Opportunities and challenges for physical rehabilitation with indigenous populations

Abstract

Indigenous peoples internationally have low access to physical rehabilitation, despite high needs. Achieving equitable outcomes requires reorientating services to be culturally appropriate for Indigenous peoples.

Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain: Needs and Preferences

“…Less than a third of clinicians rated their knowledge, ability and confidence to communicate effectively with Aboriginal and Torres Strait Islander patients as high. These findings are similar to those reported in a recent review of physical rehabilitation among Aboriginal and Torres Strait Islander patients, in which cultural development and the quality of communication were recommended as a way to realise equitable outcomes for Aboriginal and Torres Strait Islander people [13]. The cultural capability has been a major strategy to address health inequity and improve the quality of health care and outcomes among people from minority groups [40].…”

“…There are many barriers to Aboriginal and Torres Strait Islander patients being able to access health care for pain-related conditions including historical, societal, health system, health service, and clinician level factors [12]. These factors may include Aboriginal and Torres Strait Islander peoples' distrust of health care services, due to poor historical and ongoing treatment [2,13]; lack of culturally appropriate tools to measure pain [2]; and inadequate communication and cultural awareness skills among clinicians, which restrict clinicians' ability to recognise and interpret culturally specific ways of expressing and managing pain [13][14][15]. In addition, there is increasing evidence that poor communication between patients and clinicians is an important factor influencing access to health services [16].…”

Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action

“…A comprehensive approach to improving the pathway to surgery and surgical care for Aboriginal people requires consideration of opportunities for improvement at the health system, health service and clinician level 71 . Within these considerations, understanding the sociocultural context of Aboriginal people seeking care and addressing the social determinants of health and discrimination is key to delivering a culturally secure pathway to high‐quality surgical care.…”

“…System‐level considerations relate to the broader environment in which health care is delivered. These include health policy and regulation, financial and payment factors, the health workforce and mechanisms to optimize service delivery 71,72 . An overarching commitment to cultural security is required at the system level and such policies should ensure that there is Aboriginal representation in health care from leadership to delivery and that health care is shaped and improved by ongoing Aboriginal consumer input and evaluation 28 .…”

Introduction to special issue on new directions in physical rehabilitation of musculoskeletal pain conditions

“…The final 3 articles cover disparate but equally important topics. Lin et al 11 discuss the difficulties that indigenous people have in accessing rehabilitation and how these may be overcome. George and Goode venture into the controversial opioid overuse issue in many Western countries and describe how physical therapy may be used to increase exposure to nonpharmacological treatments for people with musculoskeletal pain.…”