Cultural Competance in Health Care

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Health can only be defined in relation to a person's own values, which will, of necessity, reflect the cultural background of that person. White Australian health professionals in general, and nurses in particular, need to understand the meaning of health within a traditional Aboriginal culture, in order to respond appropriately to the health needs of Aboriginal people. This essay will discuss the definition of Aboriginal health and identify how the principles of cultural competency would assist health professionals in meeting the needs of Aboriginal and Torres Strait Islanders.

To Aboriginal people, ill-health is more than physical illness; it is a manifestation of other factors, including spiritual and emotional alienation from land, family and culture. Aboriginal people have a spiritual link with the land which provides a sense of identity, and which lies at the centre of their spiritual beliefs (Jackson et al, 2000). In 1990, the National Aboriginal Health Strategy (NAHS) developed a widely accepted definition of health as perceived by Aboriginal peoples: ‘Health does not just mean the physical well-being of the individual but refers to the social, emotional, spiritual and cultural well-being of the whole community. This is a whole of life view and includes the cyclical concept of life-death-life.’ This definition of health places in perspective our history, the importance to Aboriginal people of their links with the land, and their marginalisation, sense of loss and present-day disregarded position within the Australian community. Therefore to understand Aboriginal ill-health, one must first acknowledge the impact of dispossession, theft, genocide, lost and stolen generations of families and the attempted destruction of the countless cultures of the people inhabiting Australia before 1770 (Bullimore, 2002).

There is considerable diversity in aboriginal culture. Most of the literature on aboriginal culture is about remote area or semi-traditional Aboriginal groups. It is wise to also be mindful of the urban culture of Aboriginals, as a large proportion of Aboriginal and Torres Strait Islander population live in urban areas (ABS, 2007). For many Nurses or health practitioners, assumptions about aboriginal people are likely to be grounded in stereotypes, based on the ‘traditional’ notions learned from the past. Most of these past images and education of aboriginal people have been influenced by media and public attitudes, and are not the result of personal contact and associations with Aboriginal people(Paradies et al, 2008); hence the importance of Cultural Competency education. Health professionals should be careful not to impose judgments on ‘urban’ aboriginals from literature and their experience of working with traditionally orientated Aboriginal people, as some traditional cultural ways are not practised in urban situations. Many ‘urban’ aboriginal populations may not ‘fit’ the picture of traditional Aboriginality; it does not mean that they are not ‘real’ Aboriginal people. As a health professional it is important to be aware of territorial affiliations, such as whom the original owners of an area are, and who can speak on local issues or certain topics (Dudgeon, 2000). Stressing the importance of improving partnerships between health services and Aboriginal community controlled organisations in the planning and delivery of service responses for Aboriginal patients.

Cultural competence is the application of knowledge, skill, attitudes and personal qualities required by nurses to provide appropriate care and services in relation to cultural characteristics of their clients. Cultural competence includes valuing diversity, knowing about cultural customs and traditions of the populations being served and being sensitive to these while caring for the individual (Goode et al, 2002). In order to provide the best possible patient outcome, nurses must provide culturally competent care. The responsibility of...
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