Browsing by Author "McAllister M."
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Item Study protocol: missing voices - communication difficulties after stroke and traumatic brain injury in Aboriginal Australians.(2015-07-23) Armstrong E.; Hersh D.; Katzenellenbogen J.M.; Coffin J.; Thompson S.C.; Ciccone N.; Hayward C.; Flicker L.; Woods D.; McAllister M.Background: Aboriginal and Torres Strait Islander Australians experience stroke and traumatic brain injury (TBI) with much greater frequency than non-Aboriginal Australians. Acquired communication disorders (ACD) can result from these conditions and can significantly impact everyday life. Yet few Aboriginal people access rehabilitation services and little is known about Aboriginal peoples' experiences of ACD. This paper describes the protocol surrounding a study that aims to explore the extent and impact of ACD in Western Australian Aboriginal populations following stroke or TBI and develop a culturally appropriate screening tool for ACD and accessible and culturally appropriate service delivery models. Method/Design: The 3-year, mixed methods study is being conducted in metropolitan Perth and five regional centres in Western Australia. Situated within an Aboriginal research framework, methods include an analysis of linked routine hospital admission data and retrospective file audits, development of a screening tool for ACD, interviews with people with ACD, their families, and health professionals, and drafting of alternative service delivery models. Discussion(s): This study will address the extent of ACD in Aboriginal populations and document challenges for Aboriginal people in accessing speech pathology services. Documenting the burden and impact of ACD within a culturally secure framework is a forerunner to developing better ways to address the problems faced by Aboriginal people with ACD and their families. This will in turn increase the likelihood that Aboriginal people with ACD will be diagnosed and referred to professional support to improve their communication, quality of life and functioning within the family and community context.Copyright © Australasian Society for the Study of Brain Impairment 2015.Item Yarning together: developing a culturally secure rehabilitation approach for Aboriginal Australians after brain injury.(2020-01-31) Ciccone N.; Armstrong E.; Adams M.; Bessarab D.; Hersh D.; McAllister M.; Godecke E.; Coffin J.Background and Objectives: Stroke and traumatic brain injury are more common in Aboriginal Australians than their non-Aboriginal counterparts, yet knowledge surrounding what constitutes a culturally secure and accessible rehabilitation service for Aboriginal Australians is sparse. This research (Lowitja Institute Funding 2018-2019) is working with Aboriginal people with an acquired communication disorder (ACD) following brain injury to (i) develop an understanding of the individual's perceptions of rehabilitation services and (ii) test the feasibility and acceptability of a culturally tailored model of speech pathology rehabilitation delivered via one of two modes: face to face or using telehealth technology. Method(s): Participants (n = 20) with an ACD after stroke or traumatic brain injury will be allocated to one of two groups: face-to-face therapy or therapy utilising telehealth technology and will receive 16 x 1 h treatment sessions provided twice weekly. Therapy utilises collaborative planning, integrates a yarning framework and is provided by a speech pathologist and Aboriginal co-worker. Improvement in participant communication skills is being measured through change in verbal output in discourse. The perspectives of the participants on the rehabilitation services accessed previously, the therapy provided through the study and change in everyday communication will be collected through semi-structured interviews. Result(s): This paper will present the therapy protocol, an explanation of the key elements involved in therapy implementation and some preliminary findings. Conclusion(s): The findings from this study will provide direction for rehabilitation therapists who provide services to Aboriginal brain injury survivors to improve quality of care.Item Yarning together: incorporating telehealth into the provision of culturally secure speech pathology services for Aboriginal Australians after brain injury.(2021-02-27) Ciccone N.; Armstrong E.; Adams M.; Hersh D.; McAllister M.; Bessarab D.; Godecke E.; Coffin J.; Walley M.Background and objectives: Stroke and traumatic brain injury are more common in Aboriginal Australians than their non-Aboriginal counterparts, yet knowledge surrounding what Aboriginal Australians view as a culturally secure rehabilitation service is limited. Our previous research trialled a culturally secure model of rehabilitation which was feasible to deliver and acceptable to Aboriginal people who had an acquired communication disorder (ACD) following a stroke. The model involved the use of yarning principles and an Aboriginal co-worker (ACW) working in conjunction with the speech pathologist (SP). The current project (Lowitja Institute Funding 2018- 2019) extends this previous work by adding a telehealth component and again explores the feasibility and acceptability of the treatment delivered via one of two modes: face to face or using telehealth technology. Method(s): Participants (n = 11), Aboriginal adults with an ACD after stroke or traumatic brain injury (>1 year-18 years post-onset), were case-matched and allocated to one of two groups: face-to-face therapy or therapy utilising telehealth technology and received 16 x 1 h treatment sessions provided twice weekly. Therapy integrated a yarning framework and was provided jointly by a SP and ACW in the person's place of residence. Feasibility was measured by analysing the number of sessions conducted jointly by the SP and ACW and participant attendance. Improvement in the participants' communication skills were measured through change in verbal output within language samples collected at multiple time points. Semi-structured interviews were used to explore both the participants' perspectives and the ACW's and SP's perceptions on the acceptability of and change achieved through the therapy. All interviews were analysed through qualitative descriptive analysis. Result(s): Across all sessions, 235/258 (91.1%) were attended by the ACW and SP and 10 of the 11 participants completed all prescribed sessions. Positive feedback was provided by participants, the ACW and SPs on the key components of the programme including the use of telehealth technology. Conclusion(s): The findings from this study provide direction for rehabilitation therapists who provide services to Aboriginal people to improve quality of care and provide culturally secure services. This work demonstrates that therapy can be delivered remotely by a SP but that an ACW being physically present is an important part of this rehabilitation approach.Item "You felt like a prisoner in your own self, trapped": the experiences of Aboriginal people with acquired communication disorders.(2021-08-03) Armstrong E.; Coffin J.; Hersh D.; Katzenellenbogen J.M.; Thompson S.C.; Ciccone N.; Flicker L.; Woods D.; Hayward C.; Dowell C.; McAllister M.PURPOSE: Aboriginal Australians are under-represented in brain injury rehabilitation services despite a high incidence of both stroke and traumatic brain injury in this population. This study aimed to explore the experiences of Aboriginal Australian adults with acquired communication disorders (ACDs) after brain injury for the first time to inform the development of accessible and culturally secure service delivery models. METHODS AND MATERIALS: Semi-structured interviews were undertaken with 32 Aboriginal people who had experienced a brain injury resulting in ACDs (aged 35-79 years) and 18 family members/carers across Western Australia. Thematic analysis identified common themes across participants. Results: Overall themes related to communication (both related to the communication disorder and general healthcare interactions), health and social contexts, recovery, and support, being away from family and country, knowledge and beliefs about brain injury, and follow-up. Conclusions: An increase in healthcare staff's appreciation of the health and social contexts of Aboriginal people after brain injury is needed in order to improve communication with Aboriginal patients and the ability to offer accessible rehabilitation services. Ongoing support is required, with cultural identity noted as key to ensuring cultural security and ultimately recovery. Involvement of family and other Aboriginal people in recovery processes, as well as access to relevant Aboriginal languages and proximity to ancestral lands is central.Implications for rehabilitationAcknowledgment of cultural identity and strengths through involvement of extended family and Aboriginal Hospital Liaison Officers, access to language and proximity to country all central to rehabilitation planning for Aboriginal people after brain injury.Cultural security training for rehabilitation staff is recommended focusing on clear two-way communication skills to make medical information accessible for Aboriginal patients and to listen to patients' concerns in a way that respects cultural context.Information regarding practical support and implications for ongoing management of life after brain injury (for the person and their family) is essential, and should supplement the medical-related information provided.Follow-up post discharge from hospital best facilitated through establishing contact with local Aboriginal community through Aboriginal community controlled health services, community elders, and Aboriginal health workers across organisations.