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This research aimed to gain an understanding of the acute mental health inpatient experience as described by Aboriginal women during admission. It recorded for the first time the words of Aboriginal women within the inpatient unit, including their perceptions of factors which may promote or impede a culturally safe environment. Eleven Aboriginal women inpatients gave interviews before discharge from the inpatient unit. Five Aboriginal Reference Group (ARG) members with experience of the inpatient unit also gave interviews, adding 'insider–outsider' perspectives. Interviews were recorded, transcribed, entered into NVivo software, and analysed inductively to raise codes and develop themes. Five interconnecting themes emerged: Social Context: life experience preceding, shaping, and following admission; Connection: with kin, community, and culture. Control: self‐determination, legally and physically curtailed; Caring: actions promoting reconnection and self‐determination; Communication: conveying caring and supporting agency, reconnection, and return to community. Findings reflected inpatient issues reported in previous studies, adding insights into the cultural concerns of Aboriginal women and offering practical clinical implications for culturally secure service delivery in an inpatient setting. Existing literature offered a basis for developing the model offered here for transcultural interaction for recovery in an inpatient setting. Attention to these findings can enhance Aboriginal women's inpatient experience and promote further research. The article complies with the COREQ‐32 checklist for describing qualitative studies. [ABSTRACT FROM AUTHOR]

Issue addressed: Access to meaningful health information is limited in remote regions of Australia where Indigenous languages and culture are strong but the prevalence of chronic conditions is extremely high. This qualitative study aimed to support and understand the evolution of an educational approach to improve communication about chronic conditions for Yolŋu (Aboriginal people of Northeast Arnhem Land). Methods: Within a culturally responsive research design, data were gathered through participant observation and semi‐structured interviews with educators and community members. An iterative and continuous process of data collection and inductive analysis, exploring key elements of the process as it evolved, supported the Project Team to modify and refine their approach as the project progressed. Results: A high level of community participation and control was a critical element of the project. Collaboration between Yolŋu educators and community experts, with culturally competent support from others, enabled Yolŋu to share health information in ways that could not be achieved by outsiders. Yolŋu and biomedical knowledges were integrated to build and share meaningful, in‐depth (not simplified or directive) oral explanations in local languages using culturally responsive communication processes. The urgent need for ongoing, sufficient and meaningful health education was a consistent and recurring theme in this context where chronic conditions are having a devastating impact. Conclusion: Sustained and equitable access to meaningful information, using a culturally responsive approach led by community educators, is crucial to improve health literacy and to enable genuinely informed decisions in prevention and management of chronic conditions. Long‐term funding is needed to support ongoing programs. These findings may have relevance for others who do not share the culture and language of the majority population. So what?: Equity of access to meaningful health information through sustained support for community‐led education processes is essential to improve First Nations health outcomes. [ABSTRACT FROM AUTHOR]

There is a paucity of research exploring Indigenous women's experiences in acute mental health inpatient services in Australia. Even less is known of Indigenous women's experience of seclusion events, as published data are rarely disaggregated by both indigeneity and gender. This research used secondary analysis of pre-existing datasets to identify any quantifiable difference in recorded experience between Indigenous and non-Indigenous women, and between Indigenous women and Indigenous men in an acute mental health inpatient unit. Standard separation data of age, length of stay, legal status, and discharge diagnosis were analysed, as were seclusion register data of age, seclusion grounds, and number of seclusion events. Descriptive statistics were used to summarize the data, and where warranted, inferential statistical methods used SPSS software to apply analysis of variance/multivariate analysis of variance testing. The results showed evidence that secondary analysis of existing datasets can provide a rich source of information to describe the experience of target groups, and to guide service planning and delivery of individualized, culturally-secure mental health care at a local level. The results are discussed, service and policy development implications are explored, and suggestions for further research are offered. [ABSTRACT FROM AUTHOR]

Objective To compare the outcomes of two cycles of continuous quality improvement ( CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Design Case study based at one paediatric physiotherapy service Setting Community-based paediatric allied health service in Northern Australia. Participants Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). Interventions The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Main outcome measure Comparison of findings from the two studies Results Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. Conclusion The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. [ABSTRACT FROM AUTHOR]

The Australian College of Mental Health Nurses directs that mental health nurses must 'enable cultural safety in practice, taking into account age, gender, spirituality, ethnicity and health values'. The present study is a review of the existing literature undertaken in order to identify current knowledge and knowledge gaps regarding the experience of Indigenous women in acute mental health inpatient facilities. In particular, studies that identified environments and practices promoting the development of culturally-safe healing spaces for Indigenous women, and studies that identified women's experience of seclusion, were sought. The results showed that there is little literature directly relevant to Indigenous women's experiences of inpatient mental health units in Australia. The present study consolidates existing knowledge and knowledge gaps, and advances the argument for gender-disaggregated future research. Implications for professional practice and service development are also noted. [ABSTRACT FROM AUTHOR]

Objective Little is known about Australian Aboriginal world views related to child rearing and child development. The aim of this qualitative study was to provide an opportunity for remote Aboriginal families in Central Australia to share what they felt was important for non- Aboriginal people, working in the same setting, to know about their parenting methods. Design, setting and participants A descriptive study was carried out in a remote Central Australian community by an Aboriginal and non- Aboriginal researcher, working in partnership, combining ethnographic and participatory approaches. Eight families with children under five were primary participants. Data were collected through participant observation and informal conversational interviews. Findings Three main interlinked themes were identified through this research: 'fitting in' (integration of children into community life), 'growing up' (children's development) and 'staying strong' (children's autonomy within a communal social structure). In this community, the development of independence and self-reliance within a closely nurturing environment are paramount. Children are taught responsibilities and obligations through interaction in community life from birth. Children's growth and development is not linked to chronological time scales. Rather, children are encouraged and praised for their social and emotional maturity as well as physical development, regardless of the age at which milestones are achieved. Conclusions This descriptive study provided an opportunity for Aboriginal people in one remote community to share their perspectives about child rearing and child development. It provides some insights into positive child-rearing practices and perspectives which can assist non- Aboriginal service providers to work more effectively with Aboriginal families. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article "Trial of a developmental screening tool in remote Australian Aboriginal communities: a cautionary tale," by A. D'Aprano and colleagues.