Cultural Competence in Practice

This presentation explores the concept of cultural competence in practice, focusing on the Canadian Aboriginal culture. It covers topics such as cultural knowledge, health beliefs, family patterns, communication style, and more. Gain insights into the unique perspectives and traditions of the Aboriginal community and learn how to provide culturally sensitive care.

Cultural
competence
in practice
Name of the Student
Name of the University

Cultural knowledge
– Cultural knowledge forms an essential component of cultural competence
(Shen, 2015)
– Individuals typically focus on information specific to their culture, while
interacting in a community
– Culture specific knowledge cannot be necessarily transferred across varied
cultures
– Cultural knowledge facilitates gaining a sound understanding of differences that
exist in varied backgrounds, race, and ethnicities

Objective
– To determine the family patterns, communication style and
health beliefs of Canadian Aboriginal culture
– To assess the nutritional patterns, pain responses, and
perspectives on death, dying, prayer and meditation among
Canadian Aboriginals
– To explore childbirth and perinatal care, and views on religion,
faith and spirituality among Canadian Aboriginals
Figure 1
Source- (Morelli, 2017)

Health Beliefs and practices
– They have placed a faith on the concept of traditional Aboriginal healing since
thousands of years
– They provide elders a special respect due to the fact that most elders are
traditional healers
– Healing is considered a journey (Waldram, 2014)
– Due emphasis is placed on emotional and spiritual healing, in addition to
physical recovery

Health Beliefs and practices
– Health is generally considered as a harmony and balance between the spirit,
body and the mind
– Disease or illnesses are considered to occur by ignoring natural and sacred laws
– Medicinal wheel represents interweaving of health, life, and personal values of
the individuals and their community (Bell, 2014)

Family patterns
– Based on inuit approaches of raising children
– The children enjoy considerable amount of freedom and are
thought to be born from the spirit or soul of a recently
deceased community member or relative
– Places emphasis on laws of kinship
– Believes on presence of a relation between all things in the
spiritual word, animal world, human world, and plant world
(Gerlach, Browne & Suto, 2018)
Figure 2
Source- (Bissell Centre, 2016)

Family patterns
– Elders are considered the head of the family
– Often look for family groups
– Live with extended family members
– Consider all women, and not just the biological mother, as a guardian
– Presence of fluidity in bonds between children and parents
– Acceptance of orphans in other households

Communication style
– 30 dissimilar languages are spoken by the people
– Maximum people speak Inuktitut, Anishinaabe and Cree, Northwest Territories,
Nunatsiavut, Nunavut, and Mi'kmaq language (Haque & Patrick, 2015)
– Several native languages have been lost. English is spoken as the first language
by many surviving elders.
– Some people also speak French

Communication style
– Do not like usage of the word ‘pre-history’ or ‘discovery’ of America
– Resent usage of words such as, ‘our indigenous people’ or ‘stakeholders’.
– Establishing direct eye contact is considered disrespectful since eyes act as the
window to a person’s soul
– Maintaining a low volume and soft voice tone is also considered as a sign of
respect

Space orientation and Time orientation
– Identity is a multi-layered notion that permits persons living in a
varied society for identifying themselves
– Their identity comprises a massive diversity of individuals, groups
and welfares located ins changing economic, socio-political, and
demographic situations
– They do not comprise of a focussed monolithic unit, communicating
with one voice (Hawkins & Gillett, 2015)
Figure 3
Source- (Lake, 2017)

Space orientation and Time
orientation
– Human beings are thought to be devoted to each other (and societies of origin)
effectively by common ties of blood
– Reciprocal feelings of acceptance and trust are created that attach persons to
one another
– People take birth into a social group and their social interaction with the nature
and surroundings, forms an essential part of identity

Nutritional Patterns
– Good nutrition is considered imperative for optimal health and wellbeing
– Aboriginal children are given 2-4 servings of vegetables and milk, 1-2 servings of
meat alternatives, 3-6 servings of grains, and 4-6 servings of vegetables and
fruits
– 96% of First Nations kids consume milk or milk products once a day (at least)
(Langlois, Findlay & Kohen, 2013)

Nutritional Patterns
– Winter diet principally comprises of nuts and seeds that act as supplements
– They also feed on pemmican that contains high calories and can be stored for a
long duration
– Traditional summer diet comprised of seeds and wild berries
– Food for traditional feats comprised of wild rice cakes and salmon

Pain Responses
– Number 4 is a sacred entity for the Aboriginals since there are 4 segments in
the medicine wheel.
– Components of the medicine wheel associated with pain responses include 4
seasons, 4 sacred herbs, 4 health aspects (mental, emotional, spiritual, and
physical), and 4 directions (Burnett & Read, 2016)
– Sweats act as a healing and cleansing ritual

Pain Responses
– Burning of sacred herb in bowls or smudging, followed by putting hands inside
body parts helps in reducing pain
– Healing circles involve gathering of many people in the form of a circle for
healing the pain
– Traditional healers also recommend traditional diets for restoring balance and
harmony
– Use of herbal medicines in the form of ointment, powder, or tea

Childbirth and perinatal care
– They consider happiness and health of their children and babies as the core of
health of the entire community
– Children are considered sacred gifts from spirit world (Di Pietro & Illes, 2016)
– Health of children is considered a reflection of the overall health and wellbeing
of the community
– Children are an integral component of the family, culture and community

Childbirth and perinatal care
– Absence of social prosperity among the Canadian aboriginals, when compared
to their urban counterparts
– Aboriginal women are respected and regarded with high esteem due to their
role as life givers
– Aboriginal Prenatal Wellness Program (APWP) provides client-centred care (Di
Lallo, 2014)
– Lack of access to healthcare services during pregnancy often acts as a potential
threat

Death and Dying
– While dying, a traditional aboriginal will organise prayers,
ceremonies, and medicine with the aim of guiding the soul back to
the spirit realm
– The ceremonies are typically conducted by medicine person or
spiritual leaders who are close to the deceased
– The ceremonies involve a conglomeration of clan members and
family
Figure 4
Source- (Karstens-Smith, 2016)

Death and Dying
– During death, Mother Earth who is considered to be the original mother
nourishes the body of the deceased and helps to reclaim it to the physical form
– The Creator who is considered to the original father takes the soul and returns it
to the origin place
– Spirit lives forever and travels westward and ascends to the high clouds

Spirituality, religion, and faith
– Great spiritual power is present in spirits of natural phenomena living things,
and ceremonially noteworthy places.
– Orenda, Waka or Manitou is supernatural power or mystery that is considered
as the possession of spirits
– Spiritual power is present in ritual objects like rattles, calumet, drums, medicine
wheels, ritual sanctuaries, masks, and medicine bundles

Spirituality, religion, and faith
– Smoke columns, central house posts, pole of Sun Dance lodge signify
connection with the beyond world
– Ceremonial calendars used by agricultural societies like Haudenosaunee, at the
time of harvest
– Pipe ceremonies are an important part of primary group gatherings
– Fasting is considered a time-honoured manner of hastening spirituality

Prayer and meditation
– National Aboriginal Day of Prayer- 21st June (Downey, 2015)
– Sweat lodges are used for the purpose of prayer that involves
purification, spiritual healing, and fasting
– Sage and cedar are burned for driving out negative forces
while offering prayers
– Words of prayer are initiated by a respected elder of the
community
– Spiritual leaders are given tobacco for a prayer request,
indicating honour and respect
Figure 5
Source- (Scoffield, 2014)

Prayer and meditation
– Prayers help in summoning the Great Creator at group or individual ceremonies
– God is praised for seeking transformation and celebrating spirit power
– Meditation helps in changing mindfulness pace
– Records of drumming circle are played in the background while meditating

Knowledge gained
– Indigenous Canadians are not a homogenous group
– They have unique traditions, history, economy, and culture
– Three distinct groups are the First Nation or Indian, Inuit and Métis
– Presence of more than 200 First Nation communities
– Current land base of the aboriginals is inadequate and they form a small
proportion of the population of United States

Knowledge gained
– Lack of proper education facilities, urban centres and employment
opportunities
– They consider the elders of the family of the highest authority
– They have unique creation stories that encompass elements of the natural
world, including plants and animals
– They consider the mortal world to be connected to the spirit world

Change in practice
– I will show respect to the contextual legacy of the aboriginal patients
– I will adorn the role of an active listener and display a willingness to understand
their concerns and apprehensions
– I will communicate in a manner such that their dignity and respect is
maintained
– I will recognise that cultural differences exist beyond the colour of the skin

Change in practice
– I will ask questions about their ethnicity, race, language, religion, and family
– I will involve an elder in the care giving process to understand the preferences
and demands of the patient
– I will conduct culturally sensitive assessments to reduce the likelihood
misdiagnosis

References
Bell, N. (2014). Teaching by the medicine wheel. Education Canada, 54(3).
Bissell Centre. (2016). Happy National Aboriginal Day! Retrieved from https://bissellcentre.org/blog/2016/06/20/happy-national-aboriginal-day/
Burnett, K., & Read, G. (2016). Aboriginal history: A reader.
Di Lallo, S. (2014). Prenatal care through the eyes of Canadian Aboriginal women. Nursing for women's health, 18(1), 38-46.
Di Pietro, N., & Illes, J. (2016). Closing gaps: strength-based approaches to research with Aboriginal children with neurodevelopmental disorders. Neuroethics, 9(3), 243-252.
Downey, A. (2015). Playing the Creator’s Game on God’s Day: The Controversy of Sunday Lacrosse Games in Haudenosaunee Communities, 1916-24. Journal of Canadian Studies, 49(3), 111-143.
Gerlach, A. J., Browne, A. J., & Suto, M. J. (2018). Relational approaches to fostering health equity for Indigenous children through early childhood intervention. Health Sociology Review, 27(1), 104-119.
Haque, E., & Patrick, D. (2015). Indigenous languages and the racial hierarchisation of language policy in Canada. Journal of Multilingual and Multicultural Development, 36(1), 27-41.
Hawkins, S. A., & Gillett, J. (2015). Reconstructing Aboriginal Identity and the Meaning of the Body in Blood Donation Decisions. Journal of religion and health, 54(4), 1286-1301.
Karstens-Smith, G. (2016). Native Status Question In Canada Complex, Historically-Rooted: Experts. Retrieved from https://
www.huffingtonpost.ca/2016/02/13/determining-aboriginal-status-complex-historically-rooted-experts_n_9223262.html
Lake, R. (2017). Canada’s indigenous people are still overlooked. Retrieved from https://www.economist.com/the-americas/2017/06/29/canadas-indigenous-people-are-still-overlooked
Langlois, K. A., Findlay, L. C., & Kohen, D. E. (2013). Dietary habits of Aboriginal children. Statistics Canada.
Morelli, L. (2017). 6 Things you need to know about National Aboriginal Day in Canada. Retrieved from
https://www.sbs.com.au/nitv/article/2017/06/21/6-things-you-need-know-about-national-aboriginal-day-canada
Scoffield, H. (2014). Aboriginal Well-Being In Canada: Quality Of Life Improves, But Still Struggles With Unemployment, Income. Retrieved from https://
www.huffingtonpost.ca/2012/06/26/aboriginal-quality-life-improves-employment_n_1627198.html
Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.
Waldram, J. B. (2014). Healing history? Aboriginal healing, historical trauma, and personal responsibility. Transcultural Psychiatry, 51(3), 370-386.