An Aboriginal English Ontology Framework for Patient-Practitioner Interview Encounters

Current diagnosis, treatment and healthcare delivery processes in Australia are dominated by long established westernized clinically driven methods of patient-practitioner interaction. Consequently this dominant healthcare provider influence contributes to risk of miscommunication, misinformation in patient records and reciprocal misunderstandings that go unrecognised as such. For Indigenous communities, inadequate health literacy (HL) and a pervasive semantic disconnect are major barriers. Overcoming these barriers in the primary care setting presents opportunities to deliver appropriate timely and more effective care. We propose an e-health framework that enhances the Patient-Practitioner Interview Encounter (PPIE) through the use of a patient-centric linguistic interface using semantic mappings between Aboriginal English (AE) and Standard Australian English (SAE). This will ameliorate communications and interactions, so meeting the needs of all stakeholders (Patients, Physicians, Nurses, Allied Health Professionals and their Non-Critical Carers) engaged in Indigenous patient-centric primary care. It provides healthcare practitioners and their Indigenous T2DM patients with a new platform for two-way educative sharing and knowledge exchange that will increase mutually productive treatment, care and management expectations

Development of patient-practitioner assistive communications (PPAC) ontology for type 2 diabetes management

Communication in primary care is a key area of healthcare slow to adopt new technology to improve understanding between the patient and healthcare practitioner. Patients whose cultural background and regular form of dialectal communication are far removed from that of mainstream society are particularly disadvantaged by this during the patient-practitioner interview encounter (PPIE). In this paper, we present an assistive communications technology (ACT) framework for PPIE developed using a Type-2 Diabetes Management Patient-Practitioner Assistive Communications (T2DMPPAC) ontology in order to help both Aboriginal patient and non-Aboriginal practitioner optimise their pre-encounter, during-encounter and post-encounter communication. The T2DMPPAC architecture provides knowledge and presents it in a manner that is easily accessible and understood by the user (patients and practitioners) as well as accompanying carers, and as appropriate, interpreters. An example of bi-directional mapping of concepts to language during a PPIE session is shown using the ontology

Healing conversations: Developing a practical framework for clinical communication between Aboriginal communities and healthcare practitioners

In recognition of the ongoing health disparities experienced by Aboriginal and Torres Strait Islander peoples (hereafter Aboriginal), this scoping review explores the role and impact of the clinical communication process on Aboriginal healthcare provision. A medical education lens is applied, looking at the utility of a tailored clinical communication framework to assist health practitioners work more effectively with Aboriginal peoples and communities. The initial framework, building on existing communication guides, proposes four domains: content, process, relational and environmental. It places emphasis on critical self-reflection of the health practitioner’s own cultural identity and will be guided by collective Aboriginal world-views in select Australian settings. Using a two-eyed seeing approach the framework will be developed and tested in health professional education. The aim of this research journey is to enable health practitioners to have more effective healthcare conversations with Aboriginal peoples, working toward more socially just and equitable healthcare interactions and outcome

Coupling of indigenous-patient-friendly cultural communications with clinical care guidelines for type 2 diabetes mellitus

Distance, terrain, climate and inadequate medical resources seriously constrain health care accessibility for rural and remote Indigenous communities of Western Australia (WA). Management of the Type 2 Diabetes Mellitus (T2DM), a chronic condition affecting Indigenous people much more than non-Indigenous, requires a complex assortment of time-sensitive communications activity and interventions to avert serious complications. Communications barriers arising from pervasive cultural misunderstanding in primary care go far beyond language differences and routine translation techniques. Practitioners and patients lacking the capability and capacity to facilitate dialogue for shared meaning in the examination and testing discourse need a culturally sensitive purpose-driven informatics system of support for the Patient-Practitioner Interview Encounter (PPIE). The dominant unidirectional clinician-biased forms of communication employed by healthcare professionals are a major barrier. Our developing communications support model utilizes the mapping of ontologies. The Community Healthcare ontology is dedicated to mapping a clinical taxonomy for T2DM national guidelines to Aboriginal English (AE). The eventual user interface will represent Aboriginal patient-culture-driven access to and use of interactive audio visual media in the primary healthcare setting.This research objective establishes value of and respect for the Aboriginal patient’s dialectal and pragmatic preferences, thereby enabling us to couple these preferences with Australia’s Standard English clinical communications practice in the treatment and care of IndigenousT2DM patients. A critical capability of the eventual application, especially when phrase ontology guidance enters the interface will be the interception of ambiguities and mitigation of misinterpretation risk. The emphasis is concentrated on bi-directional communications assistance that will not only enhance the Aboriginal patient opportunity to contribute to the PPIE, but will reinforce the value of and reciprocal respect for, sound clinical practice

A Framework for Patient Practitioner Information Exchange

The global Type 2 Diabetes Mellitus (T2DM) epidemic imposes a heavy burden on communities that are ethnically vulnerable to the disease and further disadvantaged by socio-economic circumstance and cultural communications barriers. Aboriginal communities in rural and remote Western Australia are representative of these high-riskgroups. Indigenous patients needing continuous management of T2DM are also experiencing disproportionate risk of co-morbidities and hospitalizations compared with nonindigenous patients. Type 2 Diabetes Mellitus (T2DM) is often described as ’the lifestyle disease’. Within clinical care and patient quality of life management domains, T2DM presents both the healthcare practitioner and the patient with a mosaic of complexities.Information processing demands for self-management of diabetes are extensive, requiring constant self monitoring and assessment of the illness state in order to apply per instance and per condition the most appropriate form of control. In this work we introduce a primary care communications concept tool centered upon optimization of the Patient-Practitioner Interview Encounter (PPIE). The target beneficiary is the Aboriginal T2DM patient living in Western Australia. Avital part of our design effort is therefore dedicated to understanding and responding to the cultural domain barriers, challenges and opportunities of this specific health care environment

A framework for assistive communications technology in cross-cultural healthcare

Rural and remote Australian Aboriginal communities suffer seriously adverse life expectancy rates, lifestyle disease complications and hospital treatment needs due to type 2 diabetes. In great part this is due to communications barriers arising from the lack of equitable acculturation within patient-practitioner consultations. This research presents a framework foundation for a computerised patient-practitioner lingua franca. Behavioural and design science ontology development delivers an intercultural patient-practitioner type 2 diabetes assistive communications system, known as P-PAC

The Ripple Effect: Promoting a Supportive Secondary School Culture by Mobilising Bystanders to Bullying

The social context of bullying is pivotal with peers present as bystanders to the majority of school bullying interactions. Bystander responses can impact profoundly on the maintenance and course of school bullying and range from inciting the bullying through joining in or assisting the perpetrator, or inhibiting the bullying through actively intervening and supporting the bullied student. This qualitative study sought to elicit students’ perceptions of the bystander role and recommendations of the supports needed at the school level to encourage positive bystander behavior

Real-Time Netnography: Rejecting the Passive Shift

Although netnography emerged in the 1990s, it is a term unfamiliar to many ethnographers and is still touted as a new methodology. Once explained, ethnographers often understand it in terms of online ethnography. While this is helpful, netnography, however, offers a set of steps and analytic approaches that can be applied across a spectrum of involvement online. Its focus is on gaining entree to an online community, distinguishing between participant observation and nonparticipant observation

Health care homes in Cairns: a mixed methods study exploring the experience of adults living with chronic conditions to inform the new model of primary health care

Mary explored the experiences of adults living with chronic conditions in Cairns, to inform the development of a new model of primary health care. She found a need to better support those living with uncommon chronic conditions; and to implement authentic, person-led approaches to care delivery

An investigation into the development of cultural responsiveness in Australian physiotherapy students and new graduates’ capability to work with culturally and linguistically diverse communities

With the increasing cultural diversity in Australia, health professionals, including physiotherapists, must be prepared to care for people from culturally and linguistically diverse communities. Entry-level physiotherapy educational programs are entrusted to assure the development of all competencies required of practicing new graduate physiotherapists. This therefore needs to include the capability to practice in a culturally responsive manner. The broad goal of the research program presented in this thesis was to investigate how entry-level physiotherapy programs deliver learning and teaching to support the development of cultural responsiveness in students, and to identify if gaps exist in the preparation of new graduates for working with people from CALD communities. To achieve this, four separate studies were conducted. The four studies examined different components and/or perspectives related to curricula and the development of cultural responsiveness in physiotherapy students