Essay on "Indigenous Australian Patients"

Essay 3 pages (1054 words) Sources: 1+ Style: Harvard

[EXCERPT] . . . .

Indigenous Australian Patients: Evidence-Based Discussion of Patient Care and Reflective Practices

Providing health care to indigenous Australian people, specifically Yvonne, a 14-year-old Yolngu girl from Yirrkala poses several significant challenges. The Yolngu people, an Aboriginal community inhabiting the Arnhem Land in northeast Australia, have limited knowledge of Western medical practices. Instead, they place an emphasis on alternative medicinal treatment based on traditional health practices (Mununggirritj).

Studies have shown that Yolngu people harbor strong feelings of distrust towards Western medicine (McGrath, P. 2006). Lack of understanding of clinical notions of pain relief, fear of administration and associated side effects, and the idea that Western pain medications will speed up the dying process and inhibit the transmission of traditional knowledge that occurs during end-of-life, all contribute to the refusal of treatment. McGrath (2006) also demonstrated that Yolngu culture believes in the natural progression of pain, which makes them less likely to complain. This further complicates the delivery of optimal treatment for the patient.

The primary symptoms of the presenting patient are very general and require a comprehensive history. Fevers and abdominal pain are applicable to a large number of possible diagnoses. A medical history of the Yolngu peoples shows a high prevalence of diabetes and kidney disease. Abdominal pain is an associative symptom for kidney disease but in no way conclusively eliminates other diagnoses. It may also be caused be a urinary tract infection, food poisoning or allergies, all of which may be relevant for the patient. It therefore becomes critical to communicate effectively with the patient to gain an understanding of past illnesses, ingestion of plants or other foods that may be related to the fevers and a history of the symptoms' progression.

Yvonne proves quiet and non-communicative and generally non-compliant to receiving medical care. She regularly leaves her room to sit outside with other members of her community. These difficulties are pervasive. A nurse-practitioner must be sensitive to the cultural values of the patient and sympathize with the distrust she has towards Western medicine. It is also worth acknowledging that English can be anywhere from a third to a tenth language for the Yolngu people (Anan. 2011). Cass (2002) shows that miscommunication between healthcare providers and Aboriginal peoples is pervasive. One study identifies communication difficulties in 28.7% of all Aboriginal patients, a prevalence that is 31 times higher than those in non-Aboriginal patients (Cheng, WY. 1996). Specific problems that were frequently cited include lack of patient control over the language, marginalization of Yolngu knowledge, absence of resources to construct a body of shared understanding, lack of staff training in intercultural communication and overreliance on biomedical knowledge (Cass, A. 2002). The patient, culturally inclined towards mistrust, is thereby further alienated from the treatment process.

The nurse-practitioner must overcome these cultural and language barriers in order to effectively treat Yvonne. She clearly lacks faith in the practitioner and feels uncomfortable with the hospital environment. In order to engage in culturally safe practices, the nurse practitioner must approach the Yolngu relatives of Yvonne. She must show cultural awareness and recognize the traditional perspective of these people. Trained interpreters, although shown to provide only a partial solution to bridging the gap… READ MORE

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