Prevalence of CKD among the Aboriginal and the Risk Factors - Essay Example

Introduction The poor health conditions of the Australian Aboriginal are a well recognized public health issue in Australia. In comparison to other Australians, the Aboriginal, specifically those living in remote regions, have disproportionate chronic diseases morbidity and mortality rate (AIHW, 2003), and as noted by Mc Donald, et al. (2003), chronic kidney disease is no exemption of this. In deed, the effect of kidney illnesses, particularly CKD (chronic kidney disease) on Aboriginal’ health has been highlighted in previous reports (AIHW, 1999). Spencer et al. (1998) points out that kidney damage shown by passing of protein in the urine, is widespread among the Aboriginal, and proportions of treated chronic kidney disease among the Aboriginal have at times been reported to be more than 30 times the levels of other Australians. Though data on the occurrences and prevalence of CKD among the Aboriginal is not present at the national level, the big burden resulting from CKD within this population is shown by the high rate of prevalence of CKD, the high cases and prevalence of ESKD, the high hospilization cases and mortality rates related with CKD among the Aboriginal. The biggest challenge facing the Aboriginal is accessibility to healthcare. This paper examines CKD among the Aboriginal and the role of community nurse (CHN) in promoting healthcare among the Aboriginal. Specific skills required in by the community nurse in accomplishing his/her role in the Aboriginal community will also be examined. To better understand this issue, the paper will begin by examining the prevalence of CKD among the Aboriginal. Prevalence of CKD among the Aboriginal and the risk factors Risk factors for chronic kidney disease are greatly prevalent among the Aboriginal communities (AIHW, 2003). Poor nutrition, alcohol abuse, tobacco smoking, obesity, high blood pressure, diabetes and other preventable diseases are widespread among many Aboriginal and have been related with kidney problems within this community (Cass et al. 2001) Data from the National Aboriginal Community Controlled Health Organization (2009) indicated higher levels of diabetes, obesity, smoking, and high blood pressure among the Aboriginal in comparison with other Australians. Add this to the poor social-economic conditions and usual remote regions resulting in poor accessibility of health services and you get increased cases of CKD as well as other chronic illnesses among the Aboriginal. There is also higher cases of low birth weights among the Aboriginal and this according to McDonald (2004), contributes to increase risk for kidney disease, outside other risk factors. Though at the moment there is no national statistics on CKD among the Australian Aboriginal, a number of past studies have revealed high numbers of CKD among this population and indicators of kidney damage. In their study, Mc Donald, et al. (2003) established that 12% of people aged over 18 in remote regions of Aboriginal in Northern Territory were having stage 3, 4 or 5 of CKD, while 36% had signs of kidney problems. Levels of treated ESKD among the sampled population were established to be about 15 times more the national rate of non-Aboriginal. Nonetheless, though disease and risk factors have been found to be high among the Aboriginal, there are some differences among different communities; this implies that health interventions as well as preventive measures for Aboriginal have to be formulated to adapt to diverse diseases profiles within the Aboriginal communities (Baker et al.2005). The role of community nurse in CKD among the Aboriginal The role of community nurses, like any other health care professionals, is as care givers of health, to promote and develop prevention strategies of CKD, perform assessment, treatment, care, rehabilitation and palliation. Whereas community nurses can take part as citizens and professional in a number of aspects in their provision of CKD health care, they have to contributions to the Aboriginal community as partners, teachers and collaborators (Baker et al.2005). Care of CKD patients must be given in a manner that is not viewed as domineering, with the community nurses imposing their individual values and wishes. Community nurses have a critical role in helping Aboriginal communities to become better self- reliant and more ale to manage CKD and other health care needs. Community nurses have the duty of communicating effectively, to assist CKD patients and the whole Aboriginal community to understand the available options to them (Mc Donald, et al., 2003). The community nurses have o be inclusive when performing their roles to allow views of the person they are serving including cultural demands of the community, and empower the Aboriginal people to assume an active role in CKD treatment and prevention in a relationship that promotes mutual respect. The role of the community nurse is related with offering care of patients in Aboriginal with CKD. Community nurses and other healthcare providers all have a role of providing care to Aboriginal, particularly those suffering with CKD. Presently, with an increase in CKD patients among the Aboriginal, community nurses have a chance to identify, provide early care and make important contributions towards health care of CKD patients. Community nurses have a role of managing CKD and also offering patient education for those yet to be infected with the disease and those already suffering from the CKD. According to McDonald (2004) taking care and educating Aboriginal patients with CKD would enable the community nurses to share their experiences from other environments and communities. To accomplish their role, community nurses require the following skills. Cross cultural nursing skill Community nurses have to be attentive to cultural aspects in health. In deed, the model of culture has been extensively been integrated into nursing theory (Seifer, 2001). Calls for nurses who are culturally sensitive continue to get louder, thus community nurses in the Aboriginal communities or providing care to Aboriginal patients are under more pressure to offer culturally responsive care. To be more cultural responsive and have a wider understanding of Aboriginal, community nurses, as well as other health care providers have to understand the complex issues involved. Below are so some key aspects that community nurses have to possess: Understand that culture as a complex and dynamic aspect Understanding that popular viewpoints of culture, which confuse culture with ethnicity and race, dictate western views and advance racial prejudice, and Knowing that culture is created relationally, this implies that, each person is involved in creation of culture and culture is created for varied purposes. For community nurses to provide cultural sensitive healthcare services, they must first consider the way culture is formed, and be aware of the blind spots that could cloud their viewpoints due to their narrow view of culture. As noted by Seifer (2001) the community nurses should therefore develop a more complex, multi dimensional approach understanding of culture. Regarding treatment of CKD among Aboriginal, this will entail community nurses developing better critical awareness of Aboriginal culture. Education skills The community nurse enhances the self-care and self reliance of the community by provision of health education as well as promotion that improves the skills of the community, increases the capacity of the community to identify and access health care resources, and encourages better practices that can make the community to avoid kidney diseases (Rawsthorne, 2003). Thus, community nurses require health teaching skill to communicate facts, proposals and skills that transform beliefs, values, beliefs and behaviors of the Aboriginal. At the same time, community nurses offer education on heath matters particularly on CKD, since they affect the community. This education also includes detection of risk factors, behavior changes plans and management of CKD. All community nurses should be appropriately educated socially, technically and professionally to effectively work as primary health care providers and to respond well to the health needs of the Aboriginal community. This includes taking care of CKD patients. Effective multidisciplinary CKD care calls for pre-entry and continuous integrated inter-professional development and nursing education. This is attained through the integration of multi-disciplinary education in the curriculum of community nurses, thus a cooperative and mutual approach to health care between the community nurses and the Aboriginal community. Hughes (2006) notes that, the community nurses should as well have a dynamic approach to education in CKD to ensure that they are prepared for the needs of the CKD patients and the Aboriginal community as whole. Communication skills The practice of nursing requires regular communication among the nurses and their patients, patients’ families, the co-workers and other stakeholders. However, communication in nursing may be complicated and possibility of passing or getting incorrect messages exists. Thus it is important that community nurses working with the Aboriginal know the main aspects of communication process, the way they can improve their skills, and the possible challenges that exist with mistakes in communication. Effective communication has three main aspects, a massage, a sender and a receiver. When providing health care for the Aboriginal, the community nurses will regularly have a huge amount of information to send to the community in a short duration of time. To undertake this successfully, community nurses should understand that there are some factors that could impact how their messages are interpreted both by the patient and the community as a whole. As claimed by Rawsthorne (2003) 80% of communication is carried out as non-verbal. Thus, community nurses need to watch their body language, tone of their voice and eye contact when addressing the patients and the community members. Conflict between the community nurse and the Aboriginal people can be certainly avoided or corrected when the nurse is aware of the way his/her attitude is interpreted. In addition, community nurse should be ware of cultural values of the Aboriginal when communicating to them. As observed by Rawsthorne (2003) community nurses should appear empathetic to the Aboriginal people suffering from CKD. Health care promotion skills Community nurses play an important role in health promotion of Aboriginal people. They offer comprehensive nursing health care across the community; community nurses also offer health interventions and social conditions affecting the Aboriginal people. To effectively carry out the promotional activities, community nurses require communication and leadership skills. This will allow them to facilitate learning by coordinating, facilitating and supporting community programs on health matters, which may entail developing programs meant to prevent kidney diseases. In addition, leadership skills are required by the community nurses to lead established community programs in accordance with specific guidelines. Community nurses should have skills and ability to develop strategies targeting to address health status inequities among the Aboriginal population. Community nurses working with this population have to focus on offering culturally acceptable promotional services across the population with specific emphasis on kidney diseases, with educational program to risk factor associated with CKD. The big burden of CKD on the Aboriginal can be reduced with proper information and care. As noted by Seifer (2001) many kidney diseases can be treated and are as well preventable, nonetheless, the consequences of diseases results in a high number of morbidity and mortality cases in Aboriginal people compared to other Australians . Community nurses have to work with Aboriginal health workers, the community leaders to make sure that promotional approaches initiated are culturally responsive and appropriate to the Aboriginal community. Community nurses in their efforts to promote health among the Aboriginal, they use knowledge from two sections, one; the academic section, which depends on nursing education, social and public sciences, two; the community’s experiential knowledge in solving their health. The promotional health intervention programs must therefore be responsive to the health situations, risks, challenges and resources within the community (Chalmers and Bramadat, 1996). The community nurse must as well be well prepared with latest information on the Aboriginal health care particularly when forming partnerships with the community members and other organizations involved in health promotion among the Aboriginal. Community development skills Community nurses have a role of identifying and or creating community structures and networks within the Aboriginal population that enhance healthy behaviors (Salvage, 2008). This can be achieved by actively participating in the organizations in the community, and forming and maintaining the networks, as well as coalitions that work together in provision of health care particularly in treatment of kidney diseases. Thus the community nurses require various skills to effectively play this role. One of the important skill required is collaboration, the community nurse through collaboration is able to commit Aboriginal community members to attain a common objective (Rudd, 2008). This is done through improving the capacity of the community to promote and protect their health care. The community nurses take part in formulation of collaborative responses to kidney diseases through cooperation with and coordination of different teams across and organizations, this allows formulation of better strategies in management of kidney disease (Rudd, 2008). Coaliation building skill is also required by the community nurse. The skill will allow the community nurse to promote and develop alliances among the community for the purpose of dealing with CKD. This will allow the community nurse to form linkages, improve local leadership within the community and solve problem. McCauley (2009) asserts that community health nurses have to develop and maintain community networks and coalitions among the Aboriginal community, health care organizations, non-governmental organizations and the government to support the provision of comprehensive and efficient health care, particularly care of CKD. According to McCauley (2009) community nurses require community organizing skill; this will help the community nurse in identifying common problem brought by renal disease, so that they can assist the Aboriginal community in formulating and implementing programs for achieving the goals that the community nurses and the community have set. In his observation, Hughes (2006) notes that community nurses are involved in community consultation on CKD and start community development programs for improving health. Conclusion As discussed in this paper, Australian Aboriginal goes through poor health conditions regarding public health issue. Compared to other Australians, the Aboriginal, specifically those living in remote regions, have disproportionate chronic diseases morbidity and mortality rate. Data have shown that the prevalence rate of CKD among the Aboriginal is 15 times that of national level. It is against this background the community nurses working in this Aboriginal community understands that the have a big role in prevention and treatment of CKD among the Aboriginal. To achieve this role, there are specific skills required by these community nurses. Community nurses require education and teaching skill to communicate facts, proposals and skills that transform beliefs, values, beliefs and behaviors of the Aboriginal. They also need communication skills for effective and regular communication among the nurses and their patients, patients’ families, the community. For Health care promotion, communication and leadership skills are also needed the community nurses to effectively carry out the promotional activities. Community nurses at the same require community development skill and collaboration skill to be able to commit Aboriginal community members to attain a common objective by improving their capacity to promote and protect their health care. Community nurses should recognize the diversity of Australian people, including the Aboriginal, and their role in provision of just, empathetic, culturally competent and cultural responsive health care to the Aboriginal people. Comprehensive and accessible health care services have to be provided to Aboriginal. References ABS & AIHW (2003): The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. ABS Cat. No. 4704.0 and AIHW Cat; No. IHW 11: Canberra: ABS & AIHW. 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