I have to do research on a subject I've done. I will add it here. the instructions are to use PICo ,PICO 1000 words . 9 SEPTEMBER 2021 BEXY FISHER S321124 INDIGENOUS AUSTRALIANS AND THE CULTURAL...

9 SEPTEMBER 2021 BEXY FISHER S321124

INDIGENOUS AUSTRALIANS AND THE CULTURAL CHALLENGES AFFECTING HEALTH OUTCOMES AND NURSING OBJECTIVES

Abstract

Aim- The literature review is constructed to examine the cultural challenges that affect the health outcomes of indigenous Australians and how these challenges affect the service delivery of Health Care services to indigenous Australians. This literature review critically analyses the factors that influence Aboriginals of Australia and the Torres Strait Island to receive Health Care services. It also analyses the cultural barriers that affect the health outcomes of indigenous Australians.

though Australia has one of the most sophisticated Health Care services in the world. This literature analyses the imbalance between health outcomes in the context of indigenous Australians as they relate to societal cultural barriers. Articles and research papers are effectively considered to make qualitative analysis and the literature is developed by making a robust analysis on the factors that influence the inequality within some facets of the Health Care system.

between 2017 and 2021. These peer-reviewed journal articles included all the factors that influence the health services to Indigenous Australians.

affected the health outcomes of indigenous Australians. The communication gap between indigenous Australians and Health Care professionals is one of the more prevalent factors that affected the standard of Health Care services to indigenous Australians.

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society and it is anticipated that further future research will provide a deeper understanding of why certain factors influence how Health Care is delivered to indigenous Australians.

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Table of Contents

Introduction.................................................................................................................. XXXXXXXXXX4Search Strategy......................................................................................................... XXXXXXXXXX4 Inclusion Criteria...................................................................................................... XXXXXXXXXX6

Indigenous Australians and Public Health Care............................................................ XXXXXXXXXX6 Cultural Barriers of Indigenous Australians................................................................. XXXXXXXXXX7 Factors that Affect the Health Outcomes...................................................................... XXXXXXXXXX8 The implication of these Challenges on Nursing.......................................................... XXXXXXXXXX8 Inequitable Healthcare Services in Australia................................................................ XXXXXXXXXX9 Access to Primary Healthcare Services for Indigenous People..................................... XXXXXXXXXX9 Communication Gap in Indigenous Healthcare.......................................................... XXXXXXXXXX10 Conclusion................................................................................................................. XXXXXXXXXX10 References.................................................................................................................. XXXXXXXXXX12

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Introduction

The inequality in health outcomes in indigenous Australians is a significant issue that the public Health Care sector of Australia has been facing for a long time. Throughout this literature review the term “Indigenous Australians” will represent both aboriginal Australian and Torres Strait Islander Australians. Research and documented evidence suggest that several chronic conditions are responsible for these uneven health outcomes in the context of indigenous Australians. There are several kinds of literature that have studied and conducted a robust analysis on the factors that influence the inequality in the Health Care service provisions for indigenous Australians. In this paper, a range of literary sources have been assessed to study and gather an effective knowledge of cultural barriers that influence the health outcomes of indigenous Australians and the implications of nursing in the context of the same. It offers a literary foundation based on the research questions and research aim and objective. Its literary words are critically examined to understand the viable aspects related to the research topic.

Search Strategy

The search strategy is summarised in Figure 1. Electronic databases that were searched are Informit, Infotrac, Blackwell Publishing, Proquest, Taylor and Francis, J'Stor, Medline, and Australian Indigenous Health Infonet. The terms that were searched in either the title or abstract of the article were, "indigenous Australians and their cultural impacts on health outcomes", "implication of health professionals on cultural aspects of indigenous Australian health outcomes". Distinct and separate searches were conducted for each database. Combined searches of the databases that were studied are produced as references at the end of the literature review.

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Records were identified through database searching Informit, Infotrac, Blackwell Publishing, Proquest, Taylor and Francis, J'Stor, Medline, and Australian Indigenous Health Infonet.

Additional records identified through the author's knowledge reflected the cultural barriers in the health sector for Indigenous Australians. (n=3)

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Records after duplicates removed (n = 202)

Records screened (n =202)

Full-text articles assessed for eligibility (n=13)

Records excluded (n =189)

Full-text articles excluded, with reasons

Not on Indigenous Australian=3 Not on health outcomes=3

Studies included in the qualitative synthesis (n=10)

Studies included in quantitative synthesis (meta- analysis)

(n=3)

IncludedEligibilityScreening

Identification

Inclusion Criteria

To capture the evidence regarding the cultural aspects that influence the health outcomes and the associated implications on nursing, included in the reviews, research and articles were discussions on the factors that influenced the health services to indigenous Australians. It also focused on the cultural barriers that hindered the health outcomes of indigenous Australians and an effective study on the implications of the health service professionals was also considered in this literature review. The peer-reviewed articles that were considered for the literature review are all published after 2017.

Indigenous Australians and Public Health Care

Access to Health Care services is an important aspect of the health and wellbeing of the citizens of a country. It influences the health status of a particular community and the development of the Health Care sector in a particular nation. However, research and literature convey the fact that indigenous Australians have very poor access to Health Care. They are in greater need for Health Care compared to the other communities in Australia. Indigenous Australians are burdened by a number of chronic diseases, but they receive limited Health Care services. However, previous studies and research claim that there has been very limited implementation of health services and programs that targeted indigenous people. Several aspects influenced the availability of Health Care services to indigenous Australians (Li, 2017).

According to Vos and Begg (2020), indigenous Australians suffer from non-communicable chronic diseases like cardiovascular diseases, diabetes, mental disorders, and chronic respiratory diseases. Additionally, some indigenous Australians engage in detrimental health risk behaviors such as smoking tobacco and the misuse of alcohol and other drugs. This was indicated by a

national survey which suggests that more than 40% of indigenous Australians are daily smokers.

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Therefore, the literature strongly suggests that there is a significant association between health risk behavior and health outcomes. Research further suggests that if health risk behavior and other cultural aspects of indigenous Australians are reduced, then it may improve their health outcomes.

Cultural Barriers of Indigenous Australians

Access to an efficient Health Care service not only depends upon its accessibility, but it depends on a strong efficient and effective financial and geographical health system, with proper cultural support. Cultural barriers in the Health Care system are influenced by several obstacles. This includes differences in language, understanding medical procedures and practices, and the patient's conceptions of gender cultural aspects and other political barriers affecting the community of the patient (Raman et al., XXXXXXXXXXThese barriers lead to serious issues for various cultural backgrounds and result in unsatisfactory outcomes of Health Care services, particularly among indigenous Australians. Such barriers inevitably lead to poor health conditions being observed among indigenous people in Australia.

Some cultural aspects such as fatalistic beliefs prevent people of indigenous communities to deliver access to health checkups or cancer screening and in some instances, they do not follow up hospital appointments. For instance, when research was undertaken with respect to the treatment of HIV-AIDS among the indigenous people, it was found that the community gave greater emphasis to maintaining their everyday schedules and routine and followed ancient customs, rather than heeding medical advice (Gomersall et al., XXXXXXXXXXHence, it is evident from the prior research and literature that some cultural differences are responsible for causing unsatisfactory outcomes for the Health Care services among indigenous Australians.

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Cultural identity along with physical and biological differences are also factors that prevent indigenous Australians from actively participating in Health Care programs. Moreover, cultural differences between those of some Health Care providers and indigenous Australians challenge the fact of provision of better Health Care services to the Aboriginal and Torres Strait Islanders(Mbuzi, Fulbrook & Jessup, XXXXXXXXXXAnother significant fact that is important in this context is thatin many cases Health Care professionals also present as an inappropriate cultural stereotype for indigenous Australians, which also serves as a cultural barrier for providing Health Care services.

Factors that Affect the Health Outcomes

The poor health status of some indigenous Australians has been a well-researched topic in recent decades. A number of studies have extensively mentioned the existence of substantial inequality among indigenous Australians. This is because of the number of challenges that affect the Health Care services accessed by indigenous Australians. Some health professionals have also expressed their concerns that substantial health problems may be left undiagnosed and untreated among indigenous Australians.

One of the greatest challenges in providing an effective Health Care plan for indigenous Australians is impeded by the fact that the Australian government has never committed to setting an achievable timeframe. The Australian government has left the achievement of equality to an unspecified future time (Lai et al., XXXXXXXXXXSo their commitments are not matched with their necessary funds and programs that vehemently support active Health Care services to indigenous Australians. Moreover, the government has not engineered health programs which are consistent with an understanding of the impacts of the broader policies and programs affecting the health outcomes of indigenous Australians. Social determinants of health such as income, education, and

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functional communities are also some of the active variables that need to be addressed when determining efficient health outcomes of indigenous Australians.

The implication of these challenges on Nursing and Health Care Professionals

Cultural competency refers to a set of harmonious values, principles, attitudes and policies that enables health care service professionals to work effectively across all cultures. Nursing aspects must be equipped with efficient cultural competencies and awareness which can reduce the Health Care disparities and thereby eliminate the challenges and cultural barriers that affect the health outcomes of the indigenous Australians (Goodman et al., XXXXXXXXXXBreaking cultural barriers also includes incorporating cultural training into Health Care services and trying to make the indigenous community understand the clinical practices, skills and behaviours of the Health Care system (Conway, Tsourtos & Lawn, 2017).

Inequitable Healthcare Services in Australia

The inequality in the health outcomes between the indigenous and the non-indigenous people of Australia is determined by the socio-economic determinants in the nation. This disparity of health outcomes is due to the health risk behavior and cultural aspects of the system within the community of indigenous Australians. Earlier sections of this literature review contemplate the cultural barriers and significant factors that are responsible for lower health outcomes in the indigenous population of Australia. These cultural barriers and socio-economic determinants cause a disparity between the health outcomes of indigenous and non-indigenous populations of Australia.

It is evident to mention in this aspect that chronic diseases affect indigenous Australians at a higher level than non-indigenous Australians. Among the communities of indigenous

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Australians, it is often observed that chronic disease occurs at early ages. This accounts for a gap in the mortality rates between indigenous and non-indigenous populations which results in early morbidity among the indigenous population.

One of the important factors that need to be considered is that the indigenous population experiences exclusion and marginalisation from the mainstream population of Australia, mainly due to socio-economic reasons. Another cultural aspect that is also responsible for this inequality in health outcomes is the influence of Western Biomedical models of Health Care (Bastos et al., XXXXXXXXXXTherefore, inequality persisting in the Health Care outcomes is influenced by the existing cultural differences in the health belief systems. This cultural discrepancy is also a challenge that affects the health outcomes and seriously affects the nursing and Health Care system.

Access to Primary Healthcare Services for Indigenous People

Accessing the primary Health Care sector is also a difficult issue for some indigenous people. Accessing Health Care for indigenous people often becomes difficult because they reside in communities that are geographically distant from primary Health Care centres. In a developed country like Australia, it is unfortunate that people die from chronic diseases because of their inability to access primary Health Care services. In many cases, indigenous people are not provided with adequate primary Health Care services. Additionally, they may experience discrimination and racism from some Health Care professionals. There are pieces of evidence that indicate that access to primary Health Care is a complex process for indigenous Australians (Shepherd et al., 2017).

This complex system is comprised of several factors that prevent indigenous Australians from accessing Primary Health Care Services. Approachability due to transparency, outreach,

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information screening also affects accessibility. Professional values, norms, culture, and gender, disrupt the acceptability of Health Care services among indigenous Australians. Geographical location, accommodation, hours of opening and scheduled appointments affect the availability of Primary Health care services (Hall et al., XXXXXXXXXXTechnical and interpersonal quality, adequacy, coordination, and continuity affect the appropriateness of Health Care amongst indigenous Australians.

Communication Gap in Indigenous Healthcare

The communication gap between the health professionals and indigenous Australians is because of a linguistic barrier and this has a significant impact on the health outcomes for indigenous Australians. Language is a basic cultural aspect that affects the relationship between Health Care professionals and indigenous Australians. It is more pronounced in the remote areas where cultural differences and linguistic differences amplify this gap, which hinders indigenous Australians from being able to access and make appointments for better Health Care services (Amery, XXXXXXXXXXIneffective communication leads to gradual failure in Health Care outcomes. Even though Australia has one of the most sophisticated Health Care systems in the world, it fails to provide adequate Health Care facilities for the indigenous population because some Health Care professionals and nurses fail to effectively communicate with indigenous Australians.

Conclusion

The purpose of this literature review was to make a critical analysis of the cultural aspects that affect the health outcomes of indigenous Australians. This paper evaluates the facts that influence the health outcomes of indigenous Australians and focuses on the implications for Health Care professionals and nursing within the Health Care sector of Australia. The literature review

focused on a comprehensive study on the cultural challenges that affect the health outcomes of

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indigenous Australians, and it makes a rigorous evaluation of the implications on nursing given this inequality of health outcomes in Australia. Cultural barriers have been a major issue for indigenous Australians.

Having reviewed the literature as it relates to this issue, it is apparent that cultural influences are directly related to indigenous Australians having a reduced ability to access primary Health Care services. It is imperative that cultural awareness training is provided to all Health Care professionals. Similarly, it is essential that indigenous Australians are provided with quality education and information as to the importance of living healthy lifestyles and removing any stigmas as they may relate to individuals accessing Health Care services.

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