Week 10: Health Literacy

Health literacy was the focus of this week’s discussions, particularly how it relates to the social determinants of health, what population groups are most at risk of low health literacy, what health promotion strategies are currently available to improve health education and whether the material is appropriate for its intended groups. We also viewed an interview with Peter Ryan [Peter], who is vision impaired and discusses various issues relating to challenges people with disabilities face.

October is Health Literacy Month (Osborne, 1999).

I was truly inspired listening to Peter in relation to the challenges he has faced and overcome. I believe there is much to be learnt from him regarding how I can help to contribute to the health education of those at risk of low health literacy. Peter talks of simple measures nurses can do to improve the experiences of people with disabilities such as listening to, speaking with and acknowledging them. While these appear to be basic steps they will enhance the involvement of patients in their own care, improve their health outcomes and ultimately result in improved health literacy (Johnson, 2014).

The Commonwealth of Australia’s, Australian Commission on Safety and Quality in Health Care [the Commission] (2014, p. 2) advises the importance of health literacy is that it shapes people’s ability to understand, apply and make decisions about their health and health care. The Commission (2014, p. 2) also highlights, while individual health literacy is important, so is the health literacy environment, as it impacts on the way people access, understand, appraise and apply health-related information and services.  This includes the infrastructure, policies, processes, materials, people and relationships that make up the health system (The Commission, 2014, p. 2). I feel this relates to what Peter was stating in the interview, that while people with disabilities face poor health literacy due to various social issues, they are also impacted by inadequate health literacy environments, such as not being able to access buildings for medical appointments. Peter mentioned health promotion strategies such as Lifeline Australia and the Sunshine Coast Access Advisory Network  which are there to assist those who face various barriers with accessing health care and health literacy.

Sunshine Coast Access Advisory Network Logo [SCAAN] (2013).

By being aware of the barriers people can face, along with what health promotion strategies are available to assist them, I feel I will be able to ensure those with disabilities or other challenges are provided with the appropriate care that they are entitled to.

References

Commonwealth Government of Australia: Australian Commission on Safety and Quality in Health Care. (2014). Health literacy: Taking action to improve safety and quality. Retrieved from http://www.safetyandquality.gov.au/wp-content/uploads/2014/08/Health-Literacy-Taking-action-to-improve-safety-and-quality.pdf.

Johnson, A. (2014). Health literacy, does it make a difference?. Australian Journal of Advanced Nursing, 31(3), 39-45 7p. Retrieved from http://www.anf.org.au.ezproxy.cqu.edu.au/.

Lifeline Australia. (2010). Lifeline main page. Retrieved from https://www.lifeline.org.au/.

Osborne, H. [Artist] (1999). October is health literacy month [Logo]. Retrieved from http://www.healthliteracymonth.org/.

Sunshine Coast Access Advisory Network [SCAAN] (Organisation). (2013). SCAAN logo. [Logo]. Retrieved from http://www.scaan.org.au/.

Week 9: Equity and Diversity in the Workplace

This week we studied equity and diversity in the workplace through recognising and valuing the differences in not only race, gender, and ethnicity but also age and faith. The role of leadership in valuing and promoting a culturally diverse and harmonious workplace was also briefly discussed.

The readings this week made me reflect on the difficulties overseas nurses face when coming to work in Australia. I thought of the midwife who delivered my sister’s second child. She was an African woman, who had studied and trained in England and had come to Australia 5 years ago. Her nature was a lot different to my sister’s previous midwife, with her direct, and what came across to be aggressive, communication style being difficult for my sister to work with during labour. After this week’s readings I realised the various challenges and difficulties she would have faced and would still be facing in coming to work in Australia such as trust and fear, belonging, differences in communication including Australian slang, body language, mannerisms and conflict resolution along with adapting nursing knowledge and practice to Australian culture (Walters, 2008).

Scene from the Movie "Meet the Parents" where Greg faces criticism for being a nurse and explains why he is a nurse. (Movie trailer, 2010)

This week I also learnt of the difficulties men in nursing face in relation to sexism, misconceptions and stereotypes not only from patients but from colleagues. Clow, Ricciardelli, and Bartfay (2014) highlight that more men are needed in nursing however promoting gender diversity in nursing is lagging behind that of racial and ethnic diversification. They also face barriers which limit their choice of specialty which in turn impacts on being eligible to certain senior positions Kouta and Kaite (2011) suggest.

By creating a harmonious workplace, I believe I will be a better nurse, as I will be able to acknowledge the importance of diversity in the workplace and embrace each individual for their skills, experience and cultural backgrounds while not allowing their age, race, gender and/or faith to negatively impact on their work environment.

References

Clow, K. A., Ricciardelli, R., & Bartfay, W. J. (2014). Attitudes and Stereotypes of Male and Female Nurses: The Influence of Social Roles and Ambivalent Sexism. Canadian Journal of Behavioural Science, 46(3), 446-455. doi:10.1037/a0034248.

Kouta, C., & Kaite, C. P. (2011). Original Article: Gender Discrimination and Nursing: Α Literature Review. Journal of Professional Nursing, 2759-63. doi:10.1016/j.profnurs.2010.10.006.

Meet the Parents. (2010). [Video File]. Retrieved from https://www.youtube.com/watch?v=hmhGzTEGa70.

Walters, H. (2008). The experiences, challenges and rewards of nurses from South Asia in the process of entering the Australian nursing system. Australian Journal of Advanced Nursing, 25(3), 95 – 105. Retrieved from http://www.ajan.com.au.

Week 8: Cultural Competence & Care in Communities

This week we explored community contexts and relationships between health care providers and various community groups, and a number of sub-groups within the community that have complicated and unique health care needs. We also looked at the challenges faced by rurally based patients and health professionals when accessing and providing health services. An interview was also viewed, with Rosalie regarding the care of her disabled daughter, Rikki, and how nurses can provide quality care for her.

In the interview with Rosalie and Rikki, Rosalie speaks about times when the care provided to Rikki in hospital was lacking. Her request that nurses treat Rikki, and all patients, with dignity made me reflect on how this is such a simple request yet crucial when caring for patients. All patients deserve to be treated with dignity and respect be it the disabled, illicit drug users and/or homeless people. This week’s readings helped me to understand that these sub-groups already face numerous health issues and by encouraging them to access health care and to be active in their treatment, can lead to their lives improving (Howie & Heidke, 2015).

This image captures a health care worker caring for a patient with dignity (Dignity in Healthcare, 2013).

This week I have learnt the importance of nurses building relationships within the communities and cultures they practice in. Grant and Luxford (2011) stress that the way health care professionals understand and work with various cultures impacts on how these groups utilise health services going forward. I also discovered during my research that while there is a high rate of childhood vaccination in most countries, those that conscientiously object to immunisation tend to cluster together, meaning that the required level for herd immunity is not met, therefore putting at risk members of the community who for medical purposes are not able to receive vaccinations (Pearce, Marshall, Bedford & Lynch, 2015). Tafuri et al. (2014) advises that doctors and health care workers need to be trained, committed, enthusiastic and have up to date knowledge about vaccinations and know the contents proposed by vaccine sceptics in order to promoted and educate the public on childhood immunisation.

Immunise Australia Program Logo (Australian Government: Department of Health, 2015) 

The topics discussed this week will enable me to be better at my practice as I have learnt the importance of acknowledging patient’s beliefs, allowing them to be actively involved in their care and treating them with dignity and respect all of which will result in a positive health experience and/or outcome for them.

References

Australian Government: Department of Health, Immunise Australia Program [Logo]. (2015). Retrieved from http://www.immunise.health.gov.au/.

Dignity in Healthcare [Photograph]. (2013). Retrieved from https://www.uctv-cart.tv/cart/shopexd.asp?id=8211.

Grant, J., & Luxford, Y. (2011). 'Culture it's a big term isn't it'? An analysis of child and family health nurses' understandings of culture and intercultural communication. Health Sociology Review, 20(1), 16-27 12p. doi:10.5172/hesr.2011.20.1.16

Howie, V., & Heidke, P. (2015). NHLT12002 - Inclusive Practice: Study Guide. Rockhampton, Qld: CQUniversity Australia.

Pearce, A., Marshall, H., Bedford, H., & Lynch, J. (2015). Barriers to childhood immunisation: Findings from the Longitudinal Study of Australian Children. Vaccine, 333377-3383. doi:10.1016/j.vaccine.2015.04.089

Tafuri, S., Gallone, M., Cappelli, M., Martinelli, D., Prato, R., & Germinario, C. (2014). Addressing the anti-vaccination movement and the role of HCWs. Vaccine, 32(Vaccine-preventable Diseases and Vaccinations Among Health-care Workers), 4860-4865. doi:10.1016/j.vaccine.2013.11.006

Week 7: Multicultralism and Health

This week we explored the needs of over-seas born people, including migrants and asylum seekers, and the health issues both groups encounter. We viewed interviews with Mark, a migrant from South Africa, Asif, an asylum seeker from Pakistan and Mercy Baafi [Mercy], a migrant and registered nurse/midwife who originates from Ghana, South Africa. The interviews discussed various issues including the processes and barriers faced by them in coming and living in Australia, along with the differences in and their experiences with Australia’s health care system.

My father and his family migrated from Malta in 1962, having watched him and his family struggle with various health issues relating to poor language skills and low literacy levels, this week’s topics helped me to recognise the barriers they have faced. Asif's story on his experiences as an asylum seeker alerted me to the struggles they must face every day with uncertainty, despair and the desperation to seek a better life. Mercy highlighted the importance of simply asking a patient “what can I do to make your stay more comfortable for you?” and solidified my thoughts from my previous blog in relation to not presuming a patient’s health needs based on their culture, religion, race or ethnicity.

This photo captures some of the emotions refugees and asylum seekers feel when coming to Australia (Australian Human Rights Commission, 2015).

Through my research I discovered how the mental health needs of migrants and asylum seekers is not being met by Australia’s health care system. Carrigan (2014) highlights the various health care needs of asylum seekers and refugees both in and out of detention centres, however identifies that it is mental health issues that is impacting most refugees and asylum seekers and that holds the greatest concern for health professionals (Carrigan, 2014, p. 9). Mental health services also do not meet the needs of migrants from culturally and linguistically diverse (CALD) backgrounds either, resulting in increased personal suffering, health care costs and chronicity, and negative effects on the health of carers and other family members (Cross & Singh, 2013, p. 156).

Emotion Quote (Quotesgram, 2015)

By being aware of the various health-related issues of migrants and asylum seekers, the need to be culturally sensitive to the differences in communication practices within cultures along with the cultural differences in illness expression and help-seeking behaviour (Cross and Singh, 2012)  I will be able to better my practice as a registered nurse. 

References

Australian Human Rights Commission [Photograph]. (2015). Retrieved from https://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/asylum-seekers-=and-refugees-guide.

Carrigan, C., (2014). Flying under the radar: The health of refugees and asylum seekers in Australia. Australian Nursing and Midwifery Journal, 21(9), 22. Retrieved from http://www.anf.org.au.ezproxy.cqu.edu.au/.

Cross, W., & Singh, C. (2012). Dual vulnerabilities: Mental illness in a culturally and linguistically diverse society. Contemporary Nurse: A Journal for the Australian Nursing Profession, 42(2), 156-166. doi:10.5172/conu.2012.42.2.156.

Emotion Quote [Image]. (2015). Retrieved from http://quotesgram.com/i-am-a-teen-quotes/#zsjEQRgE9H

Week 6: Cultural Health Practices and Beliefs

This week we explored the relevance of cultural health practices and beliefs and the impact these have in providing health care for individuals, families and communities. This included various topics including the impact of Complementary and Alternative Medicine [CAM], faith, culture and cultural values on health and health outcomes and a demonstration on the importance of nurses providing culturally sensitive care.

The topics discussed made me reflect on my own culture and health beliefs, in particular, the fact that while I am a baptised catholic, I have used contraception, would consider using IVF and believe euthanasia and abortion are an individual’s choice and should not be determined by their religion. This highlighted to me the importance of tailoring health care to the individual and not only their culture and/or religion as within all cultures and religions are subcultures, ethnic groups and individuals who do not adhere to all the values and behaviours of the dominant culture (Purnell, 2014, p. 2).

I have learnt that effective communication, acknowledgement and understanding of a patients religion, culture or use of a CAM is necessary to provide holistic care. As demonstrated in the end of life care of Dianne, palliative care requires a holistic approach which addresses patient’s physical, social, psychological and spiritual needs in equal consideration and includes assisting patients with incorporating their spiritual concerns, such as hopes, dreams, fears and beliefs, into their daily care and end of life activities (Keall, Clayton & Butow, 2014, p. 3198). The Purnell Model for Cultural Competence [PMCC] (see Figure 1.1) is an assessment tool which was developed to enable culturally relevant care and simplify health assessments and interventions quickly and accurately (Purnell, 2014, p. xiv). An assessment tool such as this allows for culturally sensitive care to be provided and improved communication between patients and health professionals (Hayward & Charrette, 2012, p. 78).

Figure 1.1: Purnell Model for Cultural Competence (Purnell, 2014)

I believe by developing an understanding for the relevance and influences that faith, culture and cultural values can have on the provision of health care and utilising such assessment tools such as the PMCC, it will enable me to better my practice as a registered nurse.  This is because I will be able to provide culturally sensitive care and will have an awareness of the importance effective communication can have on a patient’s health outcomes.

References

Hayward, L. M., & Charrette, A. L. (2012). Integrating cultural competence and core values: an international service-learning model. Journal of Physical Therapy Education, 26(1), 78-89 12p.

Keall, R., Clayton, J. M., & Butow, P. (2014). How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. Journal of Clinical Nursing, 23(21/22), 3197-3205 9p. doi:10.1111/jocn.12566

Purnell, L. D. (2014). Guide to culturally competent health care (3^rd ed.). Philadelphia, PA, USA: F.A. Davis Co.