An understanding of cultural constructs can help SCNs recognise differences and qualities that may be influenced by culture, and that need to be considered when planning person-centred care.
Misunderstanding or 'cultural blindness' that overlooks cultural differences can account for inequities in access to cancer control services. Examples:
- an SCN makes assumptions about the needs of an Indigenous person affected by cancer based solely on the SCN's experience and understanding of western culture
- an SCN provides information and education that does not reflect the cultural beliefs of different groups.
Culture can be conceptualised in many ways. The following definition is just one example:
Culture is 'a system of interrelated values active enough to influence and condition perception, judgment, communication, and behaviour in a given society'.9
Culture is a dynamic construct that changes over time, through generations of life experiences. For example, the term 'Values active enough to influence...'10 has been used to emphasise how traditions may influence contemporary world views, but values and beliefs evolve and change from one generation to the next. Thus, a particular culture may honour traditional values of their predecessors but apply these in the context of the contemporary world.
Culture, health and health policy
Culture influences how people make meaning from life experiences and how they respond to situations. Culture therefore influences:
- how we view health and being healthy
- how we define illness
- how we respond to sickness.
Discuss how you define health and being healthy.
Discuss how your definitions may influence how you respond to being ill.
Health from the perspective of many Indigenous Australians means the well-being, integrity and harmony of self and all the community.11
Indigenous health policy documents define health:
'Health is not just the physical wellbeing of individuals but the social, emotional, cultural wellbeing of the whole community. This is a whole-of-life view and it also includes the cyclic concept of life-death-life’.11
The emphasis on community in this definition of health highlights the importance of 'inter-relationships between people and land, people and creator being, and between people'.11
Reflect on how Indigenous peoples' perception of health and being healthy is similar or different from your own.
Take time to ask Indigenous people how they view health and what being healthy means to them.
Consider the following statements:
'Over and over again... we heard of serious health problems being caused or exacerbated as a result of Aboriginal people and health professionals viewing common concerns in quite different ways.'12
'What was seen as compassionate and humane treatment by the hospital staff was seen as something akin to being imprisoned by the patient and her family'.13
Reflect on the effects that differing views of health and illness can have on the way Indigenous people experience health care.
Discuss implications for your practice as a cancer nurse if Indigenous peoples' perception of health and illness is different to more commonly held views in western society.
Closing the Gap' is a national campaign to reduce the inequalities between Indigenous and non-Indigenous life expectancy and general health status. Access key resources:
- Closing the Gap in Indigenous Disadvantage. Council of Australian Governments.
- Closing the Gap. Oxfam Australia.14
Identify the key elements of the Closing the Gap campaign and discuss how these elements may influence the development of cancer control programs in Australia.
Video 7: Catherine (1.13 min)
Catherine discusses the need to do a cultural self-assessment before dealing with an Aboriginal & Torres Strait Islander person.