What informs care? Descriptions by multidisciplinary teams about burns care for Aboriginal and Torres Strait Islander children

Objective: To investigate factors informing burns care for Aboriginal and Torres Strait Islander children. Design: In-depth qualitative study with semi-structured interview questions. Setting and participants: Multidisciplinary team members who provide care for Aboriginal and Torres Strait Islander children in six tertiary burn units across five Australian jurisdictions. Results: Results from 76 interviews suggest that burns care in Australia is informed by a web of complex factors including evidence, resources and resourcing, individual clinician decision making processes and beliefs, and models of care. A Western biomedical health paradigm governs healthcare system policy for burns care, that participants report is not always aligned with Aboriginal and Torres Strait Islander families' concepts of health and healing. Within this paradigm, allocation of resources informs the provision (or not) of care; as does expert information and direction from senior clinicians. Participants reported that jurisdictional specific models of burns care developed using service and team experience, population data and other evidence derived in a scientific paradigm also influence delivery of care. Conclusion: There is a need for changes in the way evidence informs policy and practice in burns care for Aboriginal and Torres Strait Islander children and families so that it incorporates Indigenous constructs of health and wellbeing. (C) 2019 Elsevier Ltd and ISBI. All rights reserved.