A chart audit of Indigenous Australian stroke and traumatic brain injury admissions at a regional Queensland hospital: Implications for aphasia practice.

Conference Contribution ResearchOnline@JCU
Cochrane, Frances;Siyambalapitiya, Samantha;Cornwell, Petrea
Abstract

Background: Aphasia is common following stroke and traumatic brain injury (TBI). Australia’s Indigenous populations have poorer health status compared to other Australian populations, particularly in relation to stroke and TBI. Australia’s Indigenous populations vary greatly in terms of geography, culture and language. This diversity may present significant challenges for speech pathologists in the provision of effective aphasia services due to potential cultural and language differences. To date, no research has been undertaken in Queensland that focuses on exploring the clinical profiles of Indigenous Australia adults with acute neurological injury, including potential aphasia presentation and subsequent speech pathology management approaches in the acute hospital setting. The aim of this study is to examine the clinical profiles of adult Indigenous Australian acute stroke and TBI admissions, and the subsequent documented speech pathology services provided to these patients, at a regional Queensland hospital. Methods: A retrospective chart review was conducted on the medical records of Aboriginal and Torres Strait Islander adults admitted with acute stroke and TBI to a regional Queensland hospital over a two year period. Results: 138 Indigenous Australian adults (79 men, 59 women, Mage 50 years, age range: 20-90 years) were admitted due to acute stroke and traumatic brain injury over the two year period. Patients were from 25 different locations across Queensland including several Aboriginal or Torres Strait Islander communities, however the language background was recorded as ‘English only’ for all patients. Almost all patients were from outer regional, remote or very remote localities. Preliminary results indicate that informal approaches, including observations and discussions with the patient or family, are primarily used to determine whether a patient has aphasia. Other approaches used to screen or assess for the presence of aphasia include the use of a location-developed language screener, the Sheffield Screening Test for Acquired Language Disorders, and the Mt Wilga High Level Language Test. Treatment appeared to focus largely on functional approaches such as conversation and everyday reading. Speech pathologists do not appear to frequently report adaptations of assessment or therapy to accommodate cultural and language difference, nor do they appear to frequently engage Indigenous Liaison Officers in the patient management process. Discussion: Given the vast cultural and geographic diversity of these patients, English may not be the primary language spoken, despite all patients having their language recorded as ‘English Only’. The diversity of these patients may present a range of challenges for speech pathologists, particularly in relation to aphasia assessment and intervention approaches. Aphasia management approaches need to accommodate the diverse background of Indigenous Australian patients in order to provide effective and culturally appropriate care.

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Aphasiology Symposium of Australasia 2018: see change in practice

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1

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Birtinya, QLD, Australia

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Aphasiology Symposium of Australasia

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Birtinya, QLD, Australia

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