Case Study Assignment: Healthcare Inequalities for Aboriginal and Torres Strait Islanders

This case study discusses the healthcare inequalities faced by Aboriginal and Torres Strait Islanders, focusing on the experiences of Angela. It explores the impact of ineffective communication, racial discrimination, and bias in nursing care. The paper also highlights the importance of effective communication and cultural competence in providing quality healthcare.

Running head: CASE STUDY ASSIGNMENT

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Introduction
There are multiple steps and strategies that the Australian government has applied so that
the widespread inequalities in the healthcare system for Aboriginal and Torres Strait Islanders
could be eliminated (Reading and Greenwood 2018). As per Greenwood et al. (2015), the
widespread inequalities in the healthcare system not only affects their physical; health, but also
affects their mental health by disrupting their emotional and spiritual aspects of healthcare. The
challenges that the Aboriginal and Torres Strait Islanders suffer from while receiving care in the
healthcare facilities are associated with ineffective communication, racial discrimination,
unwelcoming nature and others due to which Aboriginal and Torres Strait Islanders and their
healthcare experiences are affected (Durey, Bessarab and Slack-Smith 2016). This paper would
discuss one such critical condition of an aboriginal woman Angela, who also faced these health
inequalities in her health experiences in critical conditions. In an interview, she mentions of the
situations that arises due to her aboriginal identity.
The primary aim of this paper is to identify and discuss the critical conditions that arise in
the healthcare of Angela and would discuss about the interpersonal and intrapersonal
communication. Quality and safety related aspects of her health conditions would be discussed
effectively in this paper. Finally, all the connotations of bias in her nursing care would be
mentioned in this paper so that the aspects related to culturally competent care could be
provided.

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Case scenario
This case study of Angela discusses about her health complications, her health
experiences and the way she overlooked everything and focused upon her wellbeing. She
mentioned that her Aboriginal identity always affected her healthcare condition and due to her
identity related conditions, she went through racial discrimination as well as unwelcoming
behavior. She mentioned that while delivering her first child in the healthcare facility of Sydney,
she was asked by the registered nurse that did she really belong to the aboriginal community or
not because of her fair skin color and they said that this provides her with the choice to not to use
her aboriginal identity. This comment affected her mental and emotional health as she was about
to deliver her first child and in such condition, the nursing professional made such comments that
disrupted her belief and trust upon the care system. In such condition, she was not treated with
effective communication so that she could share needs and requirements and this racial and
inappropriate comment not only affected her mental health but also affected her emotional and
spiritual wellbeing. On the other hand, while discussing about her second health experiences she
mentioned about her son’s hospital admission and the way nursing professionals neglected his
health emergency and blamed her for his health conditions.
Interpersonal and intrapersonal communication
On closely analysing the case study of Angela, it can be stated that the poor quality of
healthcare services offered to her could be significantly improved with the integration of
effective communication skills. As stated by Durey et al. (2016), effective communication can
help to establish positive therapeutic relationship with the patient that can help acquire positive
patient outcome. According to Jamieson et al. (2016), a total of two types of communication
process exists that include interpersonal communication and intrapersonal communication

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process. Interpersonal communication involves the process of sharing information by means of
verbal or non-verbal method of communication. On the other hand, intrapersonal communication
majorly involves the collaboration of a sender, receiver as well as an operational feedback loop
(Hayman, Reid and King 2015). Intrapersonal communication integrates the collaboration of
care professionals who belong to a similar cultural background and can render culturally
competent services aligned to the culture specific preferences of the client (Betancourt et al.
2016). On closely analysing the provided, case scenario, it can be commented that in both the
parallel instances, the patient Angela did not receive effective and culturally safe care. Also, the
care professionals engaged in her care process did not communicate effectively and actively
include her in the clinical decision making process.
How effective communication can help in providing effective care to service users?
Research studies on effective healthcare services have majorly focused in establishing a
positive rapport with the patient (Jeffreys 2015). In this context, Marmot (2017) states that a
positive therapeutic relationship with the client can be developed on the basis of the elements of
mutual trust, dignity and respect. The REM model has been built on the elements of respect,
active engagement as well as moving forward with the clients in order to render care services
that is distinctly aligned to the cultural preferences and other associated individual preferences of
the patient. The REM framework majorly focused on adapting effective measures to alleviate the
holistic health outcome of the indigenous patients. The framework broadly focused on bridging
the existing gap or disparity in relation to the care process and associated outcome of the elderly.
Research studies reveal that the integration of the REM framework can help to improve
interaction quality between the health professionals and the clients and can collectively improve
patient outcome (Marmot 2017). As stated by Ring et al. (2016), the quality of communication

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between the care professionals and the nurses can significantly be improved with the integration
of the 7C components of care. The 7C components comprise of correctness, coherence, courtesy,
consciousness, clarity, completeness and concreteness. Nursing research studies mention that the
integration of the identified seven care components can help to improve holistic care outcome in
the patients and help acquire effective recovery (Betancourt et al. 2016).
Consequences of personal bias
As per Laverty, McDermott and Calma (2017), personal bias is the tendency of an
individual to lean towards their preferences and hence, they tend to refuse the opinions of others.
In nursing professional as well, if the nurses are unable to overcome their personal bias, then
they would not be able to respect the culture of the aboriginal population (Matthews 2017). As
per Brown et al. (2016), while providing care to aboriginal community, the nursing professionals
should respect the cultural and personal preferences of others to deliver holistic care which
lacked in the case scenario of Angela. Therefore, it is important that nursing professionals
implement effective care provide non-judgmental and empathic and compassionate care to all the
patients irrespective of their culture, community and racial differences (Laverty, McDermott and
Calma 2017).
Conclusion
Therefore, in conclusion, it can be stated that cultural competence and establishing a
positive rapport with the patients is extremely pivotal to acquire improved patient outcome.
Historical accounts mention about the brutality and the atrocious dictatorship that the aboriginal
community members were subjected to in the past. Racial discrimination and poor treatment
services have resulted in poor health status of the aboriginal community. In order to close the gap

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and improve the wellness quotient, there is an increased need to undertake effective measures
which can help to improve access to healthcare facilities. Factors such as cultural competence as
well as effective communication with the use of appropriate verbal and non-verbal gestures
along with elements of empathy can help to improve overall health outcome of the Aboriginal
and Torres Islander community members. Despite undertaking a number of government
initiatives and creation of a number of wellness policies, the overall wellness status and quality
of life of the Aboriginal community members has still not significantly improved. In order to
foster improved care outcome there is a need to adapt improved measures in order to ensure care
professionals deliver services in a culturally competent and effective manner.

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References
Betancourt, J.R., Green, A.R., Carrillo, J.E. and Owusu Ananeh-Firempong, I.I., 2016. Defining
cultural competence: a practical framework for addressing racial/ethnic disparities in health and
health care. Public health reports.
Brown, A.E., Middleton, P.F., Fereday, J.A. and Pincombe, J.I., 2016. Cultural safety and
midwifery care for Aboriginal women–a phenomenological study. Women and Birth, 29(2),
pp.196-202.
Durey, A., Bessarab, D. and Slack-Smith, L., 2016. The mouth as a site of structural inequalities;
the experience of Aboriginal Australians. Community Dent Health, 33(2), pp.161-163.
Greenwood, M., De Leeuw, S., Lindsay, N.M. and Reading, C. eds., 2015. Determinants of
Indigenous Peoples' Health. Canadian Scholars’ Press.
Hayman, N., Reid, P.M. and King, M., 2015. Improving health outcomes for Indigenous peoples:
what are the challenges?. Cochrane Database of Systematic Reviews, (8).
Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D. and Salamonson, Y., 2015. Nursing
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education today, 35(3), pp.461-467.
Jamieson, L.M., Elani, H.W., Mejia, G.C., Ju, X., Kawachi, I., Harper, S., Thomson, W.M. and
Kaufman, J.S., 2016. Inequalities in indigenous oral health: findings from Australia, New
Zealand, and Canada. Journal of dental research, 95(12), pp.1375-1380.

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Jeffreys, M.R., 2015. Teaching cultural competence in nursing and health care: Inquiry, action,
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Laverty, M., McDermott, D.R. and Calma, T., 2017. Embedding cultural safety in Australia’s
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how to tell, and when?.