In the field of Rheumatology in Australia little is known about the suitability of current services to care for the needs of First Nations peoples. As such this study was undertaken to describe the First Nations experiences of adult Rheumatology clinics at one urban hospital in Sydney and to identify barriers and enablers to service access.
All patients who identified as First Nations Australians attending the Rheumatology clinic at Prince of Wales Hospital in Sydney from January 2021 to 2022 were invited to participate. There were 18 eligible patients of whom 16 were interviewed. Participants were interviewed using semi-structured, yarning methods which were designed in partnership with the co-author, an Aboriginal Health Worker. Interviews were then transcribed and entered into Nvivo and thematic analysis was completed in consultation with an Aboriginal Reference Group.
Four broad categories of data were identified including access to care, the cultural safety of services, rheumatic disease and pain and the role of community in rheumatic disease management. These categories encapsulated 12 distinct themes. Some themes represented barriers to care such as logistic challenges in the referral process, lack of cultural sensitivity in communication, lack of cultural support, uncomfortable clinic environments and external cultural factors influencing their perception of the specialty. Other themes described enabling factors such as the involvement of family members in care, support from Aboriginal Health Workers, the opportunity for telehealth consultation and incorporation of traditional therapies.
This study demonstrates that there are ongoing barriers for First Nations peoples trying to access care in Rheumatology. Nonetheless cultural strengths including kinship and community support circles can aid in improving access to care. These findings can help inform service development to more effectively addresses the needs for First Nations Australians.