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CSH074 - Holistic Cancer Management > Cultural Safety > Flashcards

Cultural Safety Flashcards

1
Q

equality

A

sameness, it promotes fairness and justice by giving everyone the same thing, BUT it can only work IF every one starts from the SAME place

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2
Q

equity

A

fairness, it is about ensuring people get access to the same opportunities. sometimes our differences and/or history can create BARRIERS to participation, so we must FIRST ensure EQUITY before we can enjoy equality

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3
Q

liberation

A

removing barriers => freedom to enjoy the highest attainable standard of physical and mental health

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4
Q

what is cultural safety

A

an environment which safe for people, where there is no assault, challenge or denial of their identity, of who they are and what they need. its about shared respect, shared meaning, shared knowledge and experience of learning together with dignity and truly listening

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5
Q

cultural awareness

A

is a beginning step towards understanding that there is difference. many people undergo courses designed to sensitise them to formal ritual rather than the emotional, social, economic and political context in which people exist

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6
Q

cultural sensitivity

A

alters people to the legitimacy of difference and begins a process of self-exploration as the powerful bearers of their own life experience and realities and the effect this have on others

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7
Q

cultural safety

A

is an outcome of education that enables safe service to be defined by those who receive the service

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8
Q

cultural responsiveness

A

the lifelong practice of cultural safety, reflection on interactions and actions

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9
Q

culturally unsafe Indigenous experiences of cancer treatment

A
  • high cost (travel, accommodation, treatment, medicine - shame associated with lack of affordability)
  • hospital environment and processes no recognition of cultural factors, confusing
  • lack of flexibility in hospitals for extended family
  • communication (use of medical jargon, not recognising holistic approaches to healing and well-being (physical, mental, emotional, spiritual)
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10
Q

barriers

A
  • lack of logistical access to treatment facilities and specialists care
  • healthcare systems: lack of cultural capability and trust, unmet needs and distress
  • cultural factors: nihilism, fatalistic beliefs and fear, use of traditional medicines
  • socioeconomic factors
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11
Q

enablers to healtcare access

A
  • staff communication, education, cultural capability and use of assessment tools
  • healthcare systems, continuous improvement, patient navigators and Telehealth
  • collaboration and linkages with other healthcare providers
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12
Q

communication barriers

A

lack of understanding of
- the impact of historical policies and practices on health
- diversity within and across people i.e. differences in cultural connectedness, differences in relationship terms and connections, differences in education levels
- the importance of language use - ‘othering’, creating power imbalances, impact of mixed messaging
- racism in health - impact of stereotypes, unpacking white privilege

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13
Q

communication enablers

A
  • recognise, understand and respond appropriately to trauma (trauma informed care)
  • understand social determinants of health
  • employ strength-based and rights-based approaches to health services
  • preventing re-traumatisation; awareness, understanding and education; safety; control and choice; relationships, connections and collaboration; empowerment, strength and resilience; and cultural competence and diversity
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14
Q

what is trauma informed care

A

is an approach in healthcare and social services that acknowledges the widespread impact of trauma and understands potential paths for recovery. It emphasizes creating a supportive environment to avoid re-traumatization and promotes healing and empowerment.

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15
Q

trauma-informed principles

A
  • understand trauma and its impact on individuals, families and communal groups
  • promotes safety
  • ensure cultural competence
  • support client’s control
  • share power and governance
  • integrate care
  • support relationship building
  • enable recovery
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16
Q

What are the barriers to cancer care access and use for Aboriginal and Torres Strait Islander peoples

A
  • lack of practical and logistical access to treatment

healthcare systems:
- lack of cultural capability (i.e., culturally competent and safe services)
- fear of healthcare systems (i.e., experiencing disempowerment or discrimination/racism)
- distrust of healthcare systems
- unmet needs and preferences (i.e., failure to include family and community, failure to change communication style and non-verbal communication, failure to overcome language barriers leading to miscommunication, inadequate information, explanation and follow up care)

cultural factors:
- lack of knowledge about cancer (benefits of treatment and likelihood of survival)
- cultural perceptions around cancer (feelings of shame)
- nihilism, fatalism and fear
- traditional beliefs around cancer (belief that cancer is a form of punishment, part of their fate, result of a curse, fault of the ‘white man’ after colonisation, or contagious)
- use of traditional medicines

socioeconomic factors:
- poorer education
- higher rates of unemployment
- lower income

17
Q

What are the enablers to cancer care access and use for Aboriginal and Torres Strait Islander peoples?

A
  • staff communication, education, cultural capability and use of assessment tools
  • healthcare systems continuous improvement, First Nations Health Professionals (i.e., cultural capability officer, indigenous health liaison officer, patient journey officer or Aboriginal health worker) and telehealth and outreach services such as cancer education sessions, prevention and screening programs and site visits
  • collaboration and linkages with other healthcare providers
18
Q

What are the barriers to communication for Aboriginal and Torres Strait Islander peoples?

A
  • impact of historical policies and practices (i.e., colonisation)
  • diversity within and among people (i.e., socio-cultural factors)
  • importance of language (i.e., othering, power imbalances, and mixed messaging)
  • impact of discrimination/racism (i.e., systemic racism and person racism, biases, stereotypes, assumptions, prejudices)
19
Q

What are the enablers to communication for Aboriginal and Torres Strait Islander peoples?

A
  • recognise, understand and respond to trauma (i.e., trauma-informed care)
  • understand social and cultural determinants of health
  • employ strengths- and rights-based approaches to care to support rights and dignity of patients (i.e., self-determined decision-making, partnership and collaboration through involvement of family and community)
  • cultural safety through responsive care (i.e., knowledge, skills, attitudes and competencies to deliver holistic care free from bias and racism)
  • prevent re-traumatisation
20
Q

What is the role of an Indigenous Health Liaison Officer (IHLO)?

A
  • assist multi-disciplinary teams to provide clinical and primary healthcare for patients and their families
  • engage with patients and providers and assist in arranging, co-ordination and providing culturally appropriate healthcare
  • assist patient’s and their families by providing (1) explanation of hospital system, (2) support and advocacy when speaking to hospital staff, (3) language translation services, (4) explanation of different types of services available at the hospital, (5) accountability to improve treatment adherence and completion and (6) transportation support
21
Q

discuss some cancer-specific indigenous population statistics

A
  • higher cancer incidence
  • higher mortality
  • lower 5 year survival
  • cancer diagnosis is more advanced, more preventable cancers
  • higher comorbidity
  • less likely to participate in screening
22
Q

What is culture

A

May include age, gender, sexual orientation, race, socio-economic status, occupation, religion, physical, mental or other health impairments, ethnicity

Implies the integrated pattern of human behaviour that includes thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group

23
Q

What is Cultural Competence?

A

refers to the ability of individuals and organizations to interact effectively and respectfully with people from diverse cultural backgrounds. It involves understanding, appreciating, and appropriately responding to cultural differences and similarities

Defined as a set of congruent behaviours, attitudes and policies that come together in a system, agency or among professionals to work effectively in cross-situational situations.

A culturally competent system of care acknowledges and incorporates the importance of culture, the assessment of cross-cultural relations vigilance towards the dynamics that result from cultural differences and the adaptation of services to meet culturally-unique needs.

24
Q

Principles of cultural safety

A
  • Self Reflection
  • Engage in discourse
  • Undertake a process of decolonisation
  • Ensure you do not diminish, demean or disempower others through actions
  • Seek to minimise power differentials
25
Q

Cultural Safety - Self Reflection

A

Being aware of your own cultural identity

Understanding your own assumptions, beliefs, and values about yourself and about the people that you care for

26
Q

Cultural Safety - Engage in Discourse

A

Listening and respecting

Using Laymans terms (not medical jargon)

Being aware that literacy skills may be lacking

Understanding and engaging in Indigenous knowledges and perspectives

27
Q

Cultural Safety - Decolonisation

A

Acknowledge the key role of a colonising history in contemporary health outcomes for Indigenous peoples

Learn the history of the community, peoples and families -> urban, rural and remote

Learn about your own personal history and how it has affected your lives

Learn the history of the system that you work in and the impact it has had service users

28
Q

Cultural Safety - Disempowerment

A

Not challenging peoples identity –> rather asking if people identify as ATSI

Recognising differing practices, communication methods (including silence)

Communicating respectfully and allowing people to feel safe in talking about their own cultural diversity

29
Q

Cultural Safety - Power Differentials

A

Be aware of language

Consider the patient perspective and needs

Consider the power differential the patient will feel with your professional relationship

Accept alternate ways of doing things

30
Q

Cancer beliefs of indigenous peoples

A

Lack of knowledge about cancer exists - poor understanding of its causes, available treatments and likelihood of survival

Feelings of ‘shame’ around cancer

Perceptions of culturally unsafe health services

Fatalistic attitudes and associated with a lack of survival

Fear of leaving community, family and country to seek treatment

A form of punishment for a past misdeed

Part of their fate or result of a curse

The fault of a ‘white man’ as it was not a concern before colonisation

Contagious

31
Q

Government priorities in improving healthcare

A

Engagement and involvement of indigenous communities and healthcare providers

Accuracy of identification and data collection

Access to treatment and support services

Cultural capability and responsiveness of services

Identification and development of specialised models of care

Knowledge and understanding of cancer and cancer services

Translation of evidence into action

32
Q

First Nations health professionals

A

Cultural capability officer
Indigenous health liaison officer
Patient journey officer
Aboriginal health worker

33
Q

Cultural Capability Officer Role

A

Actively participate in cultural improvement opportunities for the business

Contribute to the development of positive outcomes

34
Q

Patient Journey Officer Role

A

Assist patients and their families who are travelling from rural, remote and regional communities

35
Q

Social and cultural determinants of health

A

Social:
- Social support networks
- Income/social status
- employment and education
- occupation
- access to services (support, public transport, health services)
- Government policy

Cultural:
- Age, gender
- Sexual orientation, ethnicity, religion
- physical and mental ability
- organisational culture
- Discrimination / racism

CSH074 - Holistic Cancer Management (5 decks)

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