Assignment Title: Cultural Sensitive Healthcare
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Cultural Sensitive Healthcare
Introduction
The discernments of physical and psychological wellbeing differ across and within societies. Despite that cultures emerge, merge, and change over time, diversity in human beings points to the fact that everyone’s beliefs, perspectives, and lifestyle tend to remain the same and influence specific elements of value that are distinct (Singer et al., 2016). Health is one element that fits the description of cultural specifications since it varies in societies and cannot be described by only measuring clinical care and disease. However, it is only in the contemporary clinical settings that health is standardized to fit a universal description. Culture influences health to varying extent, affecting how a person might perceive health, illness and death, causes of disease, approaches to health promotion, and preference for treatment. Understanding health in the contemporary clinical setting and the cultural lens is imperative to provide awareness of the diversity to contextualize wellbeing (Singer et al., 2016). This will ensure that healthcare providers can express a commitment to tell patients and their care team’s needs, including friends and family, to provide patient-centered care that will optimize healthcare outcomes. This paper lenses on an Aboriginal patient, Bill, and will progress to inform on the similarities and differences between Aboriginal medical services and mainstream health services. Additionally, it will report on concepts that may influence Bill to consider seeking medical intervention from his community and culminate with strategies that can be implemented to manage his health issues in a culturally safe way.
Similarities and Differences between Health Services
The Aboriginal medical service and institutionalized healthcare services provide almost similar services. Both institutions provide multidisciplinary health services that consist of a wide range of services, such as medical, dental, outreach, and public health services (Ivers et al., 2019). Both institutions are attended by qualified and trained healthcare professionals and use accepted evidence-based care treatment pedagogies (Bar-Zeev et al., 2019; Ivers et al., 2019). Despite that the Aboriginal medical service employs local indigenous staff as enablers of culturally appropriate services, they are professionally skilled in implementing healthcare services in the medical capacities (Bar-Zeev et al., 2019). These institutions are staffed by Aboriginal doctors, nurses, and students
The Aboriginal medical services are situated within or near the community that it serves, while mainstream health services are located in any location (Ivers et al., 2019). This is essential to address the social and cultural determinants of health that are faced by Aboriginals. The Aboriginal medical services provide a link between primary healthcare and health outcomes for Aboriginals to reduce health disadvantages experienced in institutionalized settings. Contrariwise, institutionalized healthcare is located across the country and globally and shares a similar set of routines to ensure continuity of care regardless of location (Ivers et al., 2019). Thus, care can be accessed in any place across the globe, and a person can continue receiving treatment, as healthcare providers can share a patient’s information virtually.
Aboriginal medical services are community-based services that use culturally safe models of health care. In contrast, mainstream health services cater to a specific need that requires services specialized in the niche. Aboriginal medical services are primarily informal; care is centered on looking out for community members (Campbell et al., 2018). The services provided are spontaneous to fulfill specific needs at a particular time and setting. The members of the community tend to control the agenda and care schedule. On the contrary, mainstream health services predominantly use the biomedical model instead of a holistic view of health (Campbell et al., 2018). A patient presenting with an issue will be served by processes characterized by providers’ discontinuity, have numerous physicians, and make a significant number of visits to various institutions.
Aboriginal medical services provide subsidized healthcare services to the Aboriginals (Bar-Zeev et al., 2019; Campbell et al., 2018). This makes it possible for Aboriginals to access a wide range of healthcare programs, including checkups, dental services, vision care, and free prescription drugs. These institutions recognize the financial status of Aboriginals, and one of the care reasons that limits them from visiting institutionalized care is that they are expensive (Campbell et al., 2018). However, this is not the case in institutionalized care where patients have to pay or otherwise have insurance cover for healthcare services capped by a respective health institution (Bar-Zeev et al., 2019; Campbell et al., 2018). Charges are based on checkups, consultation, type of treatment, level of care or acuity, and prescription drugs, which also depends per institution.
Concepts that may influence Bill’s Choice
Social and cultural determinants of health can influence Bill’s decision not to consider accessing care at Perth. In essence, institutionalized care is not well designed to recognize and address the social and cultural determinants of health within a patient’s context (Kingsley et al., 2018). Notably, these are important towards ensuring that Aboriginals and other Indigenous populations can access healthcare concerning healthcare institutions’ ability to recognize and consider their local beliefs when facilitating healthcare services. Bill will be limited in his ability to seek care at Perth. He believes that the institution and healthcare providers do not understand his culture and historical and social fabric.
Discrimination and racism towards Aboriginal people in mainstream healthcare are one of the recognized social determinants of health (DeLacy et al., 2020; Gibson et al., 2020). Bill might not be inclined to consider visiting the hospital at Perth for fear following the colonization trauma that is still seemingly inherent in policies and practices at the mainstream healthcare services. Additionally, racism is also evident within the healthcare system and more so enhanced by healthcare professionals (Gibson et al., 2020). In this regard, this causes distrust and makes the patients avoid seeking mainstream hospital-based services. Thus, racism will continue to influence the acceptability of Aboriginals on mainstream healthcare reception significantly. This will be notable by how they will avoid screening and not present themselves for treatment. Additionally, mainstream healthcare does not cater to their cultural concerns, whereby healthcare providers tend to focus on treatment and practical issues along with the biological medical (DeLacy et al., 2020). This makes Aboriginal patients feel that their cultural concerns are not being taken into consideration. In effect, this ends up creating a barrier as Aboriginal patients will continue fearing institutionalized healthcare services.
Bill’s socioeconomic status can influence his choice towards considering receiving hemodialysis at Perth, considering that he lives in the remote desert. Research reveals that approximately 15000 Aboriginals live in the rural and remote areas of South Australia (Broe & Radford, 2018). For this population, it is evident that traveling from their locations to a city hospital to receive medical treatment poses logistic challenges and is tiresome. Additionally, for many of them, accessing safe transport is also restricted due to road conditions and poor public transport access in their locations. Traveling long distances while unwell can be a limiting factor towards Bill considering accessing healthcare services at Perth; this concerns time while in transport, pain, and discomfort (Broe & Radford, 2018). The financial concern of traveling can present Bill’s barrier towards seeking treatment in the city (Broe & Radford, 2018). Following that Bill is from the remote areas and his age; it is relative to sum up that he can find it challenging to pay travel costs upfront. Many Aboriginal patients have been known to cancel their appointments as they do not have enough travel allowances (Broe & Radford, 2018). Despite the Patient Assistance Transport Scheme (PATS) reimbursing them accordingly, it was still not enough to cover all out pocket expenses. Additionally, considering that the hemodialysis will be scheduled for three times a week present an issue of concern on back and forth travelling from home and to the city on the same day, with no accommodation or the consideration of city accommodation is expensive.
Finally, the communication barrier can hinder Bill’s prospects of seeking medical attention at Perth. Communication is an essential element in patient-provider interaction. Aboriginals’ communication is adversely affected by their socioeconomic, cultural, and historical backgrounds (Kingsley et al., 2018). Due to the inability to communicate, healthcare providers end up providing less information, less supportive talks, and less proficiency to their patients. This leads to the failure to establish an ongoing personal relationship between the two parties, leading to substandard healthcare provision. Additionally, the patient will feel that their concern is not addressed accordingly. Thus, the communication barrier can impede Bill from seeking hemodialysis at Perth.
Strategies to Manage Health Issues in a Culturally Safe way
Perth’s health service should utilize various strategies to create a culturally-safe environment and provide patient-centered, culturally sensitive health care. Culturally-sensitive care refers to healthcare that reflects a hospital and healthcare providers’ responsiveness to the cultural needs, including reflecting their attitudes, culture, race, linguistic, and religious view (Brown et al., 2016).
The healthcare institution at Perth should hire Aboriginal support persons and Aboriginal staff. //One of the concerns of Aboriginal patients in receiving city healthcare services is the language barrier. This leads to a discrepancy in communication and unsatisfied service//. Perth’s healthcare services must consider having Aboriginal support persons who will also act as interpreters and Aboriginal health staff (Mithen et al., 2020). Aboriginal support persons can also increase Aboriginal people’s access to medical care as, through their services, they assist patients in understanding the nature of their illness and discuss treatment modalities. They are also prospective towards helping other healthcare staff obtain more information from the Aboriginal patients, ensuring that they make better clinical decisions (Mithen et al., 2020). This will be significant towards ensuring that information is communicated to Bill to engage him effectively. Additionally, Bill can recognize these health providers as they reflect his community members and increase patient-provider relationships.
Additionally, the organization should hire the aboriginal workforce as direct multidisciplinary care team members who will facilitate culturally safe care. Through using an Aboriginal and Torres Strait Islander workforce, they will provide a vantage point that will bridge the gap between cultures that is often prevalent in mainstream healthcare services (Brown et al., 2020; Mithen et al., 2020). They will also provide a range of services, including translating relevant medical information and provided a comforting relationship with the patient and other health staff. In this capacity, the healthcare facility at Perth can consider providing convenient roles to attract Aboriginal staff, such as mainstream professional roles, Aboriginal Education Officer, Aboriginal Healthcare Worker, and Aboriginal Liaison Officer, among other titles (Brown et al., 2020). Therefore, meaningful opportunities should be advanced to Aboriginal people who will take up healthcare positions and become essential members of mainstream health services. The impetus will contribute to cultural safe service delivery equitably and sustainably.
The healthcare institution should advance towards developing and facilitating cultural awareness training for their staff, especially those working at the renal unit. Cultural training is revered as an important undertaking that ensures culturally safe care as it explores power imbalance and social inequality that is characteristic in mainstream healthcare services (Laverty et al., 2017; Best, 2017). The training should aim to equip the staff with the right information regarding the specific health challenges encountered by Aboriginals. The cultural training will be designed to ensure that healthcare workers develop cultural awareness of Aboriginals. Specifically, the training should ensure that healthcare workers are aware of Aboriginal culture, including social and historical factors (Laverty et al., 2017). All workers at the facility should be trained to manifest behaviors that are culturally specific to the Aboriginals. Some examples that apply to Aboriginal people include avoiding excessive eye contact, not sitting too close, preference for a gender-specific provider, and standing over versus sitting next to (Best, 2017). Therefore, the Perth healthcare facility should train its staff to be responsive to these cultural behaviors when they engage Bill, about an elderly Aboriginal, which will make him feel respected and valued. Further, they should also be trained to be aware of self-reflection on their culture and the tendency to stereotype (Best, 2017). This will be a significant undertaking towards improving staff attitudes and knowledge regarding the Aboriginal people and their culture to guide their practice. The healthcare workers will become more tolerant of Bill’s cultural concerns and adjust healthcare intervention practices accordingly.
Conclusion
Cultural safe care is imperative in the healthcare setting where people from diverse cultures interact. Understanding a patient’s culture is imperative to ensuring that healthcare providers can provide culturally-safe care that reflects their values, beliefs, and attitudes. The Aboriginal medical services are similar to mainstream healthcare services, whereby they provide multidisciplinary health services and employ a trained healthcare workforce. However, they differ based on their positioning, service models, and service charge. Several concepts may influence Bill from not seeking mainstream healthcare services. These include the social and cultural determinants of health, such as discrimination and institutionalized racism in the healthcare settings, Bill’s socioeconomic status, and communication barriers. Several strategies can be implemented by the healthcare facility at Perth to accommodate Bill’s concerns in the quest to provide culturally safe care. First, the organization should hire Aboriginal support persons and Aboriginal force in mainstream healthcare to bridge the culture gap in mainstream healthcare. The health institution should advance to provide cultural awareness training to staff to ensure social equity and power balance in mainstream healthcare services. In this training, workers will be equipped with the right skills and awareness regarding Aboriginal social and cultural factors that will manifest in culturally safe care.
References
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