The Emergency Department Response to Indigenous Women Experiencing Traumatic Brain Injury from Family Violence: Insights from Interviews with Hospital Staff in Regional Australia

Purpose: Emergency departments (EDs) play a critical role in addressing the needs of women who acquire a traumatic brain injury (TBI) caused by an assault. Little is known about how staff in Australian EDs respond to the needs of Aboriginal and Torres Strait Islander women who present with a TBI as a result of family violence, hindering the development of effective policy and frontline care. This qualitative study explored how ED health professionals working in a regionally located hospital respond to Aboriginal and Torres Strait Islander women presenting to hospital with a TBI caused by family violence. Methods: A qualitative thematic analysis was used to analyse semi-structured interviews and focus groups with 24 hospital staff to explore their ways of engaging with, supporting and providing healthcare to Aboriginal and Torres Strait Islander women who have experienced a TBI due to family violence. Results: Cultural support provided by Aboriginal and Torres Strait Islander staff, the collaboration of multidisciplinary teams, and the ability of women to stay in hospital short term when no other safe accommodation can be identified were all cited as critical factors in providing responsive healthcare. The ED presentation was perceived as an opportunity to refer Aboriginal and Torres Strait Islander women to service providers to address their immediate safety and accommodation needs and provide Aboriginal and Torres Strait Islander women with education around family violence and TBI. Conclusion: The findings provide valuable insights into the services and treatment regimes available to women and the needs of Aboriginal and Torres Strait Islander women presenting to hospital. The implications include the need for hospitals to provide a standardized, multidisciplinary pathway for Aboriginal and Torres Strait Islander women; the need to fund after-hours (e.g., nights and weekends) ED hospital social and cultural supports; and the need for specialized workers with training in responses to family violence-related TBI to facilitate effective supports of Aboriginal and Torres Strait Islander women.