Inclusion criteria

Types of participants

The review will consider studies that have included Aboriginal and Torres Strait Islander people of any age, who have been admitted to and have received care in, an Australian public hospital for a cardiac condition. Participants of interest are Aboriginal and Torres Strait Islander patients, their families and members of community, or health care providers and policy makers providing care to Aboriginal and Torres Strait Islander people in the hospital setting.

Phenomena of interest

The phenomena of interest are the experiences of Aboriginal and Torres Strait Islander peoples treated for a cardiac event in an Australian hospital, as well as an understanding of which factors impact on those experiences, expressed as attitudes, beliefs, expectations, understandings and knowledge.

Context

The context of the review is the provision of care to patients being treated for a cardiac condition within Australian public hospitals. The review will consider patients receiving "cardiac care" or being treated in a cardiac ward (including but not limited to cardiac surgery, cardiology and cardiothoracic wards).

Types of studies

The qualitative component of the review will consider studies that focus on phenomenological, action research and ethnography qualitative studies; however other qualitative methodologies will be reviewed. The textual component of the review will consider expert opinion, discussion papers, position papers and other text (e.g. reports). Mixed-method studies that support quantitative data collection, alongside qualitative inquiry or textual elements, will also be considered for their qualitative and/or textual component.

Search strategy

The search strategy aims to find both published and unpublished studies. The three-step search strategy utilized in this review is as follows:

An initial limited search of MEDLINE, CINAHL and PubMed will be undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published in English from January 2000 to the end of 2014 will be considered for inclusion in this review. The potential differences in in-hospital cardiac care between Aboriginal and Torres Strait Islander people and non-Indigenous Australians was first recognized in the literature in the early twenty-first century.9-11Therefore it was decided that to ensure all relevant literature was included, the year search would include literature dating from January 2000 to the present.

The databases to be searched include:

CINAHL

ATSIHealth via Informit Online

OVID Medline

Web of Science

PsychInfo

Australian Indigenous Health Bulletin

Embase

The search for unpublished studies will include:

Australian Institute of Aboriginal and Torres Strait Islander Studies

Australian Indigenous Health InfoNet

Initial keywords to be used will be:

Indigenous; Aboriginal; Torres Strait Islander; cardiovascular; acute coronary syndrome; cardiac; cardiac event; patient, provider experience; patient journey; hospital; in-hospital.

Assessment of methodological quality

Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the respective Joanna Briggs Institute Assessment and Review Instrument (JBI-QARI for qualitative papers) (JBI-NOTARI for textual papers) (Appendix I).

Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

Data collection

Qualitative data will be extracted from papers included in the review using the standardized data extraction tool from JBI-QARI (Appendix II). Textual data will be extracted from papers included in the review using the standardized data extraction tool from JBI-NOTARI (Appendix II).

The data extracted will include specific details about the population, study method and outcomes of significance to the review question and specific objectives. The primary and secondary reviewers will extract data from individual studies separately.

Data synthesis

Qualitative research findings will, where possible be pooled using JBI-QARI. Textual papers will, where possible, be pooled using JBI-NOTARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent the aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. These categories are then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for improvements in practice. Where textual pooling is not possible the findings will be presented in narrative form.

Conflicts of interest

None to declare.

Acknowledgements

This project is a partnership between the Heart Foundation, the South Australian Health and Medical Research Institute and the Statewide Cardiology Clinical Network Data and Information Workgroup.

References