Putting Indigenous cultural training into nursing practice
Rosie Downing
Melbourne School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton VIC
Emma Kowal
Discipline of Anthropology, School of Social and Political Sciences, University of Melbourne, Carlton VIC
PP: 010 - 020
Abstract
The provision of Indigenous cultural training for non-Indigenous health workers has been widely promoted as a method of improving health service provision to 'close the gap' in Indigenous health. However, in the absence of strong evidence, the power of Indigenous cultural training to meaningfully contribute to the health of Aboriginal and Torres Strait Islander peoples remains questionable.
This research explored how six hospital-based nurses consider the role of Indigenous cultural training and the impact it has had on their practice through individual semi-structured interviews. Thematic analysis revealed the significance of individual professionals' attitudes in determining the impact of Indigenous cultural training, as well as the need for institutional support to assist in translating Indigenous cultural training into practice.
Utilising post-colonial theory, two key findings emerge. First, the way in which Indigenous cultural training conceptualises 'identity' and 'culture' is critical to its ultimate outcomes. Second, deficits in institutional support limit the efficacy of Indigenous cultural training by placing the onus for institutional change on the shoulders of individual health workers.
Keywords
Indigenous; Aboriginal and Torres Strait Islander; nursing; Australia; cultural training
References
Australian Bureau of Statistics. (2008). 4819.0 Selected health occupations: Australia, 2006. Retrieved April 16, 2009, from http://www.abs.gov.au/ausstats/abs@.nsf/mf/4819.0
Bhabha, H. (2003). The other question. In P. Mongia (Ed.), Contemporary postcolonial theory: a reader (pp. 198-222). London: Arnold.
Board of Inquiry into the Protection of Aboriginal Children from Sexual Abuse. (2007). Ampe akelyernemane meke mekarle: 'Little children are sacred'. Retrieved January 20, 2009, from http://www.nt.gov.au/dcm/inquirysaac/pdf/bipacsa_final_report.pdf
Browne, A., & Varcoe, C. (2006). Critical cultural perspectives and health care involving Aboriginal peoples. Contemporary Nurse, 22(2), 155-167.
Camphina-Bacote, J. (2003). Cultural desire: The key to unlocking cultural competence. Journal of Nursing Education, 42(6), 239-240.
Cohen, A. P. (1994). Self consciousness: An alternative anthropology of identity. London: Routledge.
Cuellar, N. G., Walsh Brennan, A. M., Vito, K., & de Leon Siantz, M. L. (2008). Cultural competence in the undergraduate nursing curriculum. Journal of Professional Nursing, 24(3), 143-149.
Cunningham, J., & Wollin, J. (1998). The importance of clinical experience in Aboriginal communities. Contemporary Nurse, 7(3), 152-155.
Devi, N. (1998). Eight 'Cs' of caring: A holistic framework for nursing terminally ill patients. Contemporary Nurse, 7(3), 156-160.
Dreher, M., & MacNaughton, N. (2002). Cultural competence in nursing: Foundation or fallacy? Nursing Outlook, 50(5), 181-186.
Friedman, J. (1994). Cultural identity and global process. London: Sage.
Gallaher, G., Ziersch, A., Baum, F., Bentley, M., Palmer, C., Edmondson, W., et al. (2009). In our own backyard: Urban health inequalities and Aboriginal experiences of neighbourhood life, social capital and racism. Adelaide: Flinders University.
Goold, S., Turale, S., Miller, M., & Usher, K. (2002). Gettin' 'em n keepin' 'em': Report of the Indigenous nursing education working group. Canberra: Commonwealth of Australia.
Gray, M., & McPherson, K. (2005). Cultural safety and professional practice in occupational therapy: A New Zealand perspective. Australian Occupational Therapy Journal, 52(1), 34-42.
Hall, S. (2003). Cultural identity and diaspora. In P. Mongia (Ed.), Contemporary postcolonial theory: a reader (pp. 198-222). London: Arnold.
Hill, M. E., & Augoustinos, M. (2001). Stereotype change and prejudice reduction: Short- and long-term evaluation of a cross-cultural awareness programme. Journal of Community and Applied Social Psychology, 11(4), 243-262.
Hollinsworth, D. (1992). Cultural awareness training, racism awareness training or antiracism? Strategies for combating institutional racism. Journal of Intercultural Studies, 13(2), 37-52.
Johnstone, M-J., & Kanitsaki, O. (2007). Health care provider and consumer understandings of cultural safety and cultural competency in health care: An Australian study. Journal of Cultural Diversity, 14(2), 96-105.
Liamputtong, P., & Ezzy, D. (2006). Qualitative research methods. South Melbourne: Oxford University Press.
Lowell, A. (2001). Communication and cultural knowledge in Aboriginal health care. Casuarina, NT: Cooperative Research Centre for Aboriginal and Tropical Health.
Mak, D. B., Plant, A. J., & Toussant, S. (2006). 'I have learnt ... a different way of looking at people's health': An evaluation of a prevocational medical training program in public health medicine and primary health care in remote Australia. Medical Teacher, 28(6), e149-e155.
Mongia, P. (2003). Introduction. In P. Mongia (Ed.), Contemporary postcolonial theory: A reader (pp. 198-222). London: Arnold.
Mooney, N., Bauman, A., Westwood, B., Kelaher, B., Tibben, B., & Jalaludin, B. (2005). A quantitative evaluation of Aboriginal cultural awareness training in an urban health service. Aboriginal and Islander Health Worker Journal, 29(4), 23-30.
Narayanasamy, A., & White, E. (2004). A review of transcultural nursing. Nurse Education Today, 25(2), 102-111.
National Aboriginal Community Controlled Health Organisation (NACCHO) & Oxfam Australia. (2007). Close the gap; Solutions to the Indigenous health crisis facing Australia: A policy briefing paper from the National Aboriginal Community Controlled Health Organisation and Oxfam Australia. Accessed April 07, 2011, http://www.oxfam.org.au/media/files/CTG.pdf
Price, E. G., Beach, M. C., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., et al. (2005). A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals. Academic Medicine, 80(6), 578-586.
Ramsden, I. (1993). Kawa Whakaruruhau; Cultural safety in nursing education in Aotearoa, New Zealand. Nursing Praxis in New Zealand, 8(3), 4-10.
Sinnot, M. J., & Wittmann, B. (2001). An introduction to Indigenous health and culture: The first tier of the three-tiered plan. Australian Journal of Rural Health, 9(3), 116-120.
Stanhope, V., Solomon, P., Finley, L., Pernell-Arnold, A., Bourjolly, J. N., & Sands, R. G. (2008). Evaluating the impact of cultural competency trainings from the perspective of people in recovery. American Journal of Psychiatric Rehabilitation, 11(4), 356-372.
Thomson, N. (2005). Cultural respect and related concepts: A brief summary of the literature. Australian Indigenous Health Bulletin, 5(4), 1-11.
Westwood, B. (2005). Cross-cultural training for Aboriginal health issues: South Western Sydney Area Health Service. Aboriginal and Islander Health Worker Journal, 29(3), 22-25.

eContent Home




