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Wednesday, December 11, 2019

Competence and Perceptions of Community †MyAssignmenthelp.com

Question: Discuss about the Competence and Perceptions of Community. Answer: Introduction According to WHO, Palliative care refers to the improved care and management of the quality of life patients approaching end of life, and also providing psychological support to the families throughout the course of illness into bereavement (Land, et al 2016). Nurses are increasingly becoming involved in the palliative care and are source of significant information and much needed support for families and patients at the end of life. Health professionals responsible for patients with terminal illness should develop skills that enable effective communication with patients, and their respective families. Different communities of Aboriginal people have different and unique languages, beliefs, healing cultural practices(Mobula et al. 2015). It is noted that all patients are distinctively unique and cultural differences do arise while providing terminally ill aboriginal patients palliative care. Some of these patients value individual respect and involvement of family and their community during important decision making processes. The Aboriginal cultures usually have distinct approaches to revealing bad information to the patients, and also a way of encouraging the family members. Culture refers to the lifestyles, learned and commonly shared beliefs and values, learned knowledge, customized symbols, rules and regulations that guide behavior and create shared meanings within a given group of people (Driscoll, 2017). Vast cultural differences exist between the aboriginal patients and healthcare givers. Different presumptions and expectations on how communications should occur, who can participate, and the measures to be taken during decision making processes are some of the differences that are more apparent. Some aboriginal patient values indirect communication, speechlessness, and sharing of critical information and decision making with the family members.According to Alesi et al, (2011), terminally ill patients and their family members face difficult challenges when medical caregivers come from different cultural background as the patient. Difficulty on communication and decision making becomes a big challenge. The policy instrument of the residential system during the colonization process contributed to the poor state of the health sector in the aboriginal communities. Before colonization, the indigenous population was organized into groups of hunting and gathering communities with less inactivity and diseases were uncommon. Colonization process and establishments of residential schools lead to mistrust and trauma in medical practices among the indigenous people. The health of the aboriginals declined after contact with colonizers where there was an increase on the transmission of new diseases, loss of traditional lifestyle, change to a less nutritious diet, and depletion of natural food resource due to overhunting, fishing and also confinement of the reserve system and development of the residential schools (Pilcher, Charles Lancaster, 2008). There is need to integrate the aboriginals way of life into the medical practices to make it safe for the aboriginal people to access medical care. It will enhance the communication and acceptance of the medical services among the aboriginal people. Catalanotto et al. (2017) describe cultural competence as the process of accepting and respecting differences and not letting ones personal beliefs have an undue influence on those with a different beliefs, values, and lifestyles as of ones own. To the health care givers such as nurses, cultural competency involves having general cultural-specific information about other cultures and knowing what kind of questions to ask to avoid discomfort by the aboriginal patients. For nurses caring for aboriginal patients, achieving cultural competency is essential in helping handling different types of cultural barriers they might face. Cultural competency means learning, assessing, sharing, communicating and demonstrate skills within and outside ones culture is a key strength (Pilcher, Charles Lancaster, 2008). Through cultural awareness and sensitivity, nurses began to learn differences incultures leading to cultural safety which predicts the understanding of the power differentials deep-roote d in health services delivery and redressing the inequalities through the process of education. Failure to understand and appreciate the different cultural practices of Aboriginal people leads to inappropriate and poor health care service. Communication between the nurses and the aboriginals would improve if the nurses/caregivers are keenlistening to aboriginals and the healthcare givers let the communication shape their perceptions. Both the nurses and aboriginals needs to recognize that their cultural understandings come from their own individual backgrounds and therefore are saturated in their own beliefs and values development. Collaboration also plays a crucial role in building the cultural competency between the aboriginal and the nurses during the palliative and end of life care services received and delivered during terminal illnesses. Collaboration is not only expected from the aboriginals and nurses, but also from their families, health workers, interpreters and other staff members. It is vital in building up the trust between the parties involved. It is vital in planning and implementing strategies for change to produce optimum outcomes. Table 1: The core competencies of culture in the biomedical field Core Competency Key Concepts Role of the competency Postcolonial understanding The effect of colonization on Aboriginal people The nurses can provide culturally safe care, build relationships and give care to aboriginals in a compassionate manner. Also, identify the determinants of health of aboriginals and use the information to promote health among the aboriginals.. Communication Effective and culturally safe communication among in nurses and improved interactions with Aboriginal people. Establish an effective and culturally safe communication with the aboriginal patients and the families. Inclusivity To increase awareness and sensitivity among the involved parties. Engage in dialogues and build a relationship with the aboriginals. It creates culture awareness and sensitivity between the health practices and the aboriginals. Respect Respect for aboriginals cultural integrity. Consider the cultural uniqueness and diversity of all the patients and even the nurses. Identify and put in place measures that uphold cultural diversity. Demonstrate the skills of effective collaboration between the aboriginal and their families and the healthcare givers.. Indigenous knowledge Acknowledge the indigenous knowledge and Indigenous knowledge as having a place It gives insight into the way of thinking of the aboriginals and creates an easy understanding between the patients and their families and the nurses.. Mentoring support for students Supports structure to provide success in the field Role models guides nurses when still students on how to deal with different cultures. Cultural barriers in health workplace are described as any obstacle that an individual might face, such as language barriers, medical procedures, and practices or the conceptions of gender and ones sexuality. Nurses provide healthcare to the different patients with different cultural backgrounds such as the aboriginals. To ensure availability and accessibility of healthcare services and facilities for all the community members, financial and geographic health system and cultural support is required. Though there are cultural barriers that hinder the health care system functionality to the aboriginals. According to Mobula et al. (2015), cultural barriers lead to miscommunication between the nurses and the aboriginals causes unsatisfactory outcome of the healthcare services provided to the aboriginals. The miscommunication is one of the biggest challenges nurses face when trying to provide healthcare services to these indigenous people. Their beliefs, values, and interpretation of health and identity are the biggest obstacle to using the mainstream healthcare facilities. The beliefs lead to delays in accessing free medical camps, checkups and follow up appointments set up by the nurses. The culture difference causes unsatisfactory healthcare services to the aboriginals. The language is a critical component of culture and another big challenge nurses face when providing palliative care services to the aboriginals. Ineffective communications lead to failure in the palliative care outcomes due to misunderstanding and confusion between the nurses and the aboriginal patient (Lowell, 2013). Communication differences can lead to misdiagnosis leading to serious consequences. Another barrier is stereotyping of the aboriginals by medical professionals. According to Jennings et al. (2014) cultural training for healthcare staff working with indigenous communities such as aboriginals is too superficial. It is next to impossible to find a nurse attain cultural and linguistic competence through this approach. The healthcare staff cannot take the initiative to learn the linguistic, cultural aspect of the aboriginals hence poor healthcare services provided. Cultural identity refers to like the feeling of belonging to a group (Pilcher, Charles Lancaster, 2008). Biological and physical differences of aboriginals might prevent them from seeking medical treatment. People tend to trust and associate with people who practice the same values and share physically identical features (Durey, 2010). Cultural identity helps create a better relationship among people, and it is usually not the case as nurses often come from different cultural backgrounds. Cultural identity prevents indigenous people from seeking health services due to lack of cultural safety. Hence, terminally ill patients do not seek medical attention. Strengthening cultural competency of healthcare professional can be an effective solution to the communicative challenges and reduce disparities in the healthcare system. According to Mobula et al. (2015), nurses who are culturally aware and competent can reduce the communication barriers. Including the cultural competency in the service delivery and understanding other cultures beliefs and practices of other communities and inclusion in the medical school, practices can also be another solution. Also, research institutions and healthcare providers organizations can work together and come up with innovative ideas to reduce the cultural barriers in the healthcare systems. Wylie et al., 2013 suggests that it is recommended for institutions to adopt cultural competency measurement tools to provide self-assessments for healthcare staffs For future practices, strategies and policies need to be put in place to improve access and incorporate cultural protocols that would address the healthcare issues for the indigenous families. Institutions should provide the basis for the achievement of the set strategies. Aboriginals challenges in the healthcare system are the key to ensure cultural respect and equal healthcare access in the future. Conclusion Health equity is the core value and a basic human right for all human beings. Strategies and interventions should be put in place to protect and assist the indigenous groups such as the aboriginals. Cultural barriers should not prevent the communities from accessing the healthcare services provided worldwide. Nurses and healthcare providers need to research and come up with better solutions to enable aboriginals access healthcare services and do away with the cultural barriers. It can only be achieved by ensuring cultural safety communities such as aboriginals and winning their trust in the modern healthcare systems. References Alesi ER, Fletcher D, Muir C, et al. (2011) Palliative care and oncology partnerships in real practice. Oncology (Williston Park);25:12871290. 12921293. [PubMed] Behar-Horenstein, L. S., Warren, R. C., Dodd, V. J., Catalanotto, F. A. (2017). Addressing Oral Health Disparities Via Educational Foci on Cultural Competence.American Journal Of Public Health,107S18-S23. Driscoll, C. (2017). The Evolutionary Culture Concepts.Philosophy Of Science,84(1), 35-55. Durey, A. (2010). Reducing racism in Aboriginal Health Care in Australia: where does cultural education fit? Aust N Z J Public Health, 34 pp. 87-92 Jennings, G.,Spurling, D., Askew. Y, (2014).Yarning about health checks: barriers and enablers in an urban Aboriginal medical service.Aust J Prim Health, 20 pp. 151-157 Lowell, A. (2013). From your own thinking you can't help us: intercultural collaboration to address inequities in services for Indigenous Australians in response to the World Report. Disability Int J Speech Lang Pathol, 15 pp. 101-105 Pilcher ES, Charles LT, Lancaster CJ.(2008) Development and assessment of a cultural competency curriculum. J Dent Ed.; 72(9):10201028. Mobula, M.,Okoye, L.,Boulware, K., Carson, J., Marsteller, A. Cooper, L. (2015). Cultural competence and perceptions of community health workers' effectiveness for reducing health care disparities. International Health Nursing Journal, 18(2), 95-102. Pino M, Parry R, Land V et al. Engaging terminally ill patients in end of life talk: how experienced palliative medicine doctors navigate the dilemma of promoting discussions about dying. JPrim Care Commun Health, 6 pp. 10-15 Wylie, K., McAllister, L., Davidson, B. Marshall, J (2013).Changing practice: implications of the World Report on Disability for responding to communication disability in under-served populations.Int J Speech Lang Pathol, 15 pp. 1-13.

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