Cultural Presentation: Native Americans : Cultural Presentation: Native Americans Krista Power
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
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
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
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
Unsure of Native American traditions of healthcare
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 http://www.nlm.nih.gov/archive/20040823/pubs/cbm/amindhlt.html.
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 http://www.culturediversity.org/cultcomp.htm.
Like, R., Steiner, P., & Rubel, A. (2010). Recommended Core Curriculum Guidelines on Culturally Sensitive and Competent Health Care. Retrieved from http://www.stfm.org/group/minority/guidelines.cfm.
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.