AI Article Synopsis
- High rates of acute respiratory tract infections among Aboriginal children lead to a significant burden of bronchiectasis post-hospitalization, yet medical follow-up after discharge is often lacking.
- The study involved parents and pediatric hospital staff to identify barriers (like lack of information and awareness) and facilitators (such as culturally tailored training for clinicians) that affect the follow-up process.
- A twelve-step plan was developed to enhance medical follow-up for these children, emphasizing the need for a comprehensive approach that involves collaboration among parents, hospital staff, and healthcare services.
Article 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8355903 | PMC |
| http://dx.doi.org/10.1016/j.lanwpc.2021.100239 | DOI Listing |
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