Healthcare Assignment: Pacific Cultural Competency & Reflection

Question

Task: Healthcare Assignment Tasks:

• Describe an understanding of Pacific world view including values, beliefs and practices in relation to Pacific Peoples health and wellbeing.
• Discuss Pacific Cultural Competency and how this cultural awareness and knowledge can influence nursing practice when working with Pacific Peoples. Include how the use of a Pacific model of health can support this.
• Provide a personal reflection demonstrating your understanding of Pacific worldview, cultural awareness and Pacific Cultural Competency in nursing practice.
• Evidence based practice is to be supported by inclusion of at least 8 references.

Answer

Pacific Cultural Competency
The concept of Pacific cultural competency presented in this healthcare assignment is the ability to integrate the Pacific practices, attitudes, principles, values, and structure in delivering healthcare facilities to the clients of Pacific. This is a significant importance of Pacific cultural competency because it guides the healthcare workers to identify the health needs of the people of the Pacific region and provide them with quality services. This competency is also critical because it fosters the planning and delivery of healthcare services to the people of Pacific community (Ghiasuddin et al., 2015). Along with that, it has its importance in gaining and extracting accurate knowledge about the pacific community's culture and helps to promote health and other healthcare services.

Historical Factors about Health Concerns
The people of the Pacific community are the major contributing society of New Zealand, but even in the modern world, they are subject to a poor health conditions. They face adversities such as diabetes, a high rate of infant mortality, and other communicable infectious diseases. The historical factors responsible for the Pacific people's poor health are social, economic, and political injustice towards these people. All these injustices have led to the poor living standard of the people in the pacific community. In the year 2018, the net worth of people living in the Pacific region was the lowest in the economy of New Zealand. With a considerably low income, the people of this community are not to get access to a quality healthcare facility which is the cause of their health concerns.Their measures are being taken by the government to ensure that human rights are exercised so that the best interest of the people of the Pacific community is maintained(New Zealand Human Rights Commission, 2020). Policies such as National Language Policy have been introduced by the government of New Zealand to empower the people of the Pacific Community. There are also health and disability policies introduced by the government to deliver quality healthcare services in the Pacific community.

The pacific worldview is the study of learning the people's way of life residing in the Pacific island of New Zealand. This is included six islands Samoa, Tonga, Cook Islands, Niue, Fiji, and Tokelau(Semisi&Katavake, 2015). The Pacific worldview gives a holistic approach to study the relationship between nature and people living in these islands. There are 22 countries all together in these islands, which are included as the counties of New Zealand, and they are referred to and the Pacific. Understanding the pacific worldview is essential because it helps the healthcare givers fulfill the nursing competencies and develop a skill that is necessary for the treatment of the people living in this community.

The worldview can be used to recognize and outline the responsibilities of the registered nurses in New Zealand. With the use of the worldview, appropriate healthcare procedures can be designed for the people of the Pacific community because the worldview will allow the recognition of health needs. The people of the pacific community suffer from various kinds of diseases, and this can be recognized. The nursing practices can be enhanced, which will eventually improve the health of the Pacific community.

Health Concern
Identification and Discussion of Health Concerns of Pacific People
The first health concern that can be identified for the Pacific people is the life expectancy at birth. This is a concern because this factor determines the population of the Pacific community. Along with that, there is a wide gap between the Maori and Pacific communities due to this factor, and it has become a significant health concern of the Pacific people.Gestational diabetes is another health concern of the Pacific people because this is a widespread disease due to complications during pregnancy. This is a health concern because the Pacific community has the highest rate of people who have Gestational diabetes(Grey et al., 2021).

Along with that, there are several deaths due to a lack of proper maternal healthcare at the time of pregnancy. With no adequate healthcare, both the life of the mother and the child is at risk, which causesimmense complications during delivery.Other health concerns of the Pacific people are asthma, dental problems, and skin and ear infections. These are the major health concerns because the majority of people suffering from these diseases are children. The lack of proper healthcare services of the Pacific people has led to the growth of these diseases among children. These health concerns result from a gap in the development of the urban areas of New Zealand and the Pacific islands of New Zealand. With insufficient healthcare models in these areas, the Pacific people face significant difficulties in availing proper healthcare at the correct time.

Figure 1: Disparity in the Health Condition
Source: (Ryan et al., 2019)

Lifestyle Practice on the Health Concerns
Life expectancy at birth is the first health concern identified for the Pacific people. The worldview on this health issue is that there has been a significant improvement in the life expectancy of the people in the ethnic group. Still, the life expectancy of the Pacific people is comparatively low. The lifestyle of the people has a significant role in this health concern because the people of this community have faced significant barriers the access to midwifery care in New Zealand. Another health concern is Gestational diabetes among mothers who have experienced complications during their pregnancy. The worldview regarding this health issue is that it is caused due to the gaining of weight, which is one of the major factors that causes perinatal mortality(Koning et al., 2016). The lifestyle that gives rise to Gestational diabetes is the limitation in the physical activity of pregnant women. At the time of pregnancy, the woman cannot indulge herself in many physical and heavy work. This results in the change in her dietary patterns, and this causes them to become obese most of the time. Other health issues such as asthma, dental problems, and skin and ear infection are interrelated and most common among the children of the Pacific community. This is because when a child has asthma, he is liable to have oral problems such as gum disease. All these diseases have resulted from the lifestyle of people living in the Pacific region as they live in poverty and overcrowded places. These poor living conditions are liable to give rise to such diseases among the children without any proper healthcare facility.

Identification and Discussion of Current Health Resources
The first healthcare programmer that can be identified is the Well Child/TamarikoOra (WCTO), under which the government of New Zealand provided free healthcare services to children from birth till the age of 5. The program was introduced with the rising concern of low life expectancy at birth and Gestational diabetes among the mothers who had just given birth. There were several healthcare activities carried out under this program to improve the health of the children. This program was a success because, through this program, 70% of children in the Pacific community are fully immunizedby the age of 6 months.This has ensured the children of the Pacific community do not come in contact with life-threatening diseases in the future. Another program that has been identified is the ManaKidzProgramme, and under this program, the government has focused on providing clinical advice and support in the schools. Through this program, the government was aiming at the spreading of awareness regarding different harmful diseases among children and how they can cure them.

This program was launched because it was essential to teach the students and their parents the importance of hygiene so that skin diseases among children can be prevented. Through this program, around 34,000 children could be treated, and this program covered all the essential areas of health related to children. However, this program had a drawback because the clinical support and advice were given in the school, and the children at the end of the day had to go back to the poor and overcrowded areas. This reduced the effectiveness of the program because once the children went back to their homes; there were chances that they could come in contact with infectious diseases(Horwood et al., 2019). Therefore, this program had a significant impact on the health of children, but at the same time, the program was not free of drawbacks and limitations. These were the resources used by the government to address the health issue of the Pacific community.

Personal Reflection
Level of Understanding and Awareness
At the beginning of the course, I only had the basic knowledge regarding the Pacific culture competency.This understanding and awareness were gathered from reading articles, journals, websites, and news. There wasmuch information regarding the Pacific culture community that could be collected and extracted. Through this information collected, I was aware that cultural competency was the potential and capability of the healthcare system to impart service that improves the health of the people and, along with that, also ensures the wellbeing of the people(Gopalkrishnan, 2019). Along with that, I was also aware of the concept which stated that there is no single universally accepted definition of cultural competency. Every single individual has their own idea and opinion regarding cultural competency. This makes it evident that before taking up the course, I hadlittle information regarding cultural competency in the healthcare system. According to my previous knowledge, I knew that Pacific cultural competency was a complex study related to the healthcare needs of the people in the Pacific community. Along with that, I haveknowledge regarding the different islands that constitutedthe Pacific community and the lifestyle of the people living in that area.There are many interesting aspects regarding the study of people and their health in the Pacific community, and this motivated me to take the Pacific Health and Wellness course.

Current Knowledge
I have been able to gain much new knowledge and information regarding Pacific cultural competencythrough the Pacific Health and Wellness course. Before taking up the course, I was only focused on the understanding of the culture and the lifestyle of the Pacific people. However, after taking up the course, I realized the there are more than the only culture and lifestyles of the people that need to be considered to understand the cultural competency of the healthcare system in the Pacific community. Along with that, I learned about the different health conditions of the people living in the Pacific community and what are the factors that determinethese health conditions of people. Along with that, the political and socio-economy factors also need to be considered so that cultural competency can be understood more appropriately(Suk et al., 2018). My previous perspective regarding the Pacific culturalcompetency has been changed to some extent due to these reasons.Along with that, the course has helped me to explore new ideas regarding Pacific cultural competency, such as the determinants of their health, factors affecting child health. These were not the only new factors, but I also learned about different resources used by the government to bridge the gap between the Pacific community and other communities of New Zealand. This is because there is a wide gap that bars the people of the Pacific community from getting proper health care facilities.

Incorporation of New Learning
The learning that I have gained through this course will help me to practice as a registered nurse in New Zealand. This is because I have learned about Pacific health and the cultural competency that can be implied in my practice. I have also gained and developed analytical and assessing skills that will help me to analyze the health of the Pacific people. All my learning can be implemented practically to assess the healthcare needs of the people in the Pacific community. The strategy that I will be using to incorporate learning is the establishment of SMART goals because this will help me to structure my activities and what I need to do to incorporate my new learning. The second strategy is to develop and grow my skills and capabilities, which will help me to create new opportunities in the future. With these incorporation ideas, I can use my new learning to provide quality healthcare facilities and also ensure the wellbeing of society.

References
Ghiasuddin, A., Wong, J., &Siu, A. (2015). Ethnicity, traditional healing practices, and attitudes towards complementary medicine of a pediatric oncology population receiving healing touch in Hawaii. Asia-Pacific Journal of Oncology Nursing, 2(4), 227. https://doi.org/10.4103/2347-5625.158015

Gopalkrishnan, N. (2019). Cultural Competence and Beyond: Working Across Cultures in Culturally Dynamic Partnerships. The International Journal of Community and Social Development, 1(1), 28–41. https://doi.org/10.1177/2516602619826712 Grey, C., Ryan, D., &Talemaitoga, A. (2021).BULA SAUTU. https://www.hqsc.govt.nz/assets/Health-Quality-Evaluation/PR/BulaSautu_WEB.pdf

Horwood, P. F., Tarantola, A., Goarant, C., Matsui, M., Klement, E., Umezaki, M., Navarro, S., & Greenhill, A. R. (2019). Health Challenges of the Pacific Region: Insights From History, Geography, Social Determinants, Genetics, and the Microbiome. Frontiers in Immunology, 10. https://doi.org/10.3389/fimmu.2019.02184

Koning, S. H., Lutgers, H. L., Hoogenberg, K., & Berg, P. P. van den. (2016). (PDF) Gestational Diabetes Mellitus:current knowledge and unmet needs. ResearchGate. https://www.researchgate.net/publication/301698063_Gestational_Diabetes_ Mellituscurrent_knowledge_and_unmet_needs

New Zealand Human Rights Commission. (2020). Talanoa: Human rights issues for Pacific peoples in Aotearoa New Zealand Talanoa: Human rights issues for Pacific peoples in Aotearoa New Zealand 2. https://www.hrc.co.nz/files/6316/0695/6263/Talanoa_-_Human_rights_issues_for_Pacific_people_in_Aotearoa_New_Zealand.pdf

Ryan, D., Grey, C., &Mischewski, B. (2019).TofaSaili: A review of evidence about health equity for Pacific Peoples in New Zealand.
https://www.nzdoctor.co.nz/sites/default/files/2019-09/Tofa%20Saili-%20A%20review%20of%20evidence%20about%20health%20equity% 20for%20Pacific%20Peoples%20in%20New%20Zealand.pdf

Semisi, F., &Katavake, P. (2015).Their worldview and ours: an explanatory study into Pacific peoples, as seen in New Zealand government policies, 1998-2013. https://openrepository.aut.ac.nz/bitstream/handle/10292/9135/Katavake-McGrathFSP.pdf?sequence=3&isAllowed=y

Suk, M. H., Oh, W.-O., &Im, Y. (2018). Factors affecting the cultural competence of visiting nurses for rural multicultural family support in South Korea. BMC Nursing, 17(1). https://doi.org/10.1186/s12912-017-0269-4