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Diabetes

in

Indigenous Australians

Presented by

Kalindi Nimhani Wanasundara

Kudzai Norah Nyamunduru

Namita Mahato

Sachini Koshila Samaratunga

PREVALENCE

4 X more likely to have diabetes

KEY FACTS

4 x more likely to be hospitalised from diabetes

5 X more likely to die from diabetes

Remoteness

Indigenous Adults with diabetes by remoteness

Source: Australian Bureau Statistics Analysis of 2012-2013

Age

Adults with diabetes by Age and Indigenous Status

Source: Australian Bureau Statistics Analysis of 2012-2013

Hospitalisation

Diabetes hospitalisation rates, as the principal diagnosis, by Indigenous status and sex, 2012-13

Source: Australian Institute of Health & Welfare, 2014

RISK FACTORS

Risk Factors

Social

and cultural

Historical

Health risk Factors

Hypertension

Stress

Unemployment

Biomedical

Dyslipidaemia

Low Income

Loss of traditional activities

Behavioural

Poor housing

Obesity

Smoking

Physical inactivity

Poor diet

Aunty Irene's story

National Policies and Strategies

2010

Practice Incentives Program- Indigenous Health Icentive

2011

NDSS introduces National development programs for Indigenous people

2013

NATIONAL POLICIES & STRATEGIES

Aboriginal and Torress Strait Islanders and diabetes Action Plan

National Aboriginal and Torres Strait Islander health plan 2013-2013 released

2014

Indigenous Australians' health programme established

2015

New National Diabetes strategy 2016-2020 released

INTERVENTIONS

Interventions

ISSUES

Lack of respect for cultural role

Lack of space to private clinical space

Inadequately resourced health centres

Resistance to seek health services

Lack of transport to health services

Barriers to Interventions

Nurse's Role

  • Promote health and wellbeing
  • help people function well at home, at work, at leisure and in their communities

NURSING

STRATEGIES

  • undertake patient advocacy
  • display a respect for culture, beliefs and traditions of all patients

Nursing Implications

Understand social determinants of Indigenous health

Be culturally competent

Implications

Breakdown misconceptions and sterotypes

Possess cultural awareness

Collaborate across professions to improve patient outcome

Communicate by being active listener

Nursing Interventions

RECOMMENDATIONS

National strategies and Policies

Diabetes prevention and management programs

Improved outcomes in diabetes management

Culturally safe primary health care services

Nursing strategies

Healthy life style

Address risk factors

REFERENCES

Australian Institute of Health and Welfare. (2017). National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results from

June 2016. Canberra: AIHW.

Burrow, S., & Ride, K. (2016). Review of diabetes among Aboriginal and Torres Strait Islander people. Retrieved from Australian Indigenous HealthInfoNet:

https://healthinfonet.ecu.edu.au/healthinfonet/getContent.php?linkid=590810&title=Review+of+diabetes+among+Aboriginal+and+Torres+Strait+Islander+people

Canuto, K., Aromataris, E., Lockwood, C., Tufanaru, C., & Brown, A. (2017). Aboriginal and Torres Strait Islander health promotion programs for the prevention and

management of chronic diseases: a scoping review protocol. JBI Database System Rev Implement Rep, 15(1), 10-14.

Emma, W., Craig, J., Bernie, K., Valerie, S., Monica, J., & Billie, T. (2017). Theory that explains an Aboriginal perspective of learning to understand and manage

diabetes. Australian and New Zealand Journal of Public Health, 41(1), 27-31. doi:doi:10.1111/1753-6405.12605

Ferguson, M., Brown, C., Georga, C., Miles, E., Wilson., A. Brimblecombe, J. (2017). Traditional food availability and consumption in remote Aboriginal communities in

the Northern Territory, Australia, Australian and New Zealand Journal of public health, 41(3), 294-98, https://doi.org/10.1111/1753-6405.12664

Gibson, O., Luz, Z., Fielding, C., Westhead, S., Eltridge, F., Stuart, H., . . . Brown, A. (2016). The South Australian Aboriginal Diabetes Strategy 2017 – 2021. Wardliparingga

Aboriginal Research Theme: South Australian Health and Medical Research Institute.

Gracey, M. (2014). Why closing the Aboriginal health gap is so elusive, Journal of Internal medicine, 44(11), 1141-1143,

https://doi-org.ezproxy.lib.monash.edu.au/10.1111/imj.12577

Hyde, Z., Smith, K., Flicker, L., Atkinson, D., Almeida, O. P., Lautenschlager, N. T., Dwyer A., LoGiudice, D. (2018). Mortality in a cohort of remote-living Aboriginal

Australians and associated factors, PloS one, 13(4), 1-12, http://dx.doi.org.ezproxy.lib.monash.edu.au/10.1371/journal.pone.0195030.

Li, J., (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Austrlaians and Torres Strait Islanders. Chinese Nursing Research, 4(4), 207-210.

Retrieved https://doi.org/10.1016/j.cnre.2017.10.009

McDermott, R. A., Schmidt, B., Preece, C., Owens, V., Taylor, S., Li, M., & Esterman, A. (2015). Community health workers improve diabetes care in remote Australian

Indigenous communities: results of a pragmatic cluster randomized controlled trial. BMC Health Services Research, 15(1), 68. Retrieved from https://doi.org/10.1186/s12913-015-0695-5

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