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This chapter looks at the professional roles Aboriginal and Torres Strait Islander health workers and health practitioners play in the industry. It begins by looking at how the Indigenous health worker role evolved as a way to bridge the gap between Indigenous patients and healthcare professionals, and their role in contemporary medical settings. It considers the nursing and midwifery guidelines and frameworks that regulate Aboriginal and Torres Strait Islander health workers and health practitioners and provide guidance for collaboration with other healthcare workers. It concludes by discussing the challenges and opportunities of interprofessional practice when providing culturally safe care to Indigenous patients.
This chapter discusses Indigenous suicide and self-harm from a social and emotional wellbeing perspective. It begins by discussing current rates of suicide and intentional self-harm by Aboriginal and Torres Strait Islander people, compared with non-Indigenous Australians and international Indigenous communities. The chapter then considers contributing factors to Indigenous suicides, such as intergenerational trauma, poverty and loss of culture, traditions and practice. The chapter contrasts social and emotional wellbeing with Western concepts of mental health and suggests that social and emotional wellbeing is prioritised in Indigenous contexts because it more holistic and positive. The chapter discusses the importance of culturally safe care in Indigenous communities when creating mental health strategies and treatment plans, using the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023 as its basis.
This chapter considers the concept of social and emotional wellbeing in mainstream mental health services by deliberately approaching mental health from within an Aboriginal and Torres Strait Islander context, rather than the standard biomedical perspective. It discusses the political, social and cultural determinants of First Nations social and emotional wellbeing and how, throughout history, these have contributed to a stigma surrounding Aboriginal and Torres Strait Islanders. The chapter emphasises the importance of cultural connection in improving social and emotional wellbeing, and suggests prioritising cultural connection to people and place, culture and the natural environment when treating First Nations patients. Social and emotional wellbeing is discussed within the context of mainstream mental healthcare, calling for trauma-informed care and a strengths-based approach. The chapter explores various threats to social and emotional wellbeing, including Sorry Business and Sad News, and imprisonment, before suggesting ways for healthcare professionals to promote social and emotional wellbeing in their care of Aboriginal and Torres Strait Islander people.
This chapter focuses on quantitative research that is Indigenous-led and Indigenous-focused. It begins by discussing quantitative research in the context of Indigenous people to reject the commonly held assumption that quantitative research methods are less appropriate than quantitative methods in Indigenous contexts. It considers the importance of using an Indigenous methodology rather than a Western research methodology. The chapter differentiates between various research methodologies before focusing on the Indigenous research methodology in Australia. It highlights the importance of working with Aboriginal and Torres Strait Islander communities, considering Indigenous worldviews during research, and conducting research with political integrity. The chapter uses two case studies of Indigenous quantitative research to guide readers through the process and explain how to display and interpret results, and provides detailed guidance on using chi-squared tests to interpret results.
This chapter discusses the history of Aboriginal and Torres Strait Islander healthcare, from pre-invasion to contemporary healthcare systems. The chapter begins by discussing the social determinants of health and how these contribute to health inequities. It then uses historical journals and evidence from early Australian explorers to consider the health status and health system of Aboriginal and Torres Strait Islanders prior to 1788, demonstrating that Indigenous Australians had health systems in place pre-invasion. The chapter then discusses how Indigenous Australians’ health changed once Australia was established as a convict colony, through the introduction of diseases, dietary changes and the movement of Indigenous Australians into reserves and lock hospitals. The chapter continues to look at Indigenous health along the timeline post-colonisation, and considers the contemporary increase of community controlled health systems in Indigenous communities and the Closing the Gap initiative, which aims to eliminate the differences in health outcomes between Indigenous and non-Indigenous Australians.
Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care introduces students to the fundamentals of health care of Indigenous Australians, encompassing the perspectives of both the client and the health practitioner. Written for all nurses and midwives, this book addresses the relationship between Aboriginal and Torres Strait Islander cultures and mainstream health services and introduces readers to practice and research in a variety of healthcare contexts. This new edition has been fully updated to reflect current research and documentation, with an emphasis on cultural safety. Three new chapters cover Torres Strait Islander health and wellbeing, social and emotional wellbeing in mainstream mental health services and quantitative research. Chapter content is complemented by case study scenarios, author reflections and reflection questions. These features illustrate historical and contemporary challenges, encourage students to reflect on their own attitudes and values, and provide strategies to deliver quality, person-centred health care.
Community and primary health care nursing is a rapidly growing field. Founded on the social model of health, the primary health care approach explores how social, environmental, economic and political factors affect the health of the individual and communities, and the role of nurses and other health care practitioners in facilitating an equitable and collaborative health care process. An Introduction to Community and Primary Health Care provides an engaging introduction to the theory, skills and range of professional roles in community settings. This edition has been fully revised to include current research and practice, and includes three new chapters on health informatics, refugee health nursing and developing a career in primary health care. Written by an expert team, this highly readable text is an indispensable resource for any reader undertaking a course in community and primary health care and developing their career in the community.
This introductory chapter explains the social model of health and social determinants of health. It also introduces the concept of health promotion, a fundamental component of primary health care, that is then further developed throughout the text, and explores how nurses and other health care professionals may work in or with the community.
The world is facing an unprecedented number of displaced people as a result of war, conflict and natural disasters (The United Nations High Commissioner for Refugees [UNHCR], 2019). The UNHCR's UN Refugee Agency estimates that 70.8 million people around the world were forcibly displaced at the end of 2018 as a result of persecution, conflict, violence or human rights violations. During the course of the year, 13.6 million people were newly displaced including 37,000 people every day. Fifty per cent of the world’s refugees and displaced are children. Overwhelmingly, it is developing countries that are most affected. Permanent resettlement occurs in less than one per cent of cases (UNHCR, 2019). This chapter provides readers with a general overview of the impact of war and displacement on health, and an insight into the current Australian humanitarian programs for refugees arriving, including the offshore medical assessment and onshore settlement programs.
Mental illness continues to be a leading cause of illness in Australia and New Zealand. The effects of reduced mental health have significant and far-reaching consequences for individuals, families and the community. Prevention and early intervention are crucial to improve health outcomes throughout the lifespan. Much of the support and care for individuals and families experiencing mental health illness occurs within the community, and nurses are major providers of that care. This chapter focuses on the role of community mental health nurses in providing recovery-orientated care for individuals living with mental illness and their families.
A youth health nurse provides health care specifically to young people aged 12–25 years in community settings. Most often, this role requires a combination of both primary care and primary health care, although greater emphasis on one rather than the other may be apparent in some settings. Regardless of the focus of care provided, what is most important is that the service is youth-friendly, flexible and confidential where possible (Nair et al., 2015). Youth health nurses and school nurses are recognised internationally as playing an important part in contributing to the prevention of health risks among children and youth (World Health Organization, 2015). This chapter commences with consideration of the school nurse. Similarities of working in a school environment and the differences experienced between issues faced when working with primary- and secondary-aged pupils are noted. Similar client issues are addressed by secondary school nurses and youth health nurses, and the difference in setting between these two roles is explored.
This chapter explores the relationship between primary health care, health literacy and health education with empowering individuals, groups and communities to improve and maintain optimum health. Within the primary health care philosophy, principles of accessibility, affordability, sustainability, social justice and equity, self-determination, community participation and intersectoral collaboration drive health care service delivery and health care reform. Health care reform aims to meet the health care needs of people and communities through developing a sustainable health care system to reduce health disparity and improve health outcomes for all Australians and New Zealanders. A key component of this is developing the health literacy of consumers, health care providers and health care systems.
Community and primary health care nursing is experiencing a rapid metamorphosis as our population ages and the prevalence of chronic and complex conditions increase. To meet these changing needs, our health workforce has evolved with a range of specialised disciplines now working in diverse health settings. Throughout these changes, nursing continues to be the largest global health workforce providing the most direct client care. Historically, nurses were the original transdisciplinary health care workers, providing basic physiotherapy, occupational therapy, nutritional advice and all other care as required. As more detailed knowledge developed in an area of practice, specialised areas of care evolved and a variety of allied health professions emerged. Nursing itself became more specialised due to developments in clinical practice, technological advances and clients requiring more complex care. This chapter examines how professional identity and culture influence interprofessional practice, describes the behaviour and skills that facilitate effective communication, and identifies the barriers and facilitators to multidisciplinary health professionals working well together.
This chapter examines the significant impact of sex and gender to health and health outcomes for both men and women. Sex relates to biological attributes whether born female or male, while gender is sociocultural identity that is learned over time (Canadian Institute of Health Research, 2016; World Health Organization [WHO], ). The differences in morbidity and mortality between women and men have been well recognised (WHO, 2016). Biological characteristics expose both women and men to different health risks and heath conditions. Gender also exposes women and men to different health risks and gender inequity impacts on their potential to achieve health and well-being. This chapter also focuses on both biological and sociocultural factors that impact on women's and men’s health and how health professionals, in particular community nurses, can mitigate health disparities and inequities.
The provision of health care to people within correctional environments provides an essential service for a vulnerable and at-risk group in the community (Trimmer et al., 2019). Often, these people’s lives have been impaired by chronic health problems, illiteracy, poverty, unemployment, homelessness, poor relationships and high-risk behaviours such as unsafe sex, drug use and alcoholism (Australian Institute of Health and Welfare, 2014; 2015; Davidson, 2015; Gooding et al., 2015; Hickey et al., 2014; Lafferty et al., 2018). The correctional population is extremely varied and complex and is composed of male and female adults and adolescents who are both the victims and perpetrators of crime (Herber, 2014). For many, incarceration provides an opportunity for mental and physical health issues to be assessed and appropriate health care initiated (Besney et al., 2018; Bouchaud, Brooks & Swan, 2018; Bouchaud & Swan, 2017; Lafferty et al., 2018). This chapter provides an overview of the correctional health system, highlighting the complex needs of this population and the important role of nurses within correctional environments. It also identifies some of the challenges of nursing in a correctional setting and the skills needed by nurses to work effectively in this environment.