NURSING Assignment: Rheumatic Heart Disease and Cultural Awareness

This nursing assignment explores rheumatic heart disease (RHD), focusing on a case study of a patient named Shakira, and delves into the social determinants of health that make her vulnerable, such as social exclusion and lower education. The assignment covers the standard treatment for RHD, cultural awareness and sensitivity, and relevant legislation like the Aboriginal and Torres Strait Islander Act 2005. It emphasizes the importance of community participation, culturally and linguistically diverse staff, and effective communication strategies when interacting with Indigenous patients and their families. The document also examines potential biases and challenges in healthcare settings, offering insights into providing patient-centered care. The assignment highlights the need for understanding cultural beliefs, addressing language barriers, and creating a supportive environment for Indigenous patients, ensuring they receive appropriate and effective healthcare.

1Running head: NURSING
Nursing
Name of student:
Name of university:
Author note:

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1.
Rheumatic heart disease (RHD) is the condition in which the individual suffers
damage to the heart valves after an episode of acute rhematic fever (ARF). The condition is
caused by episode or recurrent episode of ARF due to which inflammation occurs in the
heart, impairing normal blood flow through the damaged valves. If left untreated, RHD leads
to heart failure, stroke and endocarditis (Stewart, 2016). Two important social determinants
of health that might have been responsibe for making Shakira more vulnerable to RHD are
social exclusion and a lower rate of education. Being socially excluded and living in the
remote rural community has been the cause of insufficient access to healthcare for Shakira. In
addition, a lower rate of education restricts the care giving approach of parents from the
indigenous community. The decision making around care for Shakira demonstrated by her
family had been guided by low education is a negative manner (Watkins et al., 2017).
Standard treatment for RHD is antibiotics for infection and blood thinning medicines.
Chances of aboriginal population to suffer rheumatic heart disease is 64 times more than non-
Aboriginal population (rhdaustralia.org.au, 2017).
2.
a. Cultural awareness involves the ability of the nurse to become aware of the cultural
perceptions, beliefs and values of the patient that is different from his own. Cultural
awareness is central to interaction carried out with people from other cultures. A nurse is to
respect the patient’s cultural values and beliefs of Shakira whilecommunciating with her.
b. Cultural sensitivity is the understanding of a nurse about the cultural similarities and
differences between people without conferring them a value- right or wrong, positive or

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negative. When Shakira puts forward her perceptions in relation to cultural beliefs, the nurse
must not undermine it (Black, 2016).
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3.1 The Aboriginal and Torres Strait Islander Act 2005 concerns self-reliance and self-
government of Aboriginal and Torres Strait Islander population. The aim of the Act it
focused on developing the cultural and economic condition of this population. The Act
institutes the Torres Strait Regional Authority (TSRA), the Indigenous Land Corporation and
a corporation called Indigenous Business Australia that formulate and implement programs
for the betterment of the population.
3.2 Aboriginal and Torres Strait Islander people are known to suffer from shortened life
expectancy and significant health concerns as compared to their counterparts. The underlying
cause of this is the historical disturbance and suffering associated with the bequest of
colonisation that have led to many unresolved issues from different domains such as poor
economic development, self-determination and identity and land rights. As a result of the
trauma of colonisation, these people suffer loss, powerlessness, grief and sense of
hopelessness and disconnection (Andersen et al., 2017).
4.
b. Community participation in decision making for indigenous population is a key approach
to be taken by a nurse for improving communication and building rapport with the patient.
Delivery of care to this population with advanced healthcare models undermines the
indigenous individual’s preferences for their treatment. Their own values and health beliefs

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are a reflection of their care practices that might not be aligned with those of non-indigenous
population. Giving a chance to the patients to put forward their ideas and preferences for care
plan fosters a trusting and credulous relationship between the patient and the care giver
(Cherry & Jacob, 2016).
5.
For communicating with Shakira and her family, it is imperative to acknowledge the
cultural beliefs and perceptions about treatment for a chronic disease such as RHD. Being
sensitive to the cultural differences holds much importance. Any differences between the
traditional treatment options and modernised concepts are to be explained to them that there
are chances of conflicts. In addition, the language barrier between the nurse and patient and
her family is to be addressed. In case they are not conversant with English, an interpreter
would be helpful in two-way exchange of information (Giger, 2016).
6.
a. Ensuring culturally and linguistically diverse staff is maintained in the healthcare
organisation would be beneficial for Shakira and her family as they would feel secure
accessing care services. The diverse staff would be better able to establish an effective strong
relationship with the patient as they might be upholding the same social and cultural beliefs
influencing healthcare (Truong et al., 2014).
7.
a.I understand that the indigenous Australian history and culture shapes their interaction with
non-indigenous society. The culture places them in a position that isolates and excluded them
from the mainstream population. The orthodox beliefs and staunch traditions are often not

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accepted by the non-indigenous population, leading to discrimination and prejudice exhibited
towards this group. While the non-indigenous lives mostly in urban areas, the indigenous
population live in remote rural areas. As a result of locational isolation, the interaction
between the two population is restricted (Duckett & Willcox, 2015).
8.
b.
• ‘Denial’ of suggestions that there is a problem- A healthcare professional might be
denying that the indigenous patient is faced with health complications and other challenges,
compelling the patient to think that the denial is due to cultural differences
• Low utilization of available services-An indigenous patient might not be presented with
comprehensive services, and the utilisation might not be optimal (Douglas et al., 2014).

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References
Andersen, C., Edwards, A., & Wolfe, B. (2017). Finding Space and Place: Using Narrative
and Imagery to Support Successful Outcomes for Aboriginal and Torres Strait
Islander People in Enabling Programs. The Australian Journal of Indigenous
Education, 46(1), 1-11.
Black, B. (2016). Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health
Sciences.
Burden of Disease. (2017). Rheumatic Heart Disease Australia. Retrieved 19 October 2017,
from https://www.rhdaustralia.org.au/burden-disease
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences.
Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M.,
Lauderdale, J., ... & Purnell, L. (2014). Guidelines for implementing culturally
competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford
University Press.
Giger, J. N. (2016). Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier
Health Sciences.
Stewart, S., Carrington, M. J., & Sliwa, K. (2016). Rheumatic heart disease. The Heart of
Africa: Clinical Profile of an Evolving Burden of Heart Disease in Africa, 121-135.

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Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency
in healthcare: a systematic review of reviews. BMC health services research, 14(1),
99.
Watkins, D. A., Johnson, C. O., Colquhoun, S. M., Karthikeyan, G., Beaton, A., Bukhman,
G., ... & Nascimento, B. R. (2017). Global, regional, and national burden of
rheumatic heart disease, 1990–2015. New England Journal of Medicine, 377(8), 713-
722.