为澳大利亚第一民族人提供文化安全的临床脏护理建议:指南摘要
David J Tunnicliffe1,2, Samantha Bateman3,4, Melissa Arnold-Chamney3
1University of Sydney, Sydney, NSW.
The Medical journal of Australia
|October 15, 2023
概括
新的指导方针旨在通过解决种族主义问题和改善护理准入来减少澳大利亚原住民的慢性病 (CKD). 建议包括早期查和社区参与,以保持功能.
科学领域:
- 公共卫生 公共卫生
- 土著健康土著健康
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 澳大利亚原住民由于殖民的代际影响,慢性病 (CKD) 的发病率不成比例地高.
- 现有的卫生系统需要大幅改进,以解决系统性不平等问题,并为第一民族人民提供文化安全.
- 社区商突出了制定有针对性的CKD管理策略的关键领域.
研究的目的:
- 专门为澳大利亚原住民制定基于证据的慢性病 (CKD) 管理指南.
- 在制定指南时,将社区的知识和优先事项与科学证据相结合.
- 为卫生系统提出可行的建议,以改善这一群体中CKD的结果.
主要方法:
- 使用了适应的GRADE证据决策框架,优先考虑社区知识和相关证据.
- 与主要的土著卫生组织进行了全国性的社区商.
- 综合数据,为CKD管理制定具体建议.
主要成果:
- 指导方针建议衡量和监测制度性种族主义,并将其与文化安全培训联系起来.
- 倡导增加社区和家庭参与临床护理,包括运输和住宿.
- 引入较早的查标准 (年龄≥18岁) 和转诊值 (eGFR ≤45mL/min/1.73m2或持续的eGFR降低>10mL/min/1.73m2/年).
结论:
- 优先考虑医疗保健服务提供变化,以打击制度性种族主义和加强文化安全.
- 强调早期检测和专家推澳大利亚第一民族人,以保持功能.
- 强调社区参与所有治疗阶段的重要性,以及改善获得护理的机会,特别是在农村/偏远地区.
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