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Respiratory follow-up to improve outcomes for Aboriginal children: twelve key steps.


ABSTRACT:

Background

Among Aboriginal children, the burden of acute respiratory tract infections (ALRIs) with consequent bronchiectasis post-hospitalisation is high. Clinical practice guidelines recommend medical follow-up one-month following discharge, which provides an opportunity to screen and manage persistent symptoms and may prevent bronchiectasis. Medical follow-up is not routinely undertaken in most centres. We aimed to identify barriers and facilitators and map steps required for medical follow-up of Aboriginal children hospitalised with ALRIs.

Methods

Our qualitative study used a knowledge translation and participatory action research approach, with semi-structured interviews and focus groups, followed by reflexive thematic grouping and process mapping.

Findings

Eighteen parents of Aboriginal children hospitalised with ALRI and 144 Australian paediatric hospital staff participated. Barriers for parents were lack of information about their child's condition and need for medical follow-up. Facilitators for parents included doctors providing disease specific health information and follow-up instructions. Staff barriers included being unaware of the need for follow-up, skills in culturally responsive care and electronic discharge system limitations. Facilitators included training for clinicians in arranging follow-up and culturally secure engagement, with culturally responsive tools and improved discharge processes. Twelve-steps were identified to ensure medical follow-up.

Interpretation

We identified barriers and enablers for arranging effective medical follow-up for Aboriginal children hospitalised with ALRIs, summarised into four-themes, and mapped the steps required. Arranging effective follow-up is a complex process involving parents, hospital staff, hospital systems and primary healthcare services. A comprehensive knowledge translation approach may improve the follow-up process.

Funding

State and national grants and fellowships.

SUBMITTER: Laird P 

PROVIDER: S-EPMC8355903 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

Respiratory follow-up to improve outcomes for Aboriginal children: twelve key steps.

Laird Pamela P   Walker Roz R   Gill Fenella J FJ   Whitby Jack J   Chang Anne B AB   Schultz André A  

The Lancet regional health. Western Pacific 20210806


<h4>Background</h4>Among Aboriginal children, the burden of acute respiratory tract infections (ALRIs) with consequent bronchiectasis post-hospitalisation is high. Clinical practice guidelines recommend medical follow-up one-month following discharge, which provides an opportunity to screen and manage persistent symptoms and may prevent bronchiectasis. Medical follow-up is not routinely undertaken in most centres. We aimed to identify barriers and facilitators and map steps required for medical  ...[more]

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