Rehabilitation after stroke for Aboriginal and Torres Strait Islander peoples and Indigenous peoples globally: a scoping review and critical content analysis.

Abstract

Purpose In settler-colonial contexts Indigenous peoples experience greater incidence of stroke alongside issues of access and quality of health care and rehabilitation. This scoping review aimed to understand the extent and range of the literature relating to rehabilitation after stroke for Indigenous peoples and to critically explore where values and worldviews of Indigenous peoples are considered. Materials and methods This scoping review followed the guidance of the Joanna Briggs Institute. An Aboriginal Advisory Group guided data extraction and analysis and principles of Indigenist research framed a critical content analysis. A comprehensive search of databases and specific Indigenous health journals was conducted to identify all potential sources of evidence including grey literature. Results This review ultimately included 108 sources. The research varied in foci and methodologies, contributing a broad awareness of multi-factorial issues in rehabilitation for Indigenous peoples. Critical content analysis revealed rehabilitation after stroke is influenced by the multiple mechanisms and ongoing consequences of colonisation, including racism and the dominance of western understandings of health in rehabilitation. Conclusion Tenets of recovery from Indigenous peoples' perspectives were evident and future research towards realising self-determined rehabilitation is needed to transform clinical care and respond to the sovereignty of Indigenous peoples.