The concept of cultural safety has been developed in the context of “First Nations” and is considered to be the preferred term for the midwifery and nursing. It is endorsed by the legislative body of the Aboriginal and Torres Strait Islander Nurses and Midwives, who have been emphasising that the cultural safety should be considered as important to quality care as the clinical safety (Brooks-Cleator, Phillipps & Giles 2018). According to Cox’s video, Cultural safety can be defined as a philosophy of practice that is not an individual term but a systemic and institutional regime of providing care irrespective of any differences. In relation to the health of the people belonging to the Aboriginal community, cultural safety offers a decolonising model of care practice that depends on the dialogue, negotiation, communication, and power sharing. However, these actions are the ways to challenge the racism at the personal as well as institutional levels, along with establishing the trust in the healthcare encounters. Cultural safety in clinical practice entails that the patients from Aboriginal community feel safe, in their interactions with the healthcare professionals, to articulate their requirements and preferences as being the partners in care and not just as the recipients of care (Cox, 2017). Patients also feel safe to comment on services they have perceived or experienced negatively and to participate in change processes. More explicitly, the healthcare professionals are support to expand a rational understanding of their own cultural beliefs, identity, values, assumptions, attitudes, expectations, and perceptions and the way this affect their therapeutic relationships with Aboriginal patient (Laverty, McDermott & Calma, 2017).
Interpersonal power is considered to be a multifaceted and an extensive concept in nursing. This entails an influential impact on the achievement of duties, satisfaction and accomplishment of the professional goals. Elucidation of the concept of interpersonal power in nursing from the viewpoint of nurses along with accessing its variety of magnitudes could potentially result in to a better understanding of this matter (Sepasi et al., 2016). The interpersonal power’s impact could be positive as well as negative that is based on the way it has been enforced. It could have a negative impact on health as it may tend the nurses in seizing the opportunities to apply their skills as well as knowledge creatively because of which the best patient outcome that could be achieved may get varied. On the other hand, if focusing on the bright side then, an interpersonal power if directed in a right way can also help in improving the relationship between the patients and nurses. This has a positive impact on the sense of empowerment as well as on the health outcomes of the patients. The interpersonal power simply means the shared power among the staff that has the ability to do or act. It also strengthens the outer materialization of the power along with enhancing the individual motivation to expand the professional performance. This also tends to enhance the health outcome of the patients (Pietromonaco & Collins, 2017 ).
According to World Health Organization, (2019) equity in social systems could be defined as the absence of the avoidable disparities among the groups of the people, whether these groups are distinct socially, demographically, economically, or geographically. Health inequities thus engross more than disparity in terms of health determinants. They directly have impact on the access to the resources that could help in improving and maintaining the health or health outcomes of the people. The social determinants are the multifaceted conditions in which the people are born and would live that can potentially have an impact on their health. This comprises of certain intangible features such as socioeconomic, political, and cultural constructs, along with the place-based circumstances. This also entails the accessible education and healthcare systems, safe environment, elegant neighborhoods, and availability of healthy and hygienic food and water (Islam, 2019). All of them have a major impact on the health and health outcomes specifically on the vulnerable populations. They create disparities and discrimination and their impact on health has been seen as increase in premature death and shorter life expectancy. Certain stress associated to the disparities also has a direct linkage to health. The mounting evidence regarding this highlights specific negative impact on both the children as well as on the adults across the lifespan. It has been seen as chronic exposure towards the social as well as environmental stressors and allostatic load this leads to the biological wear-and-tear. These in turn result in the individuals to be at higher health risk (Islam, 2019).
The human cultural qualities are their ideas, behaviors, and skills that is generally learned from the other individuals that they are living with. This could have possibly exhibit certain complex patterns of transmission as well as evolution. Culture depends on the lifestyle and on the community with which the one is living and not in the one he is born with (Ellinas, Allan & Johansson, 2017). People acquire the behavioral traits from the other not biologically and this why it is said that culture has no biological basis(Creanza, Kolodny & Feldman, 2017). The researchers have developed certain theoretical models in regard to this, both verbal as well as mathematical, for facilitating the understanding of such patterns. There were certain quantitative models concerned with the cultural evolution. They stated that the cultural evolution was bespoke from the already obtainable notions in the theoretical population genetics. This is because the evolution of the culture has various analogues with the genetic evolution as well as apparent differences from the genetic evolution. Moreover, the cultural and biological evolution may interact with each other and can potentially control both the transmission as well as the selection. But, one can’t say that culture has biological basis with (Ellinas, Allan & Johansson, 2017). The interaction that could be between the culture and biological basis needs certain theoretical treatments with respect to the gene–culture co-evolution as well as dual inheritance. The growth, age structure, and lifestyle of the populations that is affected by the standards and beliefs of the members is the reason behind the culturally transmitted behaviors (Creanza, Kolodny & Feldman, 2017).
Brooks-Cleator, L., Phillipps, B., & Giles, A. (2018). Culturally safe health initiatives for indigenous peoples in Canada: A scoping review. Canadian Journal of Nursing Research, 50(4), 202–213. https://doi.org/10.1177/0844562118770334
Cox, L. (2017). Do politicians need cultural safety training? Dr Leonie Cox, from QUT. [Video]. YouTube. https://www.youtube.com/watch?v=-bA-UANKSmc
Creanza, N. Kolodny, O. & Feldman, M. W. (2017). Cultural evolutionary theory: How culture evolves and why it matters. Proceeding of the National Academy of Sciences of the United States of America, 114(30), 7782-7789. https://doi.org/10.1073/pnas.1620732114
Ellinas, C., Allan, N., Johansson, A. (2017) Dynamics of organizational culture: Individual beliefs vs. social conformity. PLoS ONE 12(6): e0180193. https://doi.org/10.1371/journal.pone.0180193
Islam M. M. (2019). Social determinants of health and related inequalities: Confusion and implications. Frontiers in Public Health, 7, 11. https://doi.org/10.3389/fpubh.2019.00011
Laverty, M., McDermott, D. R. & Calma, T. (2017). Embedding cultural safety in Australia’s main health care standards. The Medical Journal of Australia, 207(1), 15-16. doi: 10.5694/mja17.00328
Pietromonaco, P. R., & Collins, N. L. (2017). Interpersonal mechanisms linking close relationships to health. The American Psychologist, 72(6), 531–542. https://doi.org/10.1037/amp0000129
Sepasi, R. R., Abbaszadeh, A., Borhani, F., & Rafiei, H. (2016). Nurses' Perceptions of the Concept of Power in Nursing: A Qualitative Research. Journal of Clinical and Diagnostic Research : JCDR, 10(12), LC10–LC15. https://doi.org/10.7860/JCDR/2016/22526.8971
World Health Organization. (2019). Equity. Retrieved from https://www.who.int/healthsystems/topics/equity/en/
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