Clarifying Cultural Safety: its focus and intent in an Australian context

Cox, Leonie; Best, Odette

doi:10.1080/10376178.2022.2051572

Cited by 9 publications

(3 citation statements)

References 30 publications

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“…While it can be argued that it is both impossible and culturally unsafe to teach “competency” in other peoples’ cultures, cultural safety training education that focuses on the history, current social circumstances and matters of power and dominance such as racism, should be provided ( Cox et al, 2021 ). Education needs to be actioned by having structural resourcing and support for ongoing cultural safety critically reflective practice on clinical encounters and their outcomes by staff and services ( Cox & Best, 2022 ). This is supported by the Australia Government (2019 , p. 5), which states, “Cultural safety must become embedded across health services, particularly within the mainstream sector.” It is crucial, therefore, that those providing LTC services for Indigenous and First Nations peoples, are knowledgeable about historical and contemporary institutionalized racism, traumatic relationships, and treatments at the hands of health and all government services.…”

Section: Discussionmentioning

confidence: 99%

Elements of Long-Term Care That Promote Quality of Life for Indigenous and First Nations Peoples: A Mixed Methods Systematic Review

et al. 2022

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Background and Objectives Little is known about elements of long-term care (LTC) that promote quality of life (QoL) for older Indigenous and First Nations peoples. This systematic review aimed to extend understanding of those deemed most important. Research Design and Methods Following PRISMA guidelines, systematic database and hand-searching were used to find published and unpublished qualitative studies and textual reports. A convergent integrated approach was used to synthesize data, according to the Joanna Briggs Institute methodology for mixed methods systematic reviews. Results Included papers (11 qualitative; 7 reports) explored views and experiences of Indigenous residents, families, and LTC staff from North America (8), South Africa (1), Norway (1), New Zealand (1), and Australia (7). Elements of care included: i) co-designing and collaborating with Indigenous and First Nations communities and organizations to promote culturally safe care; ii) embedding trauma-informed care policies and practices, and staff training to deliver culturally safe services; iii) being respectful of individual needs, and upholding cultural, spiritual and religious beliefs, traditional activities and practices; iv) promoting connection to culture and sense of belonging through sustained connection with family, kin and Indigenous and First Nations communities. Discussion and Implications This review identifies elements or models of care that promote QoL for Indigenous and First Nations peoples in LTC. While included papers were mostly from the United States and Australia, the congruence of elements promoting QoL was evident across all population groups. Findings may be used to inform standards specific to the care of Indigenous and First Nations peoples.

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Section: Discussionmentioning

confidence: 99%

Elements of Long-Term Care That Promote Quality of Life for Indigenous and First Nations Peoples: A Mixed Methods Systematic Review

et al. 2022

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“…Cultural safety is “defined by the patient and their communities, and … measured through progress towards achieving health equity” (Curtis et al., 2019, p. 14). It is described as a set of behaviours that reflect practice that is rooted in acknowledging and analysing inherent power differentials, engaging in critical self‐reflection, and being accountable for culturally safe care (Cox & Best, 2022; Curtis et al., 2019). Kawa Whakaruruhau (Ramsden, 1990) was an Indigenous concept specifically to create culturally safe spaces for Māori nurses to practice, as determined by Māori nurses, for the betterment of Māori (Papps & Ramsden, 1996).…”

Section: Introductionmentioning

confidence: 99%

An integrative review of racism in nursing to inform anti‐racist nursing praxis in Aotearoa New Zealand

Wiapo,

Adams,

Komene

et al. 2024

Journal of Clinical Nursing

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AimTo synthesise international literature to identify mechanisms that maintain racism in nursing and understand the factors that contribute to designing and implementing anti‐racist praxis to inform nursing in Aotearoa New Zealand.DesignAn integrative literature review was undertaken, integrating Indigenous Kaupapa Māori methodologies to ensure a cultural and philosophical lens.MethodsPeer‐reviewed literature published, between January 2011 and July 2023 were sourced. Of 1296 articles, 16 met the inclusion criteria and 4 were identified via citation chaining. In total, 20 articles were included. The Johns Hopkins Research Evidence Tool was applied, findings extracted, and thematic analysis completed utilising Indigenous Kaupapa Māori principles.Data SourcesDatabases, including CINAHL, Scopus, PubMed and Aus/NZ Reference Centre, were searched in July 2023.ResultsTwo key themes were identified: (1) colonial active resistance to change; and (2) transformational, visionary, and proactive nursing.ConclusionNurses are well‐positioned to confront the structures that maintain racism in health and education systems but are often actors in maintaining status quo. Anti‐racist praxis can be a mechanism for nurses to reimagine, redefine and transform nursing care, leadership, and nursing education to begin to eradicate racism.Reporting MethodThis integrative review adhered to the 2020 Preferred Reporting for Systematic Reviews and Meta‐Analyses (PRISMA) method.Patient or Public ContributionNo patient or public contribution.Implications for the ProfessionRacism remains prevalent in nursing and the healthcare system. It is necessary to implement anti‐racist praxis and policies that resist, deconstruct, and dismantle power and racism while validating Indigenous values, beliefs and practices. This is vital to deliver equitable health care.ImpactThis integrative review presents lived realities and knowledge of Indigenous and racially minoritised nurses and scholars, alongside nursing allies to inform anti‐racist praxis. This evidence signifies that it is time to walk the walk to challenge the colonising systems and processes that hold racism in place.

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“…sThe culturally safe service provider understands the impacts of colonisation on health and socioeconomic outcomes and realises the role white privilege plays in maintaining this status quo (Tujague & Ryan, 2021). Finally, culturally safe service provision is approached with a focus on family strengths, wisdom, and resilience (Cox & Best, 2022).…”

Section: Introductionmentioning

confidence: 99%

Occupational therapists' practice with complex trauma: A profile

Mason

Stagnitti

2022

Aus Occup Therapy J

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Introduction Many children in Aotearoa (New Zealand) and Australia experience complex trauma and its developmental impacts. Internationally, occupational therapists work with complex trauma and use sensory‐based, integrative, and functional approaches. The practices of occupational therapists in Aotearoa and Australia with children experiencing complex trauma have not previously been described. Methods This article reports the quantitative results of a mixed‐methods study which profiled occupational therapists' practice in Aotearoa and Australia with children aged 0 to 12 years old who experienced complex trauma. Twenty‐five participants completed the survey. The average age of participants was 43 years (SD = 10.65), all were female (n = 25), and most identified as New Zealand European (n = 11) or Australian European (n = 9). A survey was distributed via Occupational Therapy New Zealand – Whakaora Ngangahau Aotearoa and Occupational Therapy Australia. Results The majority of participants had a bachelor's degree (64%) and worked in community settings (76%). Fourteen participants (56%) used sensory approaches. The most common assessments used were those of sensory processing (n = 12, 48%) and observation (n = 12, 48%). The Sensory Profile was the most popular standardised assessment (n = 8, 32%). The most common interventions used with children experiencing complex trauma were sensory (n = 13, 52%) and play based (n = 13, 52%). Most participants reported not adapting their practices for Māori or Aboriginal children. Most participants felt somewhat prepared (n = 15) for working with complex trauma, with most reporting a lack of experience in this area (n = 10). Supervision was suggested by 92% (n = 23) of the participants. Conclusion Sensory‐based practices were most common among occupational therapists in Aotearoa and Australia who worked with children experiencing complex trauma. The participants suggested supervision, social support, and practical training when working with complex trauma. Advocacy and research are required within this subspecialty, and further professional engagement in the application of culturally safe practice.

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Clarifying Cultural Safety: its focus and intent in an Australian context

Cited by 9 publications

References 30 publications

Elements of Long-Term Care That Promote Quality of Life for Indigenous and First Nations Peoples: A Mixed Methods Systematic Review

Elements of Long-Term Care That Promote Quality of Life for Indigenous and First Nations Peoples: A Mixed Methods Systematic Review

An integrative review of racism in nursing to inform anti‐racist nursing praxis in Aotearoa New Zealand

Occupational therapists' practice with complex trauma: A profile

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