Animal assisted therapy in a paediatric urban Indigenous health setting

Mrs Ashley Potgieter1

1The Institute For Urban Indigenous Health, Brisbane, Australia

Background: Animal Assisted Therapy (AAT) has long been recognised as a valuable tool to engage clients and provide physical, social and emotional outcomes. AAT can help clients with supporting their ability to regulate emotions, improve motivation to participate, hand function and can decrease hyperactivity behaviours (Elmaci, & Cevizci, 2015). The Institute for Urban Indigenous Health (IUIH) has established a System of Care, which guides the operation of the organisations services to ensure that we are being culturally responsive in all activities that are undertaken. This presentation will provide an overview of AAT and how it has been used in a culturally responsive manner within this setting.

Method: The IUIH Allied Health team utilise an inter-professional approach where possible when working with Aboriginal and Torres Strait Islander clients. A certified therapy dog has attended Aboriginal and Torres Strait Islander Community Controlled Health Clinics in South East Queensland to provide Animal Assisted Therapy services to children and their families within this inter-professional service delivery model.  Examples of integrating AAT within an IP team will be provided including de-identified case studies to demonstrate the effectiveness of this intervention. Client outcomes are measured using the Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC).

Discussion: The incorporation of a therapy dog has complemented using a yarning approach and has assisted clinicians to build connections with clients, the foundation for intervention. Since using this approach, client attendance has improved, and findings from outcome measures indicate that within sessions, clients are more relaxed and motivated to engage.

Reference

Elmaci, D, & Cevizci, S. (2015). Dog-assisted therapies and activities in rehabilitation of children with cerebral palsy and physical and mental disabilities. International Journal of Environmental Research and Public Health, 12(5), 5046-5060.


Biography:

Ashley Potgieter is an Occupational Therapist currently working at The Institute for Urban Indigenous Health. She graduated from the University of Queensland in 2013 as an Occupational Therapist (B.Occ Thy), and completed further post graduate study MAdv Occ Thy. She completed Animal Assisted Therapy training in 2016 and has since worked in a variety of settings using this approach. Ashley started working with the Institute in 2017 and is committed to helping First Australians to improve health outcomes. She values working in a multidisciplinary team with Aboriginal and Torres Strait Islander children and their families, as well as working with adults.

A multidisciplinary model of chronic disease care for potentially preventable hospitalisations in a regional Indigenous community

Sharon Woods1

1Mackay Hospital & Health Service,

It is well known that there exists a gap in health equality between Aboriginal and Torres Strait Islander people and other Australians.  With higher rates than non-indigenous Australians of chronic disease, morbidity and mortality, access to primary healthcare for indigenous people living with chronic disease is crucial.  At a regional North Queensland local hospital over 50% of acute admissions for indigenous people that are potentially preventable are attributed to chronic disease.  Of those, the highest rates are in patients with complications of diabetes (27.6%), respiratory disease (16.3%), and cardiac conditions (9.8%).  In response to growing concerns that existing services were not meeting the community needs, a community based service with a multidisciplinary care model was introduced.  The aims of the service were to improve care coordination and access to allied health and specialist services for indigenous people with chronic conditions living in the local area, and to provide prevention and early detection activities for the wider indigenous community.   In view of the high rates of potentially preventable hospitalisations due to diabetes complications, cardiac and respiratory conditions, clinic based and home visiting services for dietetics and podiatry were the first allied health services to be implemented.  The purpose of this presentation is to share the challenges and successes of the Potentially Preventable Hospitalisations Team, and to highlight potential future opportunities for improving access to chronic disease care for indigenous people in regional communities.


Biography: To be confirmed

Kidney Supportive Care for Aboriginal and Torres Strait Islander people

Mrs Jenny Kirby1,2, Professor Ann Bonner1,3,4,5, Dr Louise Purtell1,3

1Kidney Health Service, Royal Brisbane & Women’s Hospital, Brisbane, Australia, 2Social Work Department, Royal Brisbane & Women’s Hospital, Brisbane, Australia, 3School of Nursing, Queensland University of Technology, Brisbane, Australia, 4NHMRC Centre of Research Excellence in End of Life Care, Queensland University of Technology, Brisbane, Australia, 5NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland , Brisbane, Australia

Background: Aboriginal and Torres Strait Islander (A&TSI) people have a higher prevalence of chronic kidney disease (CKD) than the non-A&TSI population in Australia. Kidney Supportive Care (KSC) comprises renal, palliative care and allied health professionals for people with advanced CKD who require specialist symptom management, advanced care planning (ACP) and psychosocial support. This study assessed the characteristics of A&TSI people referred to KSC.

Methods: Using data extracted from clinical records of people referred to KSC between February 2016 and November 2018, we compared age, gender, co-morbidities (Charlson Co-morbidity Index), symptom burden (Integrated Palliative care Outcome Scale – Renal) and reasons for referral. Analysis involved comparisons between A&TSI and non-A&TSI cohorts.

Results: Of the 338 people referred to KSC, 4.1% (14) identified as A&TSI; 13 were Aboriginal (8 male, 3 female) and one was Torres Strait Islander (female). A&TSI patients were significantly younger than non-A&TSI patients (median 55.5 [range 34–84] vs. 74 [27–90]; p<0.001) and had lower Charlson Co-morbidity Index scores (5 [2–11] vs. 6 [2–14]; p<0.005). A higher proportion of A&TSI patients were currently treated with dialysis or on a dialysis pathway (71% vs. 49% for non-A&TSI; p=0.09). The most common reason for referral in both groups was for symptom management.  23% of A&TSI patients were referred for ACP, compared to 15% for non-A&TSI.

Outcomes: People are referred to KSC for symptom management, psychosocial support, complex decision making and/or need for ACP.  The multidisciplinary team includes palliative medicine consultant, registrar, clinical nurse, social worker and pharmacist. Family are strongly encouraged to attend appointments.  The person’s quality of life, connection to family/community, healthcare preferences and end of life wishes are explored utilising communication techniques which build trust, are culturally sensitive and use indigenous resources as appropriate.


Biography:

Jenny Kirby is a Senior Social Worker in Metro North Hospital Health Service (MNHHS) Renal Department.      Working within 2 MNHHS dialysis units and the Kidney Supportive Care clinic Jenny provides social work assessment and intervention with people with advanced chronic kidney disease and their families/carers.  With 12 years of experience in mental health, cancer care and chronic disease Jenny provides expertise in providing person-centred psychosocial support in the areas of adjustment, quality of life, advanced care planning, end of life care, carer support, grief and bereavement.

Auditing rates of Influenza and Pneumococcal vaccination amongst an “at risk” population of Aboriginal adults in remote Western Australia: A possible role for Aboriginal health workers in service delivery

Dr Vishal Bulsara1, Dr Marianne Wood2

1South Metropolitan Health Service, Murdoch, Australia, 2Aboriginal Health Council of Western Australia, Highgate, Australia

Introduction
Aboriginal Australian adults are thought to suffer from influenza and pneumococcal disease at the same frequency as the general population but they are significantly more likely to be hospitalised or die from these vaccine preventable illnesses than the general population. The Australian Immunisation Handbook, produced by the Department Of Health (DOH) therefore recommends several additional vaccinations for Aboriginal Australians over and above those recommended in the standard schedules of vaccination for the rest of the population. This audit will assess the current rates of uptake for the recommended additional vaccinations for Aboriginal adults under the care of a remote area health service in Western Australia as well as who gave the vaccinations to this group of patients.

Methods
Type 2 diabetic Aboriginal adult patients aged over 18 years identified as current patients who had a diagnosis of type two diabetes prior to 01/01/2017 to the local Remote Aboriginal Health service from 01/01/2017 to 31/12/2017 with health records extending back at least 2.5 years who have visited at least once in the calendar period. 50 patients were selected at random and had their electronic health record reviewed.

Results
For the pneumococcal vaccination, 43/50 patients (86%) had received at least 1 dose of the 23vPPV. A further 17 patients are not yet due their second vaccination. Of the eligible patients 16/26 (61.5%) received both doses of 23vPPV within 10 years of each other. Of the first doses of 23vPPV given; Aboriginal Health Workers (AHWs) gave 10; 15 were given by the Registered Nurse (RN); 5 were given by the Doctor and 13 were undocumented. For the influenza vaccination, 14/50 patients (28%) received an influenza vaccination in the 12 months to 31/12/2017. 11/14 vaccinations were given by AHWs, the Doctor, Patient and unknown gave 1 vaccine each.

Conclusions
These results are promising for the Health service concerned after they recently implemented further training for their AHWs to give vaccinations. The rates in the first year of the program show promise and may provide a simple way to improve vaccination rates amongst Aboriginal communities in remote parts of Australia.


Biography:

Dr Vishal Bulsara is dual qualified as both a Dentist and Medical Doctor with a strong interest in Head and Neck Surgery and Indigenous Health. He is an early career researcher currently undertaking a research Masters qualification with the University of Notre Dame Fremantle as well as working as a junior doctor for the South Metropolitan Health Service in Perth.

NAHC Conferences

2007, Hobart (7th NAHC)

2009, Canberra (8th NAHC)

2012, Canberra (9th NAHC)

2013, Brisbane (10th NAHC)

2015, Melbourne (11th NAHC)

2017, Sydney (12th NAHC)

2019, Brisbane (13th NAHC)

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