Yarning about pain is the short explanation of Clinical Yarning, a collaborative study to improve communication between pain service clinicians and Aboriginal and Torres Strait Islander patients, who access Persistent Pain Clinics in Queensland.
Patients who access these clinics have experienced continuous, persistent pain for over six months.
Project coordinator, Doctor Christina Bernardes, a member of the Aboriginal and Torres Strait Islander Health Research Group of QIMR Berghofer, believes communication can be a barrier to the improvement of health for these patients.
“My background is nursing and my specialty is public health. Across the health service sector, effective communication is an important factor influencing the quality of health care for patients. The way that a clinician explains to a patient their diagnosis and treatment, can have a significant impact on the patient’s decision to readily accept
recommendations of the treating team,” she said.
Communication is an important aspect of supporting a patient to manage their pain, complicated even further by sensitivity and awareness of the significance of culture and its
implication for health care provided to Aboriginal and Torres Strait Islander patients.
“We’re working with clinicians to support their professional development and refine communication skills that engage patients in a sensitive and respectful manner that appreciates cultural protocol and preferences,” Dr Bernardes explained.
Up to eight percent of patients at the participating pain clinics are Aboriginal and Torres Strait Islander and this training was delivered to the pain service clinicians including; medical doctors, psychologists, physiotherapists, occupational therapists, pharmacists and nursing staff.
This study adapted the Clinical Yarning framework developed by Doctor Ivan Lin from the University of Western Australia and is being conducted in collaboration with the Queensland University of Technology, the University of Queensland and the Queensland Health Cultural Capability Team.
The training includes cultural aspects of engagement and communication, focusing on three elements; social, diagnostic and management yarning.
“Pain and pain management is complex, but if there is a connection between the patient and their clinician, if there is trust, pain might be better managed”, Doctor Bernardes said.
In 2021, 64 clinicians were trained at The Princess Alexandra Hospital, Townsville Hospital and The Royal Brisbane and Women’s Hospital pain clinics.
Brooke Sutton, a 16 year old contemporary Indigenous artist from the Kalkadoon people, Mount Isa, explains the meaning of her painting ‘Clinical Yarning’:
In this painting the large community symbol in the centre represents QIMR Berghofer, with the larger U Symbols (people) representing health professionals who provide support for those with chronic pain represented by the smaller U Symbols in the centre.
On the lower left hand side, the hand print and ear represents communication; listening and understanding with the circle in the bottom right corner symbolising yarning, talking about the pain, the health professional and the patient work together to find the best way to manage the pain.
The three large red circles running through the middle of the painting represent the three main types of physical pain of the body; acute, chronic and breakthrough pain and the people who it affects. The spirit in the top right corner symbolises spiritual, emotional and psychological pain, the body and spirit must be in balance.
The three black sections of the painting which contain the medicine, bones, health symbols and native bush medicines represents both ancient and modern healing remedies and techniques.
The bees represent a healthy environment and the butterflies represent change, with the greenery symbolising the rainforest. The water holes and blue colouring represents the rivers and coasts, with the brown, yellow and orange mountains representing the desert and the rugged landscape. These environments make up our beautiful country and the many locations that patients originate from.
The three handprints in the top left corner represent Aboriginal, Torres Strait Islander people and non-indigenous Australians, as well as cross cultural communication and respect between cultures. The green handprint, and green and white lines represent Torres Strait Islander people; the red and yellow handprint and the red boomerangs within the orange lines represent Aboriginal people, with the blue handprint and blue lines within the orange lines representing non Indigenous Australians.
The footprints throughout the painting symbolise the patients and their journeys in managing their pain, after they have worked with the health care professionals at QIMR Berghofer.
‘Clinical Yarning Queensland’ by Brooke Sutton
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