PDF(Pubmed)
Abstract：
BACKGROUND: This paper describes how First Nations Kidney Warriors (Aboriginal and Torres Strait Islander people living with kidney disease), dental hygienists, kidney health care professionals, an Aboriginal hostel accommodation manager and researchers co-designed an approach to improve oral health in South Australia. Kidney Warriors have strong connection to Country, Community and family that underpins health, wellbeing and approaches to research. However, significant colonisation, racism and marginalisation have impacted Kidney Warriors\' social, cultural and financial determinants of health, leading to increased chronic conditions including kidney disease. Access to culturally safe, affordable and responsive oral health care is vital but challenging for First Nations Peoples undergoing dialysis and kidney transplantation; Australian oral health care is generally provided privately, in metropolitan centres, by professionals who may hold unconscious bias about First Nations Peoples and incorrect assumptions regarding equal access to care.
METHODS: The AKction - Aboriginal Kidney Care Together Improving Outcomes Now kidney care oral health working group codesigned strategies to address disparities and gaps in care, and co-create more accessible, responsive, culturally safe and sustainable models of care. A decolonising and collaborative participatory action research was informed by Dadirri Deep Listening and Ganma Knowledge Sharing with repeated cycles of Look and Listen, Think and Discuss, Take Action Together. A small pilot evaluation survey of clinical placement in an Aboriginal setting was undertaken.
RESULTS: Four phases of collaboration were undertaken. Community and health professional consultations identified key gaps and priorities. Clinical yarning and cultural safety training and an interprofessional skills day was co-facilitated. Dental hygienist student clinical placement at Kanggawodli Aboriginal Hostel was initiated and evaluated. First Nations Kidney Warriors were positioned as educators and experts of their own lives and health care needs. A new framework for kidney health-oral health cultural safety and clinical education was developed.
CONCLUSIONS: This codesigned approach involving inter-professional collaboration and joint decision making with community members has significantly informed improvements in oral health care information, services and referral with and for First Nations Peoples with kidney disease. This project provides a working example of how to decolonise health service and education programs from the ground up.
BACKGROUND: NHMRC PAR 2004389.
METHODS: The AKction - Aboriginal Kidney Care Together Improving Outcomes Now kidney care oral health working group codesigned strategies to address disparities and gaps in care, and co-create more accessible, responsive, culturally safe and sustainable models of care. A decolonising and collaborative participatory action research was informed by Dadirri Deep Listening and Ganma Knowledge Sharing with repeated cycles of Look and Listen, Think and Discuss, Take Action Together. A small pilot evaluation survey of clinical placement in an Aboriginal setting was undertaken.
RESULTS: Four phases of collaboration were undertaken. Community and health professional consultations identified key gaps and priorities. Clinical yarning and cultural safety training and an interprofessional skills day was co-facilitated. Dental hygienist student clinical placement at Kanggawodli Aboriginal Hostel was initiated and evaluated. First Nations Kidney Warriors were positioned as educators and experts of their own lives and health care needs. A new framework for kidney health-oral health cultural safety and clinical education was developed.
CONCLUSIONS: This codesigned approach involving inter-professional collaboration and joint decision making with community members has significantly informed improvements in oral health care information, services and referral with and for First Nations Peoples with kidney disease. This project provides a working example of how to decolonise health service and education programs from the ground up.
BACKGROUND: NHMRC PAR 2004389.
摘要：
背景：本文描述了原住民肾脏勇士（原住民和托雷斯海峡岛民患有肾脏疾病），牙科保健员,肾脏保健专业人员，土著宿舍住宿经理和研究人员共同设计了一种改善南澳大利亚口腔健康的方法。肾勇士与国家有很强的联系,支撑健康的社区和家庭，福祉和研究方法。然而,重大殖民,种族主义和边缘化影响了肾脏勇士的社会，健康的文化和财政决定因素，导致包括肾脏疾病在内的慢性疾病增加。获得文化安全、负担得起和反应灵敏的口腔保健对于接受透析和肾脏移植的第一民族人民来说至关重要，但具有挑战性;澳大利亚口腔保健通常由私人提供，在大都市中心，专业人士可能对第一民族人民抱有无意识的偏见，对平等获得护理的假设不正确。
方法：AKction-原住民肾脏护理共同改善结果现在肾脏护理口腔健康工作组共同设计了解决护理差异和差距的策略，共同创造更多的可访问性，响应，文化上安全和可持续的护理模式。DadirriDeepListening和GanmaKnowledgeSharing通过反复循环的观看和聆听来进行非殖民化和协作参与行动研究，思考和讨论，一起行动。对原住民环境中的临床安置进行了小型试点评估调查。
结果：进行了四个阶段的合作。社区和卫生专业人员协商确定了关键差距和优先事项。共同促进了临床培训和文化安全培训以及跨专业技能日。开始并评估了在Kanggawodli原住民旅馆的牙科卫生学生临床实习。原住民肾脏勇士队被定位为自己生活和医疗保健需求的教育者和专家。建立了肾脏健康-口腔健康文化安全和临床教育的新框架。
结论：这种涉及专业间合作和与社区成员共同决策的共同设计方法显着改善了口腔保健信息，为患有肾脏疾病的第一民族提供服务和转诊。该项目提供了如何从头开始实现卫生服务和教育计划非殖民化的工作示例。
背景：NHMRCPAR2004389。
方法：AKction-原住民肾脏护理共同改善结果现在肾脏护理口腔健康工作组共同设计了解决护理差异和差距的策略，共同创造更多的可访问性，响应，文化上安全和可持续的护理模式。DadirriDeepListening和GanmaKnowledgeSharing通过反复循环的观看和聆听来进行非殖民化和协作参与行动研究，思考和讨论，一起行动。对原住民环境中的临床安置进行了小型试点评估调查。
结果：进行了四个阶段的合作。社区和卫生专业人员协商确定了关键差距和优先事项。共同促进了临床培训和文化安全培训以及跨专业技能日。开始并评估了在Kanggawodli原住民旅馆的牙科卫生学生临床实习。原住民肾脏勇士队被定位为自己生活和医疗保健需求的教育者和专家。建立了肾脏健康-口腔健康文化安全和临床教育的新框架。
结论：这种涉及专业间合作和与社区成员共同决策的共同设计方法显着改善了口腔保健信息，为患有肾脏疾病的第一民族提供服务和转诊。该项目提供了如何从头开始实现卫生服务和教育计划非殖民化的工作示例。
背景：NHMRCPAR2004389。
