Effective and Respectful Communication with Indigenous People in Regards to the Delivery of Health Care - Term Paper Example

EFFECTIVE AND RESPECTFUL COMMUNICATION WITH INDIGENOUS PEOPLE IN REGARDS TO THE DELIVERY OF HEALTH CARE Name Course Institution Instructor’s name Date Introduction Health plays a fundamental role in the society. In Australia, health is a determinant of the economy since it influences the labor market, which in turn affects productivity which is crucial for economic growth and development. Despite the significant role health plays in the enhancement of the living standards of people in Australia, there is a significant number of people particularly the Indigenous /Aboriginal people who are not able to access quality, affordable, available, accessible and more importantly acceptable health care, which makes universal health care for all, a dream and not a reality for so many of them (Dwyer et al., 2004). According to a report filed by the Australian Health Ministers’ Advisory Council, Non-Aboriginal population has better health compared with health among the Aboriginals (AHMAC, 2004). According to NSWDH, (2007), the poor health among the Indigenous population can be associated with the persistent vulnerability owing to disadvantage in relation to social determinants of health such as low social status, poverty, isolation, discrimination during resource and wealth allocation, disempowerment and low academic levels among other determinants. Moreover, this population has significantly high rate of chronic illnesses, their life expectancy rate is generally very low compared to Non-Aboriginal population, and they do not seek early treatment which can all be attributed to continuous liability of their situations socially, economically, environmentally and financially (NSWDH, 2005). All this implications on health for the Indigenous peoples signify a greater need in developing effective communication strategies that ensures engagement with this population and their healthcare providers in order to facilitate sustainable uptake of healthcare services. This report seeks to outline key components of a framework for health professionals to engage in effective and respectful communication with Indigenous peoples especially in regards to the delivery of health services in Australia. The key components of a framework for health professionals to engage in effective and respectful communication with Indigenous peoples especially in regards to the delivery of health services in Australia and how this potentially could be viewed as part of a strategy across a number of levels to systematically lift the cultural competency of mainstream health services Effective and respectful communication with people across different cultures and in Australia, between indigenous peoples with non-indigenous people especially in regards to the delivery of health services, can only occur when there are closer interrelationships between them and the health care providers (ACT Health, 2004). According to ACT Health (2004), this can effectively and efficiently be achieved by the healthcare providers generating and displaying some degree of respect and understanding of the different cultures of the Indigenous peoples and the wider community. This does not necessarily entail understanding all there is in the language, ideals, beliefs and customs of the different cultures, but it is more so, acknowledging that difference cultures such as the Indigenous culture varies from other non-indigenous cultures and that the Indigenous culture ultimately influences how Indigenous people perceive health and diseases, the way the communicate and the type of healthcare services they can access (DATSIPD, 1999). AHMAC, (2004) notes that cultural respect and understanding constitutes the willingness to learn and being tolerant to the cultural differences that do exists and being open to seeing things differently and new priorities. Providing culturally appropriate healthcare services that are responsive to the specific cultural needs of the Indigenous peoples is a way of communicating to them that they are considered important and that they are understood (ACT Health, 2004). The way a healthcare provider communicates and the effectiveness of communication between them and the patient significantly influences if the patient will come back for more services. Failure to communicate respectfully and effectively has the potential to not only hinder one patient from attending to a repeat health service but also, causing an entire community to shy away from accessing the health service as suggested by DATSIPD, (1999). This has far reaching impact in relation to general health. The ability for the healthcare provider to effectively communicate using suitable communication indicates respect for others and has the positive effect of placing the other party, who in this context is the Indigenous person, at ease in discussing their health concerns and other health related issues. Other than using suitable verbal and non-verbal forms of communication and observing basic rules of polite and respectful communication which includes proper body posture, paying attention and listening, it is crucial to include other elements of communication, which can be considered as key components of a framework for health professionals to engage in effective and respectful communication with not only Indigenous peoples but also other cultures (NSWASHR, 2009). This means that this framework can be viewed as part of a strategy across a number of levels to systematically lift the cultural competency of mainstream health services. Among elements of communication, which can be considered as key components of an effective framework to facilitate effective and respectful communication with Indigenous peoples especially in regards to the delivery of health services includes: 1. Building a strong rapport between healthcare provider and Indigenous clients Creating first impressions are integral in creating lasting impressions. The initial contact with a client with different cultural background is important because a wrong impression can mean an opportunity lost (DATSIPD, 1999). NSWASHR, (2009) indicates that building rapport begins from the first point of contact, which can be achieved by the healthcare provider seeking things that they have in common with the cross cultural client, although it is often easier said than done. At first glance, an indigenous client from rural setting entering an urban- located health facility may make a healthcare provider especially from non-indigenous background think they have nothing in common. However, paying closer attention to the indigenous client may prove there are certain commonalities, which the healthcare provider can capitalize on in developing closer engagement and rapport with them. ACT Health, (2004) notes that building rapport is merely not about seeking commonality, it is more about showing and recognizing some degree of respect for the client their unique attributes that makes them different. Developing a strong and reliable rapport does not occur automatically and healthcare providers need to be consistent over time in order to establish a solid ground for developing trust, which is essential in helping the indigenous clients to share their health issues and adhere to medical instructions as supported by AHMAC (2004). For Indigenous clients to be trusting enough to share their health issues entails understanding and showing respect for their cultural ideals (DATSIPD, 1999). Understanding these cultural dimensions and recognizing that an Indigenous client may react better to an alternative style of communication compared with a non-indigenous client, enhances the potential for positive interaction necessarily for delivery of healthcare services. Building a strong rapport entails being adaptable and responsive, while establishing an environment that is both open and safe for the indigenous client (ACT Health, 2004). 2. Use of appropriate language Effective and respectful communication is facilitated by use of verbal and non-verbal communication (Dwyer et al., 2004). Non-verbal communication entails the use of hand motions, body movements, body postures and facial expressions to communicate (NSWDCS, 2007). Although, this form of communication is essential in communicating effectively particularly cross-culturally, verbal communication takes a substantial space and place in communication and in development of positive interactions. Language is used as a medium in facilitating verbal communication. In delivery of health care services to clients from indigenous backgrounds, the use of medical terms can be a major constraint to the Indigenous client in accessing healthcare services, when they are not able to comprehend them (NSWASHR, 2009). This requires the healthcare providers to state matters in simple and clear terms to facilitate understanding (NSWDCS, 2007). A healthcare provider should not assume that since the client has simply responded in the affirmative, that they have understood instructions. This is because, more often than not, individuals are embarrassed if not scared to admit lack of understanding (NSWDCS, 2007). NSWASHR, (2009) indicates that indigenous people, who are more visual and verbal in comparison with non-indigenous people, are often limited in modern society that is increasingly numerated. Heavy use of medical terminologies establishes some sort of power imbalance and it contributes to clients feeling inadequate (NSWASHR, 2009). Owing to the continued history of discrimination of the Indigenous people, they are often more aware of power imbalances that exists and are more likely to feel unequal especially when served by a healthcare provider with a non-indigenous background (Dwyer et al., 2004). This being the case, using hard and many medical terminologies enhances the risk of the clients feeling inferior. It is important to note that, as much as the healthcare provider seeks to use the most suitable language in order to facilitate understanding with an indigenous client, they should be cautious not to mimic the patterns of talk used by indigenous people or use their slang. This is because doing so may be perceived and understood as being insolent and patronizing (AHMAC, 2004). In addition, it is improper to assume all indigenous people have low level of literacy. Therefore, one should establish the client’s individual level of literacy. To ensure the right language is used, interpreters can be used in specific incidents. 3. Using the appropriate style of communication Communication style significantly influences the outcome of an interaction between a healthcare provider and their client especially if the two belong to different cultures (DATSIPD, 1999). Findings from research carried out by Westerman, using various forms of questioning such as direct questions, influences the types of responses or answers one gets where a client may simply state an affirmative or on the negative to escape dwelling on the question (Westerman, 2004). For this reason, using open ended questions and positively –constructed questions when addressing an indigenous client is more applicable and productive than using direct questions that may seem threatening (Vicary & Westerman, 2004). In ordinary occasion, using open ended questions offer individuals more options especially when dealing with clients who may at first contact indicate they have a simple concern when in actual sense, they have another reason for consulting the healthcare provider. Using open ended questioning, the healthcare provider becomes better placed to uncover the hidden health concerns of the indigenous client as noted by Westerman, (2004). More often than not, being too direct generates a perception of intimidation as echoed by Vicary & Westerman, (2004). In addition to how one frames their questions, the body posture should communicate openness and should be free of confrontation. When working with indigenous people, there are those who are careful not to make direct eye contact. Unlike non-indigenous people who may interpret eye contact as politeness, indigenous people may interpret it as being assertive (DATSIPD, 1999). Therefore, when an indigenous client does not make eye contact, it is a sign of respect and not rudeness. 4. Use of written information to facilitate communication Providing additional information where possible is important in facilitating communication especially when one of the involved parties cannot effectively communicate verbally. Printed materials such as flyers can be useful in helping enhance awareness and understanding or simply in helping give thorough explanations to medical issues (NSWASHR, 2009). It is important that the additional written materials are not only available at the health care facility but also, available for the clients to carry home since, absorbing so much new information at once can prove too cumbersome for the client. In regards to developing written materials for indigenous clients and clients from varied cultures, it is crucial to ensure the written materials are culturally appropriate and the materials are aligned to the literacy abilities of the clients (NSWDCS, 2007). For instance, a poster with more illustrations than words can be more effective. Another aspect of using written materials is the use of forms to facilitate delivery of healthcare services. Since different indigenous clients have varying numeracy and literacy levels, it is important to factor that when designing information gathering tools such as forms (ACT Health, 2004). For example, clients may be required to fill in forms such as registration forms. When an indigenous client tries to access a health service, it is possible they may not be literate, which can still be the case for non-indigenous clients, limits their ability to fill the forms. This can prove to be embarrassing for the clients who may shy off from seeking healthcare to safeguard against embarrassment. Therefore, one can either use simple and clearly stated forms or alternatively, guiding the client through the form. Conclusion Conclusively, effective and respectful communication with clients from varied cultures and Indigenous peoples especially in regards to the delivery of health services in Australia is mandatory for healthcare professionals if they seek to improve the health outcomes of the Indigenous people. Coupled with building a strong rapport, using appropriate language and using written information is allocation of sufficient time per each client to facilitate reliable interrelationships, being open, avoiding technical language, recognizing there are issues that are hard to speak about, ensuring client confidentiality, avoiding intimidating body language, avoiding assumptions and offering culturally appropriate healthcare services. These elements of communication are key components of a framework for health professionals to engage in effective and respectful communication with Indigenous peoples especially in regards to the delivery of health services in Australia and thus, can be viewed as part of a strategy across a number of levels to systematically lift the cultural competency of mainstream health services. References ACT Health. 2004. Cultural Respect Implementation Plan: Aboriginal and Torres Strait Aboriginal and Torres Strait Islander Health 2004-2009. Sidney: Australian Health Ministers’ Advisory Council, Department of Health. Australian Health Ministers’ Advisory Council. 2004. Cultural Respect Framework for Islander Health Unit 2006-2009. Melbourne: ACT Health. Department of Aboriginal and Torres Strait Islander Policy and Development, Queensland Government. 1999. Protocols for consultation and negotiation with Aboriginal People. Queensland: DATSIPD. Dwyer, J., Silburn, K., Wilson, G & La Trobe University. 2004. National strategies for improving indigenous Health and health Care. Aboriginal and Torres Strait Islander Primary Health Care Review: Consultant Report No 1. Accessed on 10th Sept 2012 from http://www.health.gov.au/internet/main/publishing.nsf/Content/EC09AB903EAD9CA3CA25722B0083428F/$File/vol1national.pdf NSW Aboriginal Sexual Health Resource. 2009. Cultural respect & Communication Guide. NCAHS: NSW Aboriginal Sexual Health Resource. Accessed on 10th Sept 2012 from http://www.tvgpn.org.au/Welcome_files/Programs/ATSI_Health/Sexual_Health_guide.pdf NSW Department of Community Services. 2007. Use of appropriate language when working with Aboriginal communities in NSW. Research to Practice Notes, Centre for Parenting and Research, DoCS. NSW Department of Health. 2005. NSW Aboriginal Chronic Conditions Area Health Service Standards. Sydney: NSWDH. NSW Department of Health. 2007. NSW HIV/AIDS, Sexually Transmissible Infections and Hepatitis C Strategies: Implementation Plan for Aboriginal People 2006-2009. Sydney: NSWDH. Vicary, D & Westerman, T. 2004. ‘That’s just the way he is’: Some implications of Aboriginal mental health beliefs. Australian e-Journal for the Advancement of Mental Health, Volume 3, Issue 3. Westerman, T. 2004. Engagement of Aboriginal clients in mental health services: What role do cultural differences play? Australian e-Journal for the Advancement of Mental Health, Volume 3, Issue 3. Read More