A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease
Introduction: Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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James Cook University
2024-02-01
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| Series: | Rural and Remote Health |
| Subjects: | |
| Online Access: | https://www.rrh.org.au/journal/article/7970/ |
| _version_ | 1797293114827735040 |
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| author | Kristin Graham Katrina Fitzpatrick Joseph Agius Cathy Loughry Emilee Ong Neil McMillan Kate Gunn Robert Fitridge |
| author_facet | Kristin Graham Katrina Fitzpatrick Joseph Agius Cathy Loughry Emilee Ong Neil McMillan Kate Gunn Robert Fitridge |
| author_sort | Kristin Graham |
| collection | DOAJ |
| description |
Introduction: Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of wounds and multidisciplinary management can reduce amputation rates by 39-56%. Rural and remote communities and Indigenous populations are disproportionately affected by DFD. This is reflected in amputation rates, which are much higher for Indigenous than for non-Indigenous Australians and for those in very remote areas than for those in major cities or inner regional areas. The large geographical spread of the population in Australia is a substantial barrier for those providing or accessing health services, particularly multidisciplinary and specialist services, which undoubtedly contributes to poorer DFD outcomes in rural and remote communities.
Methods: A real-time, video-based telehealth service for DFD management was established at the Royal Adelaide Hospital Vascular Services clinic to improve access to specialist services for rural and remote Aboriginal and Torres Strait Islander communities. An exploratory qualitative study that utilised one-on-one, semi-structured interviews was conducted with 11 participants who identified as Aboriginal and who had participated in the telehealth foot service. Interviews were transcribed, de-identified and analysed using thematic analysis, using an inductive approach.
Results: Four interrelated themes emerged. 'Practical benefits of staying home' describes the reduced burden of travel and advantages of having local healthcare providers and support people at consultations. 'Access to specialists and facilities' highlights how some participants felt that there was a lack of appropriate facilities in their area and appreciated the improved access telehealth provided. 'Feeling reassured that a specialist has seen their feet' reflects the positive impact on wellbeing that participants experienced when their feet were seen by specialist health staff. 'Facilitates communication' describes how participants felt included in consultations and how seeing a person on screen assisted conversation.
Conclusion: The advantages of real-time, video-based telehealth go beyond reduced travel burden and improved access to specialist care. This model of care may facilitate relationship-building, patient wellbeing, and feelings of trust and safety for Aboriginal and Torres Strait Islander DFD patients.
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| first_indexed | 2024-03-07T20:09:13Z |
| format | Article |
| id | doaj.art-aec5e118323d40839cef697344f60d9b |
| institution | Directory Open Access Journal |
| issn | 1445-6354 |
| language | English |
| last_indexed | 2024-03-07T20:09:13Z |
| publishDate | 2024-02-01 |
| publisher | James Cook University |
| record_format | Article |
| series | Rural and Remote Health |
| spelling | doaj.art-aec5e118323d40839cef697344f60d9b2024-02-28T03:39:14ZengJames Cook UniversityRural and Remote Health1445-63542024-02-012410.22605/RRH7970A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot diseaseKristin Graham0Katrina Fitzpatrick1Joseph Agius2Cathy Loughry3Emilee Ong4Neil McMillan5Kate Gunn6Robert Fitridge7Allied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, AustraliaDepartment of Podiatry, Central Adelaide Local Health Network, Adelaide, SA, Australia; and Watto Purrunna Aboriginal Health Service, Port Adelaide, SA, AustraliaDepartment of Podiatry, Central Adelaide Local Health Network, Adelaide, SA, AustraliaAllied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, Australia; and Department of Podiatry, Central Adelaide Local Health Network, Adelaide, SA, AustraliaAllied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, AustraliaBasil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia; and Adelaide Medical School, The University of Adelaide, Adelaide, SA, AustraliaAllied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, AustraliaBasil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia; and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia Introduction: Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of wounds and multidisciplinary management can reduce amputation rates by 39-56%. Rural and remote communities and Indigenous populations are disproportionately affected by DFD. This is reflected in amputation rates, which are much higher for Indigenous than for non-Indigenous Australians and for those in very remote areas than for those in major cities or inner regional areas. The large geographical spread of the population in Australia is a substantial barrier for those providing or accessing health services, particularly multidisciplinary and specialist services, which undoubtedly contributes to poorer DFD outcomes in rural and remote communities. Methods: A real-time, video-based telehealth service for DFD management was established at the Royal Adelaide Hospital Vascular Services clinic to improve access to specialist services for rural and remote Aboriginal and Torres Strait Islander communities. An exploratory qualitative study that utilised one-on-one, semi-structured interviews was conducted with 11 participants who identified as Aboriginal and who had participated in the telehealth foot service. Interviews were transcribed, de-identified and analysed using thematic analysis, using an inductive approach. Results: Four interrelated themes emerged. 'Practical benefits of staying home' describes the reduced burden of travel and advantages of having local healthcare providers and support people at consultations. 'Access to specialists and facilities' highlights how some participants felt that there was a lack of appropriate facilities in their area and appreciated the improved access telehealth provided. 'Feeling reassured that a specialist has seen their feet' reflects the positive impact on wellbeing that participants experienced when their feet were seen by specialist health staff. 'Facilitates communication' describes how participants felt included in consultations and how seeing a person on screen assisted conversation. Conclusion: The advantages of real-time, video-based telehealth go beyond reduced travel burden and improved access to specialist care. This model of care may facilitate relationship-building, patient wellbeing, and feelings of trust and safety for Aboriginal and Torres Strait Islander DFD patients. https://www.rrh.org.au/journal/article/7970/Aboriginal and Torres Strait Islander PeoplesAustraliadiabetes-related foot diseaseIndigenousqualitativereal-time video-based telehealth |
| spellingShingle | Kristin Graham Katrina Fitzpatrick Joseph Agius Cathy Loughry Emilee Ong Neil McMillan Kate Gunn Robert Fitridge A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease Rural and Remote Health Aboriginal and Torres Strait Islander Peoples Australia diabetes-related foot disease Indigenous qualitative real-time video-based telehealth |
| title | A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease |
| title_full | A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease |
| title_fullStr | A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease |
| title_full_unstemmed | A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease |
| title_short | A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease |
| title_sort | qualitative exploration of the experiences of aboriginal and torres strait islander people using a real time video based telehealth service for diabetes related foot disease |
| topic | Aboriginal and Torres Strait Islander Peoples Australia diabetes-related foot disease Indigenous qualitative real-time video-based telehealth |
| url | https://www.rrh.org.au/journal/article/7970/ |
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