• Subject Name : Nursing

Cultural Competence Dimensions and Outcomes

Cultural competent communication is important to support the different values and belief of the diverse population improves the care process. The lack of cultural competency in the care increases the chances of the poor health status of the Aboriginal and Torres Strait Islander Peoples due to unaddressed cultural health care need (Brown et al., 2016). The essay is going to discuss the impact of the lack of culturally competent care over the aboriginal and Torres Strait Islander Peoples in the health care sector. The essay will also discuss colonization impact, two social determinant and barriers that are associated with the lack of culturally competent communication in the care.

The increasing diversity of the world population demand special consideration of the different cultural aspect like values, belief and language. The lack of competent communication skill led to the poor health outcome due to the unaddressed cultural specific need of the population. The cultural and linguistic difference increases the chances of the disparity as minority group need are not addressed by cultural competent communication. There is a major lack in the healthcare sector when it comes to the cultural competent communication which leads to the unaddressed cultural need of the population which result in decreased patient satisfaction (Alizadeh & Chavan, 2015). The cultural and linguistic difference population have widely been linked to the health care sector and they experience poor healthcare access that leads to deteriorated health care outcome. The disparity of the services lead to compromised care, increase hospital stays, increase chances of medical error and decrease patient involvement. The current working pattern of the health care services has a huge cultural competent gap when it comes to addressing the cultural specific requirement of the patient belong to the different cultural and linguistic background (White et al., 2019).

There is a lack of awareness concerning the cultural diversity approach that leads to the poor utilization of the cultural competent communication leading to poor health services. The lack of culturally competent communication in the health care sector generally leads to the increase chances of miscommunication that lead to the generation of the cultural disparity which can lead to poor adherence to the treatment. The transformed health care sector is improving the quality of care, safety in care but cultural competent communication is still missing that lead to the increasing prevalence of the adverse event for the culturally diverse population due to poor care experiences (Brooks et al., 2018).

The lack of culturally competent communication has increased the chances of the health care disparity which lead to increase complication for the Aboriginal and Torres Strait Islander Peoples. The lack of culturally competent communication in the health care sector leads to the 70% health gap between the Indigenous and non-Indigenous population that is directly reflected from the prevalence of the disorders. The indigenous population are more prone to different disorder due to lack of understanding and poor communication with the health care professionals that includes 23% of the Indigenous population face cardiovascular issue. Some other health care complication that arises due to the lack of culturally competent communication with the health care professionals includes 12% individual diagnosed with diabetes, 10% have a mental issue and around 9% have chronic respiratory issue (Waterworth et al., 2015). The Aboriginal and Torres Strait Islander Peoples have been facing multiple issues after the colonization like discrimination and racism that directly affected the health care sector also. The lack of cultural competency in the care increases the risk for the decrease life expectancy, psychological distress and increasing prevalence of the disorders (Power et al., 2018).

The communication gap that arises due to the lack of culturally competent communication between the health care workforce and the Aboriginal and Torres Strait Islander Peoples negatively impacted the health outcomes of the patients. The limited health literacy of the Aboriginal and Torres Strait Islander Peoples also demand more efficient cultural competent communication skills that will help to improve patient healthcare-related understating. The Aboriginal and Torres Strait Islander Peoples have different cultural values and belief concerning the health care services thus health care professional lack of cultural competency can lead to the reluctance of the Indigenous population toward health care facilities. The lack of culturally competent communication will lead to mistrust and lesser engagement of the patient in the care that lead to poor health outcome due to the less patient participation with negative perception toward the care (Amery, 2017). Cultural competent communication is one of the risk factors that can lead to poor experience of the Indigenous population that occur due to the poor communication styles and miscommunication. Aboriginal and Torres Strait Islander Peoples face major communication barrier and this lead to the racism which is faced by about one-third of the total Indigenous population in the health care setting. Cultural safe communication is important to assist the cultural specific need of the Aboriginal and Torres Strait Islander Peoples to improve the equity in the care by respecting the cultural belief of the population (Jennings et al., 2017).

Colonization has been a devastating period for the Aboriginal and Torres Strait Islander Peoples as it increases the survival complication for the population that left them with serious mental and physical health complication (Axelsson et al., 2016). The colonization period has increased the discrimination and racism in the field that lead to the major cultural and linguistic barriers in a different section of the society due to the poor education which leads to poor health literacy. The disparity in the health care sector is due to the traditional health care delivery system which leads to the equal distribution of services but not equity that leads to the unaddressed cultural specific need of the Aboriginal and Torres Strait Islander Peoples. The lack of culturally competent communication in the health care sector leads to poor patient satisfaction leading to increase susceptibility to acquiring the different disorders in the care (Axelsson et al., 2016).

One of the social determinants that lead to the lack of culturally competent communication in the community/social context that leads to the discrimination of the Aboriginal and Torres Strait Islander Peoples. The Indigenous population are discriminated when it comes to power, facilities and addressing the need. The less power and attention lead to the ignorance toward the cultural and linguistic pattern of the Aboriginal and Torres Strait Islander Peoples. The discrimination leads to the irrational behaviour of the health care workforces which due to the lack of cultural safe practise which ultimately lead to the poor health outcome of the patient (Markwick et al., 2015). Moreover, another social determinant that leads to the disparity in the cultural safe practice is the health care systems that are expected to deliver the cultural and linguistic compatible care. The issue in the health care system working lead to the poor compatibility of the services with the cultural and linguistic diverse population which negatively impact cover health of the Aboriginal and Torres Strait Islander Peoples. The lack in the health care organizational pattern, workforce knowledge or poor supply of resources can increase the chances of lack of the cultural competent. Health care services need to be improvising to address the cultural and linguistic need of the Aboriginal and Torres Strait Islander Peoples that will directly improve the health status of the Indigenous population (Fisher et al., 2018).

Different barriers are associated with the implementation of the cultural competent communication and one of them is poor skills of the workforce. The lack of understanding of the workforce related to the cultural competent communication strategies leads to the poor use of the cultural aspect of communication (Almutairi, 2015). The lack of a diverse workforce in the care is also one of the barriers in the cultural competent communication in the care concerning to the Indigenous population. The lack of a diverse workforce leads to poor compatibility to the cultural and linguistic aspect of the Aboriginal and Torres Strait Islander Peoples (Grandpierre et al., 2018). The third barrier is the lack of organizational support which leads to the poor working pattern of the workforce that leads to the unaddressed cultural and linguistic need of the Aboriginal and Torres Strait Islander Peoples. The lack of organizational support leads to the poor implementation of the change that can help to improve the culturally competent care to address the specific need of the Aboriginal and Torres Strait Islander Peoples in the care to improve health outcome.

During going through these findings I understand different aspect of the health care sector that can directly impact the health status of the Aboriginal and Torres Strait Islander Peoples. I have realised that there is a great importance of culturally competent communication in the care when the health care professional is going to deal with the diverse population. The findings help me to understand how the lack of competency in the communication concerning the different cultural and linguistic belief increases the complication of the patient. The different findings I have discussed the different point of view that is related to the impact of the cultural competency over the health of the Aboriginal and Torres Strait Islander Peoples.

I was unhappy about the impact of the colonization that depowered the Aboriginal and Torres Strait Islander Peoples by increasing the disparity of health care. I was also unhappy by analysing the bad experience Aboriginal and Torres Strait Islander Peoples have faced due to the lack of culturally competent communication that leads to the poor health outcome. The article presented by Dauvrin & Lorant (2015) discussed that health care professional is expected to deliver quality care by using effective leadership and cultural competency skills. The findings can be concluded by adding that the lack of culturally competent communication increases the complication for the Aboriginal and Torres Strait Islander People by increasing risk for poor health outcomes that need to be addressed by improvising the practice. I will try to improve by cultural competent skills that are also discussed in the Nursing and Midwifery Board Nursing standard that helps to improve the quality and cultural safety of the care. I ensure that in my future practise I will utilize by cultural competent communication skill to help the culturally diverse patients in the care.

The essay can be concluded by adding that right communication is a major point for the Aboriginal and Torres Strait Islander Peoples and lack of cultural competency in communication can lead to poor health outcome of the patient. The lack of culturally competent communication led to the disparity in the care for the Indigenous population which leads to the unaddressed cultural specific issue which lead to the poor health outcome. These findings helped me to understand the importance of culturally competent communication that I can utilize in my future practice to improve the experience and health status of the Aboriginal and Torres Strait Islander People.

References for The Lack of Cultural Competent Communication

Alizadeh, S. & Chavan, M. (2015). Cultural competence dimensions and outcomes: A systematic review of the literature. Health & Social Care in the Community, 24(6), 117-130. https://doi.org/10.1111/hsc.12293 

Almutairi K. M. (2015). Culture and language differences as a barrier to provision of quality care by the health workforce in Saudi Arabia. Saudi Medical Journal36(4), 425–431. https://doi.org/10.15537/smj.2015.4.10133

Amery, R. (2017). Recognising the communication gap in Indigenous health care. The Medical Journal of Australia, 207(1), 13–15. https://doi.org/10.5694/mja17.00042 

Axelsson, P., Kukutai, T. & Kippen, R. (2016). The field of Indigenous health and the role of colonisation and history. Journal of Population Research, 33(1), 1–7. https://doi.org/10.1007/s12546-016-9163-2 

Brooks, L. A., Manias, E. & Bloomer, M. J. (2018). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 1-9. https://doi.org/10.1016/j.colegn.2018.09.007 

Brown, E. A., Bekker, H. L., Davison, S. N., Koffman, J. & Schell, J. O. (2016). Supportive care: communication strategies to improve cultural competence in shared decision making. Clinical Journal of the American Society of Nephrology, 11(10), 1902–1908. https://doi.org/10.2215/cjn.13661215 

Dauvrin, M. & Lorant, V. (2015). Leadership and cultural competence of healthcare professionals: A social network analysis. Nursing Research64(3), 200–210. https://doi.org/10.1097/NNR.0000000000000092

Fisher, M., Battams, S., Mcdermott, D., Baum, F. & Macdougall, C. (2018). How the social determinants of indigenous health became policy reality for Australia’s national aboriginal and torres strait islander health plan. Journal of Social Policy, 1–21. https://doi.org/10.1017/s0047279418000338

Grandpierre, V., Milloy, V., Sikora, L., Fitzpatrick, E., Thomas, R. & Potter, B. (2018). Barriers and facilitators to cultural competence in rehabilitation services: A scoping review. BMC Health Services Research18(23), 1-14. https://doi.org/10.1186/s12913-017-2811-1

Jennings, W., Bond, C. & Hill, P. S. (2018). The power of talk and power in talk: A systematic review of Indigenous narratives of culturally safe healthcare communication. Australian Journal of Primary Health, 24(2), 100-109. https://doi.org/10.1071/py17082 

Markwick, A., Ansari, Z., Sullivan, M. & McNeil, J. (2015). Social determinants and psychological distress among Aboriginal and Torres Strait islander adults in the Australian state of Victoria: A cross-sectional population based study. Social Science & Medicine, 128, 178–187. https://doi.org/10.1016/j.socscimed.2015.01.014

Power, T., Virdun, C., Gorman, E., Doab, A., Smith, R., Phillips, A. & Gray, J. (2018). Ensuring Indigenous cultural respect in Australian undergraduate nursing students. Higher Education Research & Development, 37(4), 837–851. https://doi.org/10.1080/07294360.2018.1440537 

Waterworth, P., Pescud, M., Braham, R., Dimmock, J. & Rosenberg, M. (2015). Factors influencing the health behaviour of indigenous Australians: Perspectives from support people. PLOS ONE, 10(11), 1-17. https://doi.org/10.1371/journal.pone.0142323 

White, J, Plompen, T., Tao, L., Micallef, E. & Haines, T. (2019).What is needed in culturally competent healthcare systems? A qualitative exploration of culturally diverse patients and professional interpreters in an Australian healthcare setting. BMC Public Health, 19(1096), 1-8. https://doi.org/10.1186/s12889-019-7378-9

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