cultural presentation- native americans

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Cultural Presentation: Native Americans : 

Cultural Presentation: Native Americans Krista Power Creighton University July 15, 2010

Importance of Cultural Sensitivity and Competence : 

Importance of Cultural Sensitivity and Competence America = melting pot of cultures In order to provide appropriate healthcare, nurses must seek to become familiar with different cultures Important to: value the diversity other cultures bring to the table, assess one’s own cultural competency, understand and adapt to other cultures, realize that various dynamics are present when cultures interact with one another

Stop and Think… : 

Stop and Think… How many cultures have you experienced within the past week while providing nursing care? The past year? Your nursing career? What were some of the strategies you employed to provide culturally competent care? What were some of the barriers you faced in providing care to patients and families of another culture?

At Risk : 

At Risk Many minorities and different ethnic groups are considered vulnerable within the complex US healthcare system Socioeconomic factors Different diseases and health conditions prevalent within different ethnic groups and cultures Traditions and values

Basic Values of US Healthcare System : 

Basic Values of US Healthcare System Opportunity Efficiency Power Consumerism How do these values align with the different cultures present in the US?

Native Americans : 

Native Americans To begin a discussion of healthcare practices and concerns of Native Americans, demographics and history must be taken into account

Native Americans : 

Native Americans One of the smallest minorities in the US Term refers to those belonging to one of over 545 tribes recognized federally Indian Health Services (IHS) is the provider of health care to a majority of Native Americans Since inception, it has greatly reduced maternal and infant mortality, pneumonia, influenza, tuberculosis, and gastrointestinal mortality

Native Americans: History and Demographics : 

Native Americans: History and Demographics First cultural group in US Diverse group with many tribes (recognized and unrecognized) Since European settlement of US, Native Americans have been relocated to reservations and have lost ownership of property Reservations often have poor land quality Over a quarter of the Native American population lives in poverty

Native Americans: History and Demographics : 

Native Americans: History and Demographics Over 30% of Native Americans have no health insurance. Another 20% are covered with Medicaid Health status is lower for Native Americans than for the general US population

Native American Health Concerns : 

Native American Health Concerns Alcoholism Diabetes mellitus Obesity Suicide Stomach/liver cancers Cervical cancer Hypertension Heart disease Stroke

Native American General Health Practices : 

Native American General Health Practices Use of traditional healers Strong link between religion and medicine (as opposed to US view of healthcare relation to science) Belief that there is a connection between all life through the Creator, Mother Earth and Father Sky Must follow lifeways to achieve best possible overall health (spiritual, mental, and physical)

Native American General Health Practices : 

Native American General Health Practices Physical disabilities = body weakness but strong mind and spirit Physical ailments and inherited disorders = negative spirits, immoral behavior, breaking of a taboo. Lessons to be learned! Illness is a disruption of balance between being and universe – the cure is to restore balance Ceremonies & herbal remedies

Western vs. Native American Medicine : 

Western vs. Native American Medicine Western: Medication & technology Physician is authority Intellect & science Look for microscopic cause of disease Diseases have biological basis Strong focus on pathology

Western vs. Native American Medicine : 

Western vs. Native American Medicine Native American Confidence, awareness & taking charge of health Healer is counselor and advisor Intuition & spiritual truths provide healing Looks at big picture: causes and effects No simple explanation for diseases Focus on health and healing for individual and community

Native American General Health Practices : 

Native American General Health Practices Have become much more assimilated with US practices over centuries Stems from the opportunities associated with Native American children attending European-style schools Still distrust of Western medicine Many traditional practices and rituals of Native American health no longer being followed or passed on

Family : 

Family Lower intact family structure when compared to other cultures and ethnicities, including Caucasians and Asians Alcoholism main reason for dissolving family structures Grandparents often raise children High incidence of domestic violence and fetal alcohol syndrome

Women’s Role : 

Women’s Role Native American women traditionally have held certain roles including child rearing Respected members of community Able to become medicine women as easily as men, through apprenticeships or revelations in dreams Domestic violence has played a major role in women’s lives – most Native American women report domestic abuse has occurred at some point in their lives

Nutritional Practices : 

Nutritional Practices Historically have had excellent nutritional practices by eating crops that were grown, etc. Have mostly adopted western diet, leading to high incidence of diabetes mellitus, heart disease, and obesity Poverty/socioeconomics play a role – reservations are usually on land that doesn’t produce adequate crops

Prenatal Care/Childbirth Practices : 

Prenatal Care/Childbirth Practices Effective at reducing unfavorable pregnancy outcomes for at-risk women Native American women believe: Pregnancy is natural/normal Information exists that is unique to pregnancy and needs to be communicated to pregnant women Childbirth should be attended to by experienced person Caring for baby begins during pregnancy

Prenatal Care/Childbirth Practices : 

Prenatal Care/Childbirth Practices Distrust of physicians/Western medical practices Domestic violence Alcoholism Unsure of Native American traditions of healthcare Poverty All lead to decreases in prenatal care among Native American women

Death/Dying Rituals : 

Death/Dying Rituals Many different death and dying rituals due to vast number of tribes Becoming increasingly Westernized Shaman still important to traditional death ceremonies – in many cases, ceremonies must be performed before anyone can touch the body Cremation is disapproved of, burial remains favored

Sources : 

Sources Broome, B., & Broome, R. (2007). Culture and diversity issues. Native Americans: traditional healting. Urologic Nursing, 27 (2), 161. Retrieved from CINAHL database. Conway, M., et al. (1999). American Indian and Alaska Native Health. Retrieved from Edwards, K., & Patchell, B. (2009). State of the science: a cultural view of Native Americans and diabetes prevention. Journal of Cultural Diversity, 16(1), 32-35. Retrieved from CINAHL database. Fernandez, V., & Fernandez K. (2008). Cultural Competence. Retrieved from Like, R., Steiner, P., & Rubel, A. (2010). Recommended Core Curriculum Guidelines on Culturally Sensitive and Competent Health Care. Retrieved from Long, C., & Curry, M. (1998). Living in two worlds: Native American women and prenatal care. Health Care for Women International, 19(3), 205-215. Retrieved from CINAHL database. Wen, M. (2007). Racial and ethnic differences in general health status and limiting health conditions among American children: parental reports in the 1999 National Survey of America's Families. Ethnicity & Health, 12(5), 401-422. Retrieved from CINAHL database.

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