Aboriginal and Torres Strait People’s Rate of DAMA

Running Head: DISCHARGE AGAINST MEDICAL ADVICE (DAMA) 1
Aboriginal and Torres Strait People’s Rate of DAMA
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Aboriginal and Torres Strait People’s Rate of DAMA 2
Introduction
According to Shaw (2016), most people Aboriginal and Torres Strait Islanders (ATSI)
have a poor healthcare outcome and access compared to the non-Indigenous population. The
reason for this health gap is due to the social, economic, political and cultural factors.
Furthermore, the people of ATSI suffers from higher rates of chronic diseases which include
diabetes, kidney diseases, and cancer. Also, they get hospitalized at a rate that is higher than that
of the non-Indigenous population. These are some of the factors that have caused the rate of the
DAMA to be high in the ATSI people compared to that of the non-Indigenous population.
Moreover, the access to healthcare services is a serious issue especially for the ATSI people
living in the rural areas (Shaw, 2016). This article aims to address the health factors that have
contributed to the ATSI peoples' rate of DAMA. Also, the article has identified a health system
improvement strategy that could reduce the incidences of ATSI peoples' rate of DAMA. The
importance of managing the DAMA is because it is the primary cause of readmissions and it
poses a severe problem for patients in care continuity.
Health System Factors That Contribute to ATSI Peoples’ Rates of DAMA
1. Cross-cultural Communication and Linguistic Issues
Some of the Aboriginal and Torres Strait Islanders (ATSI) have an issue with communication
especially between the staff and the ATSI patients which raised concerns. The hospital staff
admitted that the ATSI people have a different understanding when it familiar with the disease
process, medical treatment and hospital routine must be followed by all patients (Holmes, 2017).
Moreover, the use of medical language was often not understood by the patients, and this
contributed to the ATSI people lack understanding of their sickness and the procedure of
treatment. An Indigenous patient said that the hospital staff had a mindset that urban Indigenous

Aboriginal and Torres Strait People’s Rate of DAMA 3
patients were the ones that could understand what the nurse or doctor said (Emma, 2011). It is
because most of the medical staff communicated in English and assumed that the ATSI patients
from the rural areas could not understand what they were saying which was not always the case.
According to Holmes (2017), this got noted across the various ATSI language groups which
were worrying and frustrating because assumptions were being made by the hospital staff
concerning medication administrations. Furthermore, the ATSI people made it difficult to
administer treatment because there were cases that some of the Indigenous patients had a fear of
needles and instruments. Moreover, the Indigenous people made it difficult for the nurse to carry
out procedures such as x-rays, ultra-sounds, and they also found it challenging to complete
antibiotics before they got officially discharged from the hospital. Furthermore, ATSI patients
who required long-term treatment made it difficult for the nurses to carry out their nursing
responsibilities because some of them were quick to leave the hospital even before they fully
recovered. These communication difficulties contributed to the high DAMA in the ATSI people.
2. Social and Cultural Issues
The hospital staff also identified that various cultural and social issues that contributed to the
high rate of self-discharge in ATSI people. Also, women especially mothers left their children
under the care of relatives back home because they were anxious for them to get well (Emma,
2011). The reason for this is that the mothers got increasingly worried when they heard children
carry in the Children's Ward who made the ATSI mothers feel the sense of taking their children
back home. Furthermore, the ATSI mothers thought that the nurses never had an understanding
of the need for them to be close to their children because it was cultural for them. Also, mothers
who had sick or premature babies often faced pressure from their family to go back home which
led to the high DAMA of the ATSI. Some of the mothers were pressured by their families to go