Creating "a Safe Place to Go": Yarning With Health Workers About Stroke Recovery Care for Aboriginal Stroke Survivors-A Qualitative Study.

Abstract

Stroke affects Aboriginal people at disproportionate rates compared to other populations in Australia. Aboriginal peoples are less likely to receive a timely stroke diagnosis, or timely culturally responsive treatment, as there are very few stroke resources and recovery plans that have been developed by Aboriginal peoples for Aboriginal peoples. Understanding how to develop and implement culturally responsive stroke care requires research approaches that are informed by and with Aboriginal people. A qualitative Indigenous research methodology including "yarning" was undertaken to understand the experiences of both Aboriginal and non-Aboriginal health workers from nine health services providing stroke rehabilitation and recovery support to Aboriginal people living within the participating communities. Data were analyzed using an inductive approach driven by an Indigenous research approach. Yarns revealed three themes: (i) the role of culturally safe health environments to support stroke survivors, their family, and health workers; and how (ii) complicated, under-resourced systems impede the capacity to support stroke survivors; and (iii) collaborative and adaptive practices prevent people "falling through the cracks." This study highlights the need to scrutinize the cultural safety of health care, current health systems, workforce, and culture and how these influence the capacity of health workers to provide care that is responsive to the individual needs of Aboriginal stroke survivors and their families. These learnings will inform the co-design of a culturally responsive stroke recovery care strategy to improve the recovery experience and health and well-being of Aboriginal people and their families living with stroke.