Question 1:
- Rheumatic heart disorder is mainly caused by the damage of the heart valves that persists after an occurrence of acute rheumatic fever (Ralph et al., 2018).
- The social determinants that contributed to this disorder in the child are accessibility to the healthcare centers. Poverty and overcrowding is another social determinant of health that affected the patient. As the family of the patient cannot ensure sanitation and hygienic house, therefore bacterial infection affected her causing rheumatic fever
- As they were poor, and cannot arrange for better living conditions, they might have decided to compromise with the situation and this had resulted in worsening of the situation
- Antibiotics for treatment of the infection for the heart valves, blood thinning medicine for prevention of stroke and repeated cardiac strokes. Antibiotics need to be injected every three weeks for as long as the effect decreases of the disorder
- Governmental data shows that indigenous people are 69 times more likely in developing rheumatic fever. They are seen to be 64 times more likely to be developing the rheumatic heart disorder than the non-indigenous people
Question 2:
- Cultural awareness is the ability by which individuals becomes aware that every individual possess their unique ways of perceiving the world around them based on their cultural backgrounds well as acknowledging this beliefs for benefitting all individuals inclusively (Kendall & Barnett, 2015). For example, Due to poor education as well as poor health literacy, the family members might not be able to take proper care of the patient. Therefore, nurses need to be aware of this fact and should not judge the situation from their perspectives.
- Cultural sensitivity is attribute that makes them to respect and value other cultures so that they can reduce cultural barriers with the patients and the family members. Often family members of the indigenous patients accompany them and want to be present with the patient according to their tradition. In such situation, I will respect their decision and allow the family ember to be present.
Question 3:
- The main objective of the Aboriginal and Torres Strait Islander Act 2005 is ensuring maximum participation of the indigenous people in development of governmental policies, promoting development of self-management and self-sufficiency among indigenous people, development of their economic, social and cultural stability and ensure coordination in the implementation of policies affecting the indigenous people.
- Racism and discrimination are faced by the indigenous people in the different spheres of life in the nation. They do not receive culturally competent services and are looked down upon by many healthcare professionals. Even in the employment sectors, employers are seen to avoid recruiting the indigenous people (Hart et al., 2015). All these would affect their dignity and self-esteem.
Question 4:
- The indigenous people respect their seniors in their families and expect them to take decisions on the behalf of the families. Such senior heads of the families should be requested to participate in decision-making sessions in order to develop community services (Hunt et al., 2015).
- Effective participation and guidance from the senior members of the family will help in jotting down important arenas that need improvement. The nurses might get the opportunity to observe their communication style and thereby learn from observation about their preferences and inhibitions during their communication process
Question 5:
- The indigenous families cannot easily develop trust and engage in effective communication. They do not reveal personal information of the family with strangers. Therefore, professional nurses need to engage in informal communication with the families at first and develop rapport with the families (McDonald et al., 2018).
- Often indigenous people like to maintain silence during communication as they consider this to be important to show respect. Although western culture do not prefer silence in communication, they need to be aware of this communication attribute of the indigenous people and should respect the silence an should not try to fill the gap
Question 6:
It might have happened that the communication conducted by the western healthcare professionals with the family in the urban healthcare center was not culturally competent. They might not have maintained eye contact protocols, silence, rapport building and others. They might have also shown racial discrimination through their communication procedures. Therefore, for this reason, they might have not preferred visiting the healthcare centers again
Question 7:
1.(a) Culturally insensitive and biased nursing professionals will never be able to understand the viewpoints and thinking procedures of the indigenous people. Therefore, such professionals would never be able to ensure sympathetic, compassionate and culturally competent care to the family and the patient. Therefore, the healthcare department of the nation should develop policies where they would ensure that nurses who care for the indigenous people have developed cultural competency through development of cultural knowledge, cultural awareness and cultural sensitivity (Holland, 2017).
Question 8:
(b) During the time of placement, I had understood the different types of cultural preferences, inhibitions, values and traditions that they follow that had helped to re-shape our value. I have also tried to identify the cultural perspective as well as emotions of the indigenous people.
Question 9:
- “Will the western healthcare service be able to provide care according to our cultural traditions and preferences?”
“Will they discriminate us as we do not have white skin?”
- Two indicators are”
- culturally incompetent communication style
- racism and discrimination
References:
Hart, B., Cavanagh, M., & Douglas, D. (2015). The “Strengthening Nursing Culture Project”–an exploratory evaluation study of nursing students’ placements within Aboriginal Medical Services. Contemporary nurse, 51(2-3), 245-256. https://doi.org/10.1080/10376178.2016.1150190
Holland, K. (2017). Cultural awareness in nursing and health care: an introductory text. Routledge. https://content.taylorfrancis.com/books/download?dac=C2013-0-28249-1&isbn=9781482245639&format=googlePreviewPdf
Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D., & Salamonson, Y. (2015). Nursing students' perspectives of the health and healthcare issues of Australian indigenous people. Nurse education today, 35(3), 461-467. https://doi.org/10.1016/j.nedt.2014.11.019
Kendall, E., & Barnett, L. (2015). Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy. Ethnicity & health, 20(5), 437-452. https://doi.org/10.1080/13557858.2014.921897
McDonald, H., Browne, J., Perruzza, J., Svarc, R., Davis, C., Adams, K., & Palermo, C. (2018). Transformative effects of Aboriginal health placements for medical, nursing, and allied health students: A systematic review. Nursing & health sciences. https://doi.org/10.1111/nhs.12410
Ralph, A. P., de Dassel, J. L., Kirby, A., Read, C., Mitchell, A. G., Maguire, G. P., ... & Carapetis, J. R. (2018). Improving delivery of secondary prophylaxis for rheumatic heart disease in a high?burden setting: outcome of a stepped?wedge, community, randomized trial. Journal of the American Heart Association, 7(14), e009308. https://www.ahajournals.org/doi/abs/10.1161/JAHA.118.009308
