy Keech and Amanda Rischbieth and Alex Brown",
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Experiences of Aboriginal and Torres Strait Islander people admitted for a cardiac event in Australian public hospitals: a systematic review protocol. / McBride, Katharine; Kelly, Janet; Kite, Elaine; Keech, Wendy; Rischbieth, Amanda; Brown, Alex.

In: JBI Database of Systematic Reviews and Implementation Reports, Vol. 12, No. 9, 09.2014, p. 45-57.

Research output: Contribution to journalArticle

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AU - Kelly, Janet

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AB - Review question/objective: The objective of the systematic literature review is to identify the experiences of Aboriginal and Torres Strait Islander people admitted for a cardiac event in Australian public hospitals, and ascertain the factors which shape these experiences. The specific review question to be addressed is: What are the factors which shape the experiences of Aboriginal and Torres Islander people who have been admitted for a cardiac event in Australia?Background: Cardiovascular disease (CVD) is the leading cause of death for Aboriginal and Torres Strait Islander people; accounting for a quarter of all deaths.1 Aboriginal and Torres Strait Islander people are more likely to have multiple risk factors for and experience early onset of CVD, with significant differentials in outcomes, which are particularly notable in younger age groups.2,3 Aboriginal and Torres Strait Islander people also experience hospitalization for heart attack at significantly higher rates (males: 2.2 times, females: 3.1 times). However, national data demonstrates that Aboriginal and Torres Strait Islander people are significantly less likely to receive angiography; coronary angioplasty; and coronary bypass surgery when compared to other Australians.4 Furthermore, their in‐hospital mortality is 2.2 times that of non‐Indigenous people.5Once admitted to hospital, a range of clinical, health system and individual patient factors may contribute to poorer experiences and worse outcomes for Aboriginal and Torres Strait Islander people who have been admitted for a cardiac event. The health of Aboriginal and Torres Strait Islander people, such as the greater presence of diabetes, comorbidities and more diffuse coronary disease, may influence both the level of treatment received and the experience of hospitalization.6,7 Health systems factors may also influence the patient's experience. In particular, racism and disrespectful treatment, poor communication, a sense of being invisible, and a disengagement of family structure have been identified as barriers to appropriate care and detrimental to long‐term health outcomes.8 Other factors, such as lack of access to follow‐up care, assumptions around “compliance” and adherence, and language barriers are also believed to influence the care received by Aboriginal and Torres Strait Islander people, and their experience of hospitalization.6A search of the literature on existing systematic reviews was conducted. Whilst there are systematic reviews which focus on the experiences of Indigenous peoples in seeking hospital care, none have specifically considered what factors shape these experiences for Aboriginal and Torres Strait Islander peoples with CVD in Australia.This systematic review will therefore focus on: the experiences of Aboriginal and Torres Strait Islander people receiving hospital care for a cardiac event within the Australian public hospital system, and; the individual, clinical and system factors which shape these experiences.The systematic review will center on the experience of Aboriginal and Torres Strait Islander people from their perspective and that of their families and communities. It is also recognized that the perspective of health care providers and policy makers may provide a valuable, and potentially alternative perspective, of the experiences of patients and the factors which shape these experiences. These will also be explored.This systematic review will bring together recent qualitative and text/opinion literature to provide an understanding of the factors which impact the experiences of Aboriginal and Torres Strait Islander people, potentially supporting the development of strategies to improve the Aboriginal and Torres Strait Islander experience of cardiac hospital care.Outcomes from this systematic review will provide health care providers and system administrators with a foundation to overcome barriers to positive experiences and improve access and quality of care for Aboriginal and Torres Strait Islander people accessing care for cardiac events in hospitals.

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