"Only your blood can tell the story"--a qualitative research study using semi-structured interviews to explore the hepatitis B related knowledge, perceptions and experiences of remote dwelling Indigenous Australians and their health care providers in northern Australia.

2014-11-28

Davies, Jane

Bukulatjpi, Sarah

Sharma, Suresh

Davis, Joshua

Johnston, Vanessa

Menzies School of Health Research, Rocklands Drive, Tiwi, Darwin, NT 0811, Australia. Jane.davies@menzies.edu.au.

Adult

Attitude of Health Personnel

Australia

Communication

Cultural Competency

Culture

Female

Health Knowledge, Attitudes, Practice

Health Literacy

Health Personnel

Health Services, Indigenous

Hepatitis B

Humans

Interviews as Topic

Language

Male

Middle Aged

Northern Territory

Perception

Qualitative Research

Rural Population

Journal Article

Publication

BACKGROUND: Hepatitis B is endemic in the Indigenous communities of the Northern Territory of Australia and significantly contributes to liver-related morbidity and mortality. It is recognised that low health literacy levels, different worldviews and English as a second language all contribute to the difficulties health workers often have in explaining biomedical health concepts, relevant to hepatitis B infection, to patients. The aim of this research project was to explore the knowledge, perceptions and experiences of remote dwelling Indigenous adults and their health care providers relating to hepatitis B infection with a view to using this as the evidence base to develop a culturally appropriate educational tool. METHODS: The impetus for this project came from health clinic staff at a remote community in Arnhem Land in the Northern Territory, in partnership with a visiting specialist liver clinic from the Royal Darwin Hospital. Participants were clinic patients with hepatitis B (n = 12), community members (n = 9) and key informants (n = 13); 25 were Indigenous individuals.A participatory action research project design was used with purposive sampling to identify participants. Semi-structured interviews were undertaken to explore: current understanding of hepatitis B, desire for knowledge, and perspectives on how people could acquire the information needed. All individuals were offered the use of an interpreter. The data were examined using deductive and inductive thematic analysis. RESULTS: Low levels of biomedical knowledge about Hepatitis B, negative perceptions of Hepatitis B, communication (particularly language) and culture were the major themes that emerged from the data. Accurate concepts grounded in Indigenous culture such as "only your blood can tell the story" were present but accompanied by a feeling of disempowerment due to perceived lack of "medical" understanding, and informed partnerships between caregiver and patient. Culturally appropriate discussions in a patient's first language using visual aids were identified as vital to improving communication. CONCLUSIONS: Having an educational tool in Indigenous patient's first language is crucial in developing treatment partnerships for Indigenous patients with hepatitis B. Using a culturally appropriate worldview as the foundation for development should help to reduce disempowerment and improve health literacy.

link

BMC Public Health . 2014 Nov 28:14:1233. doi: 10.1186/1471-2458-14-1233.

1471-2458

1471-2458

https://pubmed.ncbi.nlm.nih.gov/25430502/?otool=iaurydwlib