ORCID Profile
0000-0001-8143-6081
Current Organisation
James Cook University
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Publisher: Wiley
Date: 10-10-2023
DOI: 10.1111/AJR.12932
Abstract: To focus on the needs, challenges and opportunities to improve access to cardiac rehabilitation (CR) (Heart: Road to health [HRH]) for Aboriginal and Torres Strait Islander peoples in rural and remote (R& R) areas of North Queensland. It is known that there is insufficient access to HRH for Aboriginal and Torres Strait Islander peoples in R& R areas of NQ, who have the highest rates of heart disease and socioeconomic disadvantage mainly due to poor social determinants of health. However, at least in part due to the impact of colonialism and predominantly western medicalised approach to health care, few gains have been made. This commentary draws on recent research and literature and reflects on cultural issues that impact on improving access to an HRH for Aboriginal and Torres Strait Islander peoples in R& R areas. The underutilisation of the skills of Aboriginal and Torres Strait Islander Health Workers (ATSIHW) and a lack of a defined process to ensure access to culturally responsive HRH are discussed. Finally, a way forward is proposed that includes the development of policies, pathways and guidelines to ensure that appropriate support is available in the client's home community. It is proposed that culturally responsive, accessible and effective HRH is achievable through the reorientation of current health systems that include a continuous client‐centred pathway from hospital to home. In this model, ATSIHW will take a lead or partnership role in which their clinical, cultural brokerage and health promotion skills are fully utilised.
Publisher: Penerbit Universiti Kebangsaan Malaysia (UKM Press)
Date: 30-04-2019
Publisher: Wiley
Date: 21-12-2022
DOI: 10.1111/AJR.12818
Abstract: To assess implementation of in‐patient cardiac rehabilitation (Phase‐1‐cardiac rehabilitation), impact on people in rural and remote areas of Australia and potential methods for addressing identified weaknesses. Exploratory case study methodology using qualitative and quantitative methods. Qualitative data collection via semi‐structured interviews, using thematic analysis, augmented by quantitative data collection via a medical record audit. Four regional hospitals (2 Queensland Health and 2 private) providing tertiary health care. (a) Hospital in‐patients with heart disease ≥18 years. (b) Staff responsible for their care. Implementation of Phase‐1‐cardiac rehabilitation in tertiary hosptials in North Queensland and the impact on in‐patients discharge planning and post discharge care. Recommentations and implications for practice are proposed to address deficits. Phase‐1‐cardiac rehabilitation implementation rates, in‐patient understanding and multidisciplinary team involvement were low. The highest rates of Phase‐1‐cardiac rehabilitation were for in‐patients with a length of stay three days or more in cardiac units with cardiac educators. Rates were lower in cardiac units with no cardiac educators, and lowest for in‐patients in all areas of all hospitals with length of stay of two days or less days. Low Phase‐1‐cardiac rehabilitation implementation rates resulted in poor in‐patient understanding about their disease, treatment and post‐discharge care. Further, medical discharge summaries rarely mentioned cardiac rehabilitation/secondary prevention or risk factor management resulting in a lack of information for health care providers on cardiac rehabilitation and holistic health care. Implementation of Phase‐1‐cardiac rehabilitation in regional hospitals in this study fell short of recommended best practice, resulting in patients' poor preparation for discharge, and insufficient information on holistic care for health care providers in rural and remote areas. These factors potentially impact on holistic care for people returning home following treatment for heart disease.
Publisher: Wiley
Date: 19-01-2020
DOI: 10.1111/AJR.12588
Abstract: To describe rates of hospitalisation and Coaching on Achieving Cardiovascular Health referral, for Queensland's adults with heart and related disease, and comparisons between Aboriginal and Torres Strait Islander and non-Indigenous peoples in northern Queensland. Descriptive retrospective epidemiological study of Queensland Health Patient Admission Data Collection for adults with heart and related disease, and Coaching on Achieving Cardiovascular Health referral data. Relative risk and age standardisation were calculated for Aboriginal and Torres Strait Islander and non-Indigenous peoples. Queensland's adults ≥20 years, hospitalised with heart and related disease (1 January 2012-31 December 2016). Queensland, Australia. Queensland Health Hospital and Health Services' hospitalisation and Coaching on Achieving Cardiovascular Health referral rates for heart and related disease. Queensland's Aboriginal and Torres Strait Islander peoples have a higher hospitalisation rate for heart and related disease, with higher rates for northern Queensland. Queensland's overall Coaching on Achieving Cardiovascular Health referral rates were low, but higher for Aboriginal and Torres Strait Islander peoples. Deficiencies in documentation of Aboriginal and Torres Strait Islander people's status affected results in some areas. Queensland's Aboriginal and Torres Strait Islander peoples were more likely to be admitted to hospital for heart and related disease and referred to Coaching on Achieving Cardiovascular Health than non-Indigenous peoples. However, hospitalisation and Coaching on Achieving Cardiovascular Health referral rates are unlikely to reflect the needs of Aboriginal and Torres Strait Islander peoples especially in rural and very remote areas given their higher mortality and morbidity rates and fewer services.
Publisher: Wiley
Date: 17-03-2022
DOI: 10.1111/AJR.12861
Abstract: To address access to cardiac rehabilitation (CR) for people in R&R areas, this research aimed to investigate: (1) post discharge systems and support for people returning home from hospital following treatment for heart disease (HD). (2) propose changes to improve access to CR in R&R areas of NQ. Four focus communities in R&R areas of NQ. Focus communities' health staff (resident/visiting) (57), community leaders (10) and community residents (44), discharged from hospital in past 5 years following treatment for heart disease (purposeful s ling). A qualitative descriptive case study, with data collection via semi-structured interviews. Inductive/deductive thematic analysis was used to identify primary and secondary themes. Health service audit of selected communities. Health services in the focus communities included multipurpose health services, and primary health care centres staffed by resident and visiting staff that included nurses, Aboriginal and Torres Strait Islander Health Workers, medical officers, and allied health professionals. Post-discharge health care for people with HD was predominantly clinical. Barriers to CR included low referrals to community-based health professions by discharging hospitals poorly defined referral pathways lack of guidelines inadequate understanding of holistic, multidisciplinary CR by health staff, community participants and leaders limited centre-based CR services lack of awareness, or acceptance of telephone support services. To address barriers identified for CR in R&R areas, health care systems' revision, including development of referral pathways to local health professionals, CR guidelines and in-service education, is required to developing a model of care that focuses on self-management and education: Heart: Road to Health.
Publisher: Rural and Remote Health
Date: 07-11-2018
DOI: 10.22605/RRH4738
No related grants have been discovered for Patricia Field.