Improving physiotherapy services for indigenous children with physical disability
: a continuous quality improvement and qualitative approach

  • Caroline Faith Greenstein

    Student thesis: Professional Doctorate - CDU

    Abstract

    Disability is a complex phenomenon that affects more Indigenous Australians than non-Indigenous Australians throughout their lifespan. Physiotherapists provide services integral to children with physical disability and gross motor delay but little is known about the particular profile, needs or experiences of Indigenous children with physical disability.

    This thesis presents the first research involving physiotherapy services for Indigenous children with physical disability or gross motor delay. The mixed methods study involved 1) a continuous quality improvement process based on the Audit and Best Practice for Chronic Disease model that involved one participating physiotherapy department; 2) open-ended semi-structured interviews with previous or current clients of the participating service and their carers and 3) a comparison and reflection of the results of the two projects.

    Principal findings were:

    1. The continuous quality improvement project identified weaknesses in service delivery, and measured and identified improvements in clinical and organisational aspects of physiotherapy care.

    2. Carers of Indigenous children with physical disability experienced complex lives filled with multiple demands. Clients and their carers valued relationships involving caring, consistency and communication with their physiotherapists and had lives that were influenced by their Indigenous background in ways that may not be obvious to non- Indigenous service providers. The research highlighted the importance of effective communication.

    3. Comparison of the findings of the two studies highlighted that the continuous quality improvement process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients. This underlined the importance of including clients in the continuous quality improvement process so that indicators reflecting their values are included.

    These findings contribute to the small body of literature on physiotherapy practice in Indigenous healthcare, perspectives from Indigenous children and carers with physical disability and continuous quality improvement in community-based physiotherapy.
    Date of AwardMay 2016
    Original languageEnglish
    SupervisorDavid Thomas (Supervisor)

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