Australian indigenous people

The holistic nature of life and cultural sensitivity:

The indigenous people of Australia hold that emotional, social, and physical wellbeing demonstrate the holistic nature of life, which is significant for both the person and society at large. The cornerstone of modern efficient health care delivery is cultural sensitivity. Aboriginal Australians are considerably different from non-Aboriginal people in terms of socioeconomic status, culture, and language.

Chronic obstructive pulmonary disease (COPD) in Aboriginal Australians:

A lung disorder that worsens over time and reduces air intake is chronic obstructive pulmonary disease. In Australia, one of the leading sources of morbidity is COPD. When compared to their cohorts, Aboriginal Australians are prone to report twice as many COPD cases. The diseases’ high prevalence rates highlight the threat they pose to aboriginal Australians. Since the illness progress with an increase in symptoms, most cases are reported in their mild or severe stages. The disease has no cure since the damaged lung tissue cannot be healed. However, treatments such as medications, pulmonary rehabilitation, nutritional counseling, and oxygen therapy are used to reduce the occurrence of symptoms and to prevent further deterioration. The article provides insight on the importance of closing the gap in health care with a particular focus on Aboriginal Australian male COPD patients.

Case Study:

Name: Akma Unaipon

Gender: Male

Age: 49

Religion: Christianity

Next of kin: Amelia Bindi Unaipon

Family Situation: The patient is married with four children. The family can be described as a middle class

Place of Residence: New South Wales

Employment: Constructor

Medical and surgical history: The patient was diagnosed with lower respiratory tract infections twice at the age of two. Exposure to bacterial and viral infections was listed as the cause of the disease.

Lifestyle choices: The patient admitted to smoking in his late teens and early twenties for several years before quitting. However, his still admits to exposure to smoking from his friends and co-workers. Moreover, he confesses to exposure to smoking during his childhood years since his father was a smoker.

Cultural needs: The patient speaks English with a couple of Aboriginal phrases. His affiliation to Christianity illustrates some of the customs and beliefs he holds dear.

Topic Information:

Chronic obstructive pulmonary disease (COPD) is an enduring breathing condition associated with a decline in lung functionality which limits air flow to the lungs. The condition is accompanied by respiratory symptoms such as a cough, sputum release, wheezing, and chest tightness (Toella et al., 2013). The disease is common in the older population mainly male. While the condition is commonly associated with smoking or exposure to smoking, some people may suffer from COPD yet they have never smoked in their lifetime. Other risk factors of COPD include environmental and biological conditions. COPD is a term that encompasses several lung conditions including chronic bronchitis and emphysema. Chronic bronchitis is associated with over production of mucus by the lungs resulting in a consistent progressive cough. Emphysema, on the other hand, occurs when the bronchi and bronchioles and alveoli of the lungs are damaged causing breathlessness. The progressiveness of the disease can become so severe that an individual may require help breathing. COPD is among the leading causes of death in Australia. One in every 20 Australians aged above 45 years suffers from COPD. Statistics indicate the self-reported incidents of COPD is 2.5 higher among Aboriginal and Torres Strait islanders Australians as compared to non-indigenous individual (Australian Institute of Health and Welfare, 2014)s. Reports indicate indigenous people living in remote areas have a higher occurrence of COPD compared to those in metropolitan areas. The slow progress of the disease means that the condition may not be detected until severe symptoms present themselves hence reported cases might be lower than the actual data.

Nursing interventions:

COPD is a long-term lung disease that progresses with time and is not reversible. After the destruction of the lung tissue, the organ does not heal itself hence there is no cure for COPD. As such, the intervention for COPD involves preventing further deterioration and maintenance respiratory functions. Meditation can reduce the occurrence of the symptoms and slow the progress of the disease. Other forms of treatment include pulmonary rehabilitation and oxygen therapy (Wang & Holy, 2014). The most frequent intervention involves assisting smokers to quit. Since the patient is not a smoker and the disease is yet to progress to the severe condition, treatment includes medications and pulmonary rehabilitation. Drugs used in the treatment of COPD prevent and control symptoms while reducing the regularity of exacerbations. In recent years several new drugs have been approved for treatment of COPD in Australia for both indigenous and non-indigenous individuals. Pulmonary rehabilitation is a system of care that involves education, exercise training and psychosocial assistance provided by therapists (Australian Institute of Health and Welfare, 2014). It works to reduce symptoms and hospitalization rates for COPD patient through improvement of physical and emotional functioning. Exercise training aims to improve breathing techniques and optimize cardiovascular fitness through encouraging consistent training. Pulmonary rehabilitation encompasses nutritional counseling.

Cultural safety:

Although Indigenous Australians are considered as part of the Australian population, they differ significantly socially, culturally and linguistically from the non-indigenous population. Cultural competence is essential for efficient delivery of health care for COPD patients (Salsberg et al., 2009). Since the patient resides in a metropolitan region, he has likely been exposed to dust in his line of work. It is important for nurses to recognize the cultural needs of Akma as related to his language. Understanding the Aboriginal phrases coupled with the English is important to grasp the explanations on his lung condition. Similarly, his affiliation with the Christian denomination should be recognized in the delivery of health. Recognition of cultural needs of the patients will assist the therapist to determine the best exercise training that will appeal to the patient and encourage him to participate. Culture is a critical influence on nutrition (Vol et al., 2009). Since pulmonary rehabilitation involves nutritional counseling, it is important to recommend food that charms the patient. In COPD, it is important to optimize nutritional intake while controlling weight. Both excess and little weight are associated with increased morbidity. Obesity increases cases of difficulty in breathing while poor nutrition results in impaired muscle functions that may well lead to respiratory issues (Gomersall, et al., 2015). Moreover, the psychosocial support is typically based on culture and socioeconomic status of the patient. The program involves social and emotional support that is only valid with an understanding of an individual’s cultural beliefs.

References

Australian Institute of Health and Welfare, 2014. Coronary heart disease and chronic obstructive pulmonary disease in Indigenous Australians. Australian Goverment: Australian Institute of Health and Welfare, pp. 1-55.

Gomersall, J. S. et al., 2015. Systematic review to inform prevention and management of Chronic disease for Indegenous Australians: Overview and priorities. Australian and New Zealand Journal of Public Health, pp. 1-8.

Salsberg, J., Louttit, S., McComber, A. & Fiddler, R., 2009. Knowledge, Capacity and readiness: Translating Successful Experiences in Community-based participatory research for health promotion. A journal of Aboriginal and Indegineous Community Health, 5(2), pp. 125-150.

Toella, B., Xuan, W., Bird, T. & Abramson, M., 2013. Respiratory symptoms and illness in older Australians: the Burden of Obstructive Lung Disease(BOLD) study. Medical Journal of Australia, 198(3), pp. 144-148.

Vol, T. et al., 2009. Burden of disease and injury in Aboriginal and Torres Strait Islander peoples: the indigenous gap. international journal of Epidemol, pp. 470-477.

Wang, Z. & Holy, W. E., 2014. Lifetime risk of hospital diagnosed chronic obstructive pulmonary disease in remote Aboriginal people: a cohort study. Australian and New Zealand Journal of Public Health , 38(4), pp. 340-343.