General practitioners’ perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders

Authors

Deborah Hersh, Edith Cowan UniversityFollow
Elizabeth Armstrong, Edith Cowan UniversityFollow
Meaghan McAllister, Edith Cowan UniversityFollow
Natalie Ciccone, Edith Cowan UniversityFollow
Judith Katzenellenbogen
Juli Coffin
Sandra Thompson
Colleen Hayward, Edith Cowan UniversityFollow
Leon Flicker
Deborah Woods

Author Identifier

Deborah Hersh

https://orcid.org/0000-0003-2466-0225

Elizabeth Armstrong

https://orcid.org/0000-0003-4469-1117

Natalie Ciccone

https://orcid.org/0000-0002-1822-7217

Document Type

Journal Article

Publication Title

Patient Education and Counseling

Publisher

Elsevier

School

School of Medical and Health Sciences

RAS ID

29633

Funders

National Health and Medical Research Council

Grant Number

NHMRC Number : 1046228

Grant Link

http://purl.org/au-research/grants/nhmrc/1046228

Comments

This is an Author's Accepted Manuscript of: Hersh, D., Armstrong, E., McAllister, M., Ciccone, N., Katzenellenbogen, J., Coffin, J., ... Woods, D. (2019). General practitioners’ perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders. Patient Education and Counseling, 102(12), 2310-2317. https://doi.org/10.1016/j.pec.2019.07.029

© 2019. This manuscript version is made Available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Abstract

Objective:

Aboriginal people have high rates of stroke and traumatic brain injury (TBI), often with residual, chronic communication deficits and multiple co-morbidities. This study examined general practitioners’ (GPs’) perceptions of their communication with Aboriginal patients with acquired communication disorders (ACD) after brain injury. Effective communication underpins good care but no previous research has explored this specific context.

Methods:

A qualitative descriptive approach was employed using interviews and focus groups with 23 GPs from metropolitan Perth and five regional sites in Western Australia. Data were analysed thematically. Results: GPs reported low visibility of Aboriginal patients with ACD in their practices, minimal training on neurogenic ACD, and difficulty distinguishing ACD from cultural-linguistic factors. They had few communication resources, and depended on families and Aboriginal Health Workers to assist in interactions. They rarely used formal interpreting services or referred to speech pathology. They reported communication (dis)ability having low priority in consultations.

Conclusion:

GPs report difficulty recognising ACD and their lack of prioritising assessment and treatment of communication ability after brain injury potentially compounds the disadvantage and disempowerment experienced by many Aboriginal people.

Practice implications:

GPs require further communication and cultural training. Improved access to speech pathology and formal interpreting services would be beneficial.

DOI

10.1016/j.pec.2019.07.029

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.