Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study

Christina M Bernardes,1 Paul J Clark,2 Cath Brown,1 Katherine Stuart,3 Gregory Pratt,1 Maree Toombs,4 Gunter Hartel,1 Elizabeth E Powell,3,5,&ast; Patricia C Valery1,&ast; 1QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; 2Department of Gastroenterology and Hepatology, Mat...

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Autores principales:	Bernardes CM, Clark PJ, Brown C, Stuart K, Pratt G, Toombs M, Hartel G, Powell EE, Valery PC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	chronic liver disease patient reported outcomes perceived needs unmet needs indigenous australians introduction Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/95ebe27db8514407b3dcc111af598fec
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spelling	oai:doaj.org-article:95ebe27db8514407b3dcc111af598fec2021-11-23T18:43:01ZDisparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study1177-889Xhttps://doaj.org/article/95ebe27db8514407b3dcc111af598fec2021-11-01T00:00:00Zhttps://www.dovepress.com/disparities-in-unmet-needs-in-indigenous-and-non-indigenous-australian-peer-reviewed-fulltext-article-PPAhttps://doaj.org/toc/1177-889XChristina M Bernardes,1 Paul J Clark,2 Cath Brown,1 Katherine Stuart,3 Gregory Pratt,1 Maree Toombs,4 Gunter Hartel,1 Elizabeth E Powell,3,5,&ast; Patricia C Valery1,&ast; 1QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; 2Department of Gastroenterology and Hepatology, Mater Hospitals, Brisbane, QLD, Australia; 3Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; 4Rural Clinical School, Faculty of Medicine, University of Queensland, Toowoomba, QLD, Australia; 5Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia&ast;These authors contributed equally to this workCorrespondence: Patricia C Valery Tel +61 07 3362 0376Email Patricia.Valery@qimrberghofer.edu.auPurpose: Understanding and responding to the supportive care needs of people with cirrhosis is essential to quality care. Indigenous Australians, Aboriginal and Torres Strait Islander people, are overrepresented amongst patients with cirrhosis. This study documented the nature and extent of supportive care needs of Indigenous Australians with cirrhosis, in comparison with non-Indigenous Australians.Patients and Methods: The supportive care needs of adult patients diagnosed with cirrhosis attending public hospitals in Queensland were assessed through the Supportive Needs Assessment tool for Cirrhosis (SNAC). Patients indicated how much additional help they needed on four subscales: 1. psychosocial issues; 2. practical and physical needs; 3. information needs; and 4. lifestyle changes. We examined the rate of moderate-to-high unmet needs based on Indigenous status (Poisson regression; incidence rate ratio (IRR)).Results: Indigenous (n=20) and non-Indigenous (n=438) patients included in the study had similar sociodemographic and clinical characteristics except for a lower educational level among Indigenous patients (p< 0.01). Most Indigenous patients (85.0%) reported having moderate-to-high unmet needs with at least one item in the SNAC tool. Following adjustment for key sociodemographic and clinical factors, Indigenous patients had a greater rate of moderate-to-high unmet needs overall (IRR=1.5, 95% CI 1.31– 1.72; p< 0.001), and specifically for psychosocial issues (IRR=1.7, 95% CI 1.39– 2.15; p< 0.001), and practical and physical needs subscales (IRR=1.5, 95% CI 1.22– 1.83; p< 0.001), compared to non-Indigenous patients.Conclusion: Indigenous Australians with cirrhosis more frequently had moderate-to-high unmet supportive care needs than non-Indigenous patients. Specific targeting of culturally appropriate supportive care for psychosocial, practical and physical needs may optimize cirrhosis care and improve the quality of life for Indigenous Australians with cirrhosis.Keywords: chronic liver disease, patient reported outcomes, perceived needs, unmet needs, Indigenous AustraliansBernardes CMClark PJBrown CStuart KPratt GToombs MHartel GPowell EEValery PCDove Medical Pressarticlechronic liver diseasepatient reported outcomesperceived needsunmet needsindigenous australians introductionMedicine (General)R5-920ENPatient Preference and Adherence, Vol Volume 15, Pp 2649-2658 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic liver disease patient reported outcomes perceived needs unmet needs indigenous australians introduction Medicine (General) R5-920
spellingShingle	chronic liver disease patient reported outcomes perceived needs unmet needs indigenous australians introduction Medicine (General) R5-920 Bernardes CM Clark PJ Brown C Stuart K Pratt G Toombs M Hartel G Powell EE Valery PC Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study
description	Christina M Bernardes,1 Paul J Clark,2 Cath Brown,1 Katherine Stuart,3 Gregory Pratt,1 Maree Toombs,4 Gunter Hartel,1 Elizabeth E Powell,3,5,&ast; Patricia C Valery1,&ast; 1QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; 2Department of Gastroenterology and Hepatology, Mater Hospitals, Brisbane, QLD, Australia; 3Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; 4Rural Clinical School, Faculty of Medicine, University of Queensland, Toowoomba, QLD, Australia; 5Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia&ast;These authors contributed equally to this workCorrespondence: Patricia C Valery Tel +61 07 3362 0376Email Patricia.Valery@qimrberghofer.edu.auPurpose: Understanding and responding to the supportive care needs of people with cirrhosis is essential to quality care. Indigenous Australians, Aboriginal and Torres Strait Islander people, are overrepresented amongst patients with cirrhosis. This study documented the nature and extent of supportive care needs of Indigenous Australians with cirrhosis, in comparison with non-Indigenous Australians.Patients and Methods: The supportive care needs of adult patients diagnosed with cirrhosis attending public hospitals in Queensland were assessed through the Supportive Needs Assessment tool for Cirrhosis (SNAC). Patients indicated how much additional help they needed on four subscales: 1. psychosocial issues; 2. practical and physical needs; 3. information needs; and 4. lifestyle changes. We examined the rate of moderate-to-high unmet needs based on Indigenous status (Poisson regression; incidence rate ratio (IRR)).Results: Indigenous (n=20) and non-Indigenous (n=438) patients included in the study had similar sociodemographic and clinical characteristics except for a lower educational level among Indigenous patients (p< 0.01). Most Indigenous patients (85.0%) reported having moderate-to-high unmet needs with at least one item in the SNAC tool. Following adjustment for key sociodemographic and clinical factors, Indigenous patients had a greater rate of moderate-to-high unmet needs overall (IRR=1.5, 95% CI 1.31– 1.72; p< 0.001), and specifically for psychosocial issues (IRR=1.7, 95% CI 1.39– 2.15; p< 0.001), and practical and physical needs subscales (IRR=1.5, 95% CI 1.22– 1.83; p< 0.001), compared to non-Indigenous patients.Conclusion: Indigenous Australians with cirrhosis more frequently had moderate-to-high unmet supportive care needs than non-Indigenous patients. Specific targeting of culturally appropriate supportive care for psychosocial, practical and physical needs may optimize cirrhosis care and improve the quality of life for Indigenous Australians with cirrhosis.Keywords: chronic liver disease, patient reported outcomes, perceived needs, unmet needs, Indigenous Australians
format	article
author	Bernardes CM Clark PJ Brown C Stuart K Pratt G Toombs M Hartel G Powell EE Valery PC
author_facet	Bernardes CM Clark PJ Brown C Stuart K Pratt G Toombs M Hartel G Powell EE Valery PC
author_sort	Bernardes CM
title	Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study
title_short	Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study
title_full	Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study
title_fullStr	Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study
title_full_unstemmed	Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study
title_sort	disparities in unmet needs in indigenous and non-indigenous australians with cirrhosis: an exploratory study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/95ebe27db8514407b3dcc111af598fec
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Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study

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