Participatory Action Research-Dadirri-Ganma, using Yarning: methodology co-design with Aboriginal community members

Background: Appropriate choice of research design is essential to rightly understand the research problem and derive optimal solutions. The Comorbidity Action in the North project sought to better meet the needs of local people affected by drug, alcohol and mental health comorbidity. The aim of the study focused on the needs of Aboriginal peoples and on developing a truly representative research process. A methodology evolved that best suited working with members of a marginalised Aboriginal community. This paper discusses the process of co-design of a Western methodology (participatory action research) in conjunction with the Indigenous methodologies Dadirri and Ganma. This co-design enabled an international PhD student to work respectfully with Aboriginal community members and Elders, health professionals and consumers, and non-Indigenous service providers in a drug and alcohol and mental health comorbidity project in Adelaide, South Australia. Methods The PhD student, Aboriginal Elder mentor, Aboriginal Working Party, and supervisors (the research team) sought to co-design a methodology and applied it to address the following challenges: the PhD student was an international student with no existing relationship with local Aboriginal community members; many Aboriginal people deeply distrust Western research due to past poor practices and a lack of implementation of findings into practice; Aboriginal people often remain unheard, unacknowledged and unrecognised in research projects; drug and alcohol and mental health comorbidity experiences are often distressing for Aboriginal community members and their families; attempts to access comorbidity care often result in limited or no access; and Aboriginal community members experience acts of racism and discrimination as health professionals and consumers of health and support services. The research team considered deeply how knowledge is shared, interpreted, owned and controlled, by whom and how, within research, co-morbidity care and community settings. The PhD student was supported to co-design a methodology that was equitable, democratic, liberating and life-enhancing, with real potential to develop feasible solutions.Results The resulting combined Participatory Action Research (PAR)-Dadirri-Ganma methodology sought to create a bridge across Western and Aboriginal knowledges, understanding and experiences. Foundation pillars of this bridge were mentoring of the PhD student by senior Elders, who explained and demonstrated the critical importance of Yarning (consulting) and Indigenous methodologies of Dadirri (deep listening) and Ganma (two-way knowledge sharing), and discussions among all involved about the principles of Western PAR.. Conclusions Concepts within this paper are shared from the perspective of the PhD student with the permission and support of local Elders and Working Group members. The intention is to share what was learned for the benefit of other students, research projects and community members who are beginning a similar journey.Hepsibah Sharmil, Janet Kelly, Margaret Bowden, Cherrie Galletly, Imelda Cairney, Coral Wilso

Health Information Technology Media by Nurses in Patient Care

Health Information Technology (HIT) is an electronic application of patient management system in health services that yield data for enhanced patient care. This literature review article examined the ability of nurses using HIT. Nurses being the highest proportion of population in the health sector, examining the extent of HIT use from nurses, will provide a clarified outlook on the implications of HIT. Evidential literature search was done in Pubmed, Google Scholar and Science Direct and collectively it yielded 1801 articles. The articles was carefully skimmed for applicability and relevancy. The deemed inclusion criteria was met by eleven articles and it was entirely reviewed and sorted. The findings revealed that for the HIT system to be successful, from the conceptualisation of HIT, to its planning, to designing, to the application of HIT and also at the feedback stage all the members involved and affected by HIT and its implications must be consulted, especially nurses being the major number of health workers in the health care realm, its crucial that nurses are involved in every stage of HIT management and its execution. Application of HIT was found to improve skill of nurse in informatics and electronic documentation. It was found that issues like medication errors, missing-out of service by the patients were reduced. Good standard of practice was also evident by continuation of care, and reaching the unreached remote marginalised communities was the best of all HIT’s benefit