These mob here have integrity; they genuinely care about the people: Service users’ and care providers’ perspectives on enablers of good chronic disease care for Aboriginal and Torres Strait Islander peoples

Abstract

Research about Aboriginal and Torres Strait Islander chronic disease management in primary healthcare services rarely considers the perspectives of service users in identifying what works. This research aimed to elevate the voices of clients and providers from high performing primary healthcare services (termed Lighthouse Services) around Australia about the successes and opportunities for improvement in chronic disease management for Aboriginal and Torres Strait Islander peoples. Seventy-five individuals, representing clients (n = 29), their carers (n = 7) and health providers (n = 39), from four Lighthouse Services participated in in-depth focus groups and interviews conducted by the researchers and local partners. The transcripts of these discussions were reviewed in NVivo 14 (https://lumivero.com/products/nvivo/) using reflexive thematic analysis to identify key themes representing their lived experiences.

Access, Communication, Systems, Hub and spokes, Relationships and Workforce were the six themes chosen to represent the range of personal experiences about what works for managing chronic disease at the primary healthcare level. Services that effectively employed a holistic patient-centred model of care, provided culturally safe spaces and were connected to and involved in the community were viewed as providing good care for their clients. The findings of this study support existing literature and make an important new contribution by focusing on the insights of clients, carers and service providers about what and why different aspects of chronic disease care work. It is suggested that this research approach would be beneficial across a range of other settings (e.g. non-Aboriginal community-controlled health organisations and urban services) and conditions (e.g. acute care, social and emotional wellbeing) to enhance Aboriginal and Torres Strait Islander health outcomes.