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NSG2FNH First Nations Health - La Trobe University

Learning Outcome 1: Describe the key features of Australian First Nations culture and history and apply an understanding of diversity within the First Nations population to person-centered care.

Learning Outcome 2: Describe First Nations concepts of health and healing, and analyse how interconnected physical, social, historical, political and cultural factors impact on health outcomes.

Learning Outcome 3: Describe the meaning of ‘cultural safety' in relation to improving health outcomes for First Nations people and critically analyse how it influences effective nursing and midwifery practices, and health service delivery.

Learning Outcome 4: Engage in culturally appropriate communication that facilitates respectful therapeutic relationships, and supports effective partnerships with First Nations health professionals, organisations and communities.

Learning Outcome 5: Outline the concepts of health inequality, the factors that contribute to it, and ways of redressing it to close the gap in health outcomes between Indigenous and non-Indigenous Australians.

Assessment 1: Culture and Health

Part 1: Cultural Determinants of Health and wellbeing for First Nations people

The Mayi Kuwayu Study is a ground-breaking national study exploring what culture means to Aboriginal and Torres Strait Islander peoples and aims to create greater understanding of how culture affects health and wellbeing outcomes. The first part of the study involved a review of the existing published evidence to identify cultural determinants of health and wellbeing for Aboriginal and Torres Strait Islander peoples.

The six broad cultural domains identified in this study are;

1. Connection to Country
2. Cultural Beliefs and Knowledge
3. Language
4. Family, kinship and community
5. Cultural Expression and Continuity
6. Self-determination and Leadership

Choose one of the cultural domains listed above and discuss how it impacts positively on the health and wellbeing of Aboriginal and Torres Strait Islander (First Nations) peoples.

Integrate material from credible published sources through effective paraphrasing to support your discussion. Ensure you appropriately acknowledge your sources of information with in-text referencing. Direct quotes can be included but take care not to overuse; APA guidelines suggest that direct quotes should make up no more than 10% of your discussion on a particular topic.

The integration of adequate and appropriate references is included in the marks allocated for this part of the assignment.

TIPS: Your discussion must be informed by evidence.
Resources relating to the Mayi Kuwayu Study can be found in e-Book 4.
The discussion needs to specifically relate to the impact of the chosen cultural domain on health and wellbeing. First Nations understandings of health are holistic and multi-dimensional therefore the discussion can relate to physical, mental, emotional, social, cultural, spiritual and/or economical health & wellbeing.
References used to support your discussion must relate specifically to Aboriginal and Torres Strait Islander people (not Indigenous peoples from other countries, especially Canada who also use the terms Aboriginal, Indigenous, First Nations).
Remember to match your word count to the marks allocated for this part. This part should be roughly 375 words

Part 2: Reflecting on your own culture and understanding of health.

Identify and describe how aspects of your own cultural identity influence your personal health beliefs (what does health and wellbeing mean to you) and your personal choices of health management (how you keep well and what you do when you get sick).

Your discussion should include but not be limited to ethnicity - use the Diversity Wheel highlighted in e- Book 1 and Workshop 1 for ideas about other aspects of cultural identity you might wish to discuss.

TIPS: Personal reflections and discussions should be expressed in first person and do not require referencing.

A strong response in this part of this assignment will demonstrate you have thought about where your personal ideas on health come from and what influences the choices you make about your own healthcare. Your reflection needs to discuss both your health beliefs and choice of health management.

Everybody has a cultural background/identity which influences their worldview, their beliefs and the choices they make in life - recognising this is an important aspect of developing cultural awareness.

The Diversity Wheel is designed to get you thinking about the different factors that can make up a person's cultural identity and influence values, beliefs and behaviours.

Remember to match your word count to the marks allocated for this part. This part should be roughly 375 words

Assessment 2: Addressing Health Inequality

Instructions

Part 1: The role of Aboriginal Community Controlled Health Organisations (ACCHOs)

Central to efforts to build healthier communities is the Aboriginal Community Controlled Health Service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people.

Panaretto, K.S., Wenitong, M., Button, S., Ring, I.T. (2014).
Aboriginal community controlled health services: leading the way in primary care.
Medical Journal of Australia 200(11): p.649

In Part 1 you are required to discuss the role Aboriginal Community Controlled Health Organisations (ACCHOs) play in reducing the health inequality experienced by Aboriginal and Torres Strait Islander Australians. Please review e-Book 5 prior to approaching this part.

a) Equality vs Equity
Equality and Equity are related but different concepts. Discuss the difference between the terms Equality and Equity and describe how Aboriginal Community Controlled Health Organisations are an example of addressing health inequity to reduce the health inequality experienced by First Nations people.

b) ACCHSs improving health and wellbeing

"Aboriginal health means not just the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole Community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their Community. It is a whole- of life view and includes the cyclical concept of life-death-life."

National Aboriginal Health Strategy Working Party. (1989, p.ix). A National Aboriginal Health Strategy.
Canberra: Australian Government Publishing Services

Using examples of programs/services delivered by your local ACCHO*(see list below) discuss how the Aboriginal Community Controlled Health Organisation model of comprehensive primary health care reflects the above definition of health.

Part 2: The role of hospitals

The NSQHS Standards provide a nationally consistent statement of the level of care consumers can expect from health service organisations regardless of where they live. The eight standards were developed to protect members of the public form harm and to enhance the quality of health services. Each standard consists of a set of action items. The second edition of the Standards, released in 2017, includes actions designed to ensure that healthcare is tailored to the unique needs of Aboriginal and Torres Strait Islander people.

In this part of the assignment you are required to discuss how the implementation of the NSQHS standards in hospitals can contribute to reducing the health inequality experienced by First Nations Australians.
Of course, all NSQHS Standards should be applied to all patients but there are specific standards and actions that relate directly to improving the health of Aboriginal & Torres Strait Islander peoples
The specific standards and actions related directly to improving the care provided to Aboriginal & Torres Strait Islander peoples are;

Choose two (2) specific actions from the table above. Describe strategies hospitals can use to implement these actions and discuss how implementation can improve patient outcomes for Indigenous Australians.
There are 5 marks available for each action you discuss, with the marks awarded as follows

• The description of strategies used to implement the action

• The discussion of how implementation of the action will improve patient outcomes

Integrate material from credible published sources through effective paraphrasing to support your discussion. Supporting literature can include peer-reviewed journals articles (highly recommended as they are the strongest form of evidence), relevant textbooks, credible websites and grey literature reports. Ensure you appropriately acknowledge your sources of information with in-text referencing.

Direct quotes can be included but take care not to overuse; APA guidelines suggest that direct quotes should make up no more than 10% of your discussion on a particular topic.

The integration of adequate and appropriate references is included in the marks allocated for this part of
the assignment.

TIPS: Your response must be informed by evidence. The information and links to resources provided below and in e-workbook 6 are a good place to start but you are also encouraged to do some independent research to find evidence to support your ideas and arguments.

Ensure you discuss relevant ACTIONS (which are specific to Aboriginal and Torres Strait Islander health not Standards (which apply to all users of the health service)

The implementation strategies discussed need to be specific to hospitals; health policies and strategic frameworks at a state and national level should not be included in your response.

Ensure you have clearly identified the 2 actions you have chosen from the table above so that the marker is able to award marks for both strategies. The discussion for each action is worth the same amount of marks and should have roughly the same amount of discussion (number of words).

Part 3: The role of individual nurses and midwives

Aboriginal and Torres Strait Islander peoples experience poorer health outcomes than non- Indigenous peoples. Cultural safety is a proven way for nurses and midwives to contribute to better health outcomes and experiences for Aboriginal and/or Torres Strait Islander peoples.

In Part 3 you are required to discuss how individual nurses and midwives can deliver culturally safe care and contribute to reducing the health inequality experienced by Aboriginal and Torres Strait Islander Australians.
Best (Best & Fredericks, 2018) describes 5 principles of cultural safety as follows:

1. Reflect on your own practice

2. Seek to minimise power differentials

3. Engage in discourse with the client

4. Undertake the process of decolonisation

5. Ensure that you do not diminish, demean or disempower through your actions

Choose two (2) of these principles of cultural safety. Describe strategies individual nurses and/or midwives can use to incorporate these principles into the care they provide and discuss how these strategies can improve patient outcomes for Indigenous Australians.
There are 5 marks available for each principle you discuss, with the marks awarded as follows:

• The description of strategies to incorporate the principle

• The discussion of how implementation of the strategies will improve patient outcomes

Integrate material from credible published sources through effective paraphrasing to support your discussion. Supporting literature can include peer-reviewed journals articles (highly recommended as they are the strongest form of evidence), relevant textbooks, credible websites and grey literature reports. Ensure you appropriately acknowledge your sources of information with in-text referencing.

Attachment:- First Nations Health.rar