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What does the “third space” mean to you as a health professional?. Eileen Tan Lisa Molony Kate Brazzale. Introduction. Who we are What is our topic Ask the focus questions. Importance of identity. Quote here? What is identity Why is it important?. Culture shock. What is it?

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what does the third space mean to you as a health professional

What does the “third space” mean to you as a health professional?

Eileen Tan

Lisa Molony

Kate Brazzale

introduction
Introduction
  • Who we are
  • What is our topic
  • Ask the focus questions
importance of identity
Importance of identity
  • Quote here?
  • What is identity
  • Why is it important?
culture shock
Culture shock
  • What is it?
  • What are the implications?
aboriginal terms of reference
Aboriginal terms of reference
  • What is it?
  • What are Aboriginal values?
  • ACTIVITY AND CASE STUDY
  • Define the ‘third space’ from the activity
how third space to the health industry
How third space to the health industry?
  • “WA Health Is dedicated to working with the Australian Department of Health and Aboriginal communities in building new partnership for services provided; developing culturally appropriate Health services and providing safe, high equality and accountable Health service to the Aboriginal community” (Health Reform Implementation taskforce, 2007).
  • Indigenous and Health professions has a variety of differences that are met and respected together as one.
    • Cultural belief
    • Views and Values
    • Expectations
    • Traditions
    • Historical factors
    • Family structure
how third space applies to the health industry
How third space applies to the health industry?
  • It is the space for the four dimensions to be met between the Aboriginal and non- aboriginal domain.
    • Experiences
      • Concentrates on the experience of Aboriginals in relation to the issue under discussion.
    • Aspiration
      • Concentrates on what the critical reference group wants to achieve in relation to the issue.
    • Understanding
      • Focuses on the persons understanding of the issue; as well as judging if further explanation is needed.
    • Cultural element
      • It draws on cultural differences and traditions which includes current culture practices.
challenges for health professionals
Challenges for health professionals
  • Communicating among the aboriginals
  • Understanding their traditions and beliefs
  • Traditional healing where some professions might disagree on
  • Not being able to achieve the outcome until a certain level of trust has been created
  • Obtaining informed consent for treatment
  • Explaining diagnosis and treatment to patients
health professions and aboriginal may clash in a health environment
health professions and aboriginal may clash in a health environment
  • Communication and language issues
  • Poor cultural understanding
  • Racism and prejudice
  • Values and beliefs
  • Mistrust of the system
operating within the third space
Operating within the third space

Advantages

Disadvantages

  • Access to higher quality services
  • Culturally secure services that will improve health outcome for Aboriginal people
  • Improve customer satisfaction
  • Provide opportunity to improve the broader determinants of health
aboriginal health statistics
Aboriginal Health Statistics

Life expectancies of Indigenous versus Non-Indigenous Males and Females.

  • On average
    • Indigenous Men die 11 years earlier then Non- Indigenous Males
    • Indigenous Females die 9 years earlier then Non-Indigenous Females.

Data from the Australian Bureau of Statistics 2005-2007 data surveys.

aboriginal health statistics3
Aboriginal Health Statistics

Selected Chronic Conditions: Ratio of Indigenous Australian’s to Non-Indigenous Australians — 2004–05

aboriginal health statistics4
Aboriginal Health Statistics
  • Diabetes Comparison between Indigenous and Non Indigenous 2005
  • Cardiovascular Comparison between Indigenous and Non Indigenous 2005
implications for health professionals
Implications for Health Professionals
  • Third Space
    • “A place where Indigenous and Non-Indigenous people can come and work together without fear of prejudice from ‘baggage’.”
    • An area of mutual respect between Indigenous and Non-Indigenous people where they can work collaboratively.
  • Health Professionals need
    • Knowledge.
      • Of where the other comes from; their “space”
    • Understanding
      • Of roles and responsibilities
    • Empathy
      • Towards both sides
    • Willingness to be open
      • Accepting of differences
    • Avoid stereotyping
implications for health professionals1
Implications for Health Professionals
  • Aboriginal and Torres Strait Islanders are not the same.
  • Discontinue use of out-dated, derogatory terminology.
    • Half-caste, full-blood, quadroon, etc.
    • Always use the terms Aboriginal Man/Woman/People or Torres Strait Islander Man/Woman/People.
  • Aboriginal people mistrust people who offer services related to “protection” and “intervention.
    • European colonisation.
    • Government Policies post colonisation.
    • The “Stolen Generation”. Government policy til 1969.
      • “Keep your word.”
    • Changes made.
      • e.g. Kevin Rudd’s “Apology”.

NSW Department of Community Services 2009 & National Disability Services WA 2009

implications for health professionals2
Implications for Health Professionals
  • Sensitive issues due to past Government policies have contributed to:
      • Dispossession of land
      • Family fragmentation
      • Mental health issues
      • Social and emotional wellbeing issues
      • Grief and loss issues
        • Self-harm and intentional injury
        • Over-representation of Suicide rates
        • Family and domestic violence issues
        • Loss of country
        • Loss of identity
      • Poverty
      • Racism
      • Unemployment
      • Poor health outcomes
      • Poor education outcomes
      • Below standard literacy and numeracy rates
      • Alcohol and substance abuse/misuse
      • Over-representation in the juvenile and criminal justice system

NSW Department of Community Services 2009 & National Disability Services WA 2009

implications for health professionals3
Implications for Health Professionals
  • Respect
    • Elders,
    • The Land,
    • Animals,
    • Ancestors.
    • “Sorry Business”
  • Kinship
    • Defines roles and responsibilities within the family.
    • Ensure that extended family is included in important meetings or when making decisions.
  • Gender responsibilities.
    • Men’s Business – issues which have a male perspective within aboriginal culture.
    • Women’s Business – issues which have a female perspective within aboriginal culture.

NSW Department of Community Services 2009 & National Disability Services WA 2009

implications for health professionals4
Implications for Health Professionals
  • Language
    • Originally 300 nations speaking 250 languages with up to 600 dialects.
    • Nonverbal cues
      • Eye contact.
      • Hand and facial gestures.
      • Silence
      • Progression of Conversation.
    • Semantic Ambiguity
    • Swearing
  • Communication Techniques
    • Use uncomplicated language, Not “jargon”.
    • Be wary of comprehension

NSW Department of Community Services 2009 & National Disability Services WA 2009

close the gap campaign
Close the Gap Campaign
  • Australia’s largest Campaign to improve Indigenous Health.
    • Aimed at reduced the Life Expectancy Gap between Indigenous and Non Indigenous Australians to 0 years by 2031.
  • OXFAM is campaigning to:
    • Increase Aboriginal and Torres Strait Islanders’ access to health services
    • Address critical social issues such as poor housing, nutrition, employment and education
    • Build Indigenous control and participation in the delivery of health and other services
    • Get governments at state and national level to work in partnership with Indigenous communities, health organisations and experts to develop and monitor a plan to tackle the Indigenous health crisis
    • Promote real and meaningful partnerships between Indigenous

COAG, 2011 and OXFAM 2006

need for education
Need for Education
  • To understand the needs of our Aboriginal or Torres Strait Islander Patients
    • The majority of Aboriginal people access health care from Non-Aboriginal services.
  • Downing and Kowal 2011
    • Majority of Nurses interviewed felt that didn’t receive enough cultural training to look after Aboriginal and Torres Strait Islander patients
    • They felt that they weren't giving them the level of care the needed and deserved.
  • Canada’s Approach
    • Kilpatrick, 2004
      • Looked at the need for Aboriginal Education.