Anaesthesia for Aboriginal Australians

Abstract

This prospective study was designed to describe problems that arise when Aboriginal people undergo anaesthesia, in order to develop guidelines for anaesthetists who are not accustomed to treating Aboriginal people. Data were collected on 1122 consecutive different individuals undergoing anaesthesia at Royal Darwin Hospital, 24.5% of whom described themselves as Aboriginal. Aboriginal patients were in a poorer physiological state than were non-Aboriginal patients. The prevalence of diabetes mellitus, renal disease and rheumatic heart disease reported in Aboriginal patients was very high. Communication difficulties were more commonly reported in Aboriginal patients; the most common difficulty was apparent shyness or fear, rather than actual language difficulty. The results suggest that the treatment of Aboriginal people involves diagnosis and management of diverse preoperative medical problems, and that better management may be achieved by learning simple cultural strategies and by adding Aboriginal interpreters and health workers to the anaesthetic team.

Unmet Needs of Aboriginal Australians With Musculoskeletal Pain: A Mixed‐Method Systematic Review

“…Holiday et al reported that Aboriginal patients were more than twice as likely to be prescribed opioids in primary care (odds ratio 2.2 [95% CI 1.6–2.9]) despite increasing concerns regarding efficacy, addiction, and overdose. Disparities in pharmacologic pain management have also been reported for Aboriginal women during labor (increased likelihood of opioid prescription) and postoperatively (less likelihood of receiving more complicated analgesia techniques such as epidural analgesia) . This situation contrasts with the US, where prescriptions for opioids or other analgesia are similar between indigenous and white Americans, with black Americans less likely to receive analgesic prescription than white Americans .…”

Assessing pain across the cultural gap: Central Australian Indigenous peoples’ pain assessment

“…In this situation the non-Indigenous nurse is not providing culturally safe care. To ensure cultural safety, it is necessary that nurses adapt pain assessment tools to suit the recipient's culture, such as using verbal pain descriptors based on Indigenous languages; using numerical pain assessment tools limited to the numbers one to five; or by engaging Aboriginal health workers in the pain assessment process (Howe, Condon & Goodchild, 1998). Fenwick (1998) revealed that nurses adopted two main patterns to pain assessment, suggestive assessment and comparative assessment.…”

Low uptake of Aboriginal interpreters in healthcare: exploration of current use in Australia’s Northern Territory

“…While many people whose first language is an Aboriginal language have conversational English skills, an interpreter is still highly valuable for complex medical communication, decision-making and for helping to mitigate alienating medical environments [ 12 , 22 ]. When conversational English skills are present, patients and healthcare providers can both underestimate the extent of miscommunication [ 12 ].…”