RRITH Week 4 - Lecture 4: working with Aboriginal and Torres Strait Islander communities

- individual sense of identity, rather than communal

- information given is specific

- emphasis on verbal communication

- time specific

What are some of the defining features of a low context society?

- collectivism, rather than individual sense of identity

- indirect and more general information

- more focused on listening than speaking

- more focus on non-verbal cues

- non time-specific

What are some of the defining features of a high context society?

- making incorrect diagnosis

- inability to gain proper consent or illusion of consent when it was not given freely

- misinformation of diagnosis and prognosis for patients

- patient feeling marginalised

- avoidance behaviours arise for patients

- disagreements

What are some of the negative outcomes of miscommunication for a doctor trying to treat patients?

- traditional Language

- creole (blending of traditional language and English)

- English

What are some of the language proficiencies that may be present in ATSI communities?

- higher para-linguistic focus

- head movements, eye moevements, posture and positioning an integral part of communication

What are some differences in communication for ATSI communities, compared to western culture?

- Follow the locals behaviour ie. if they engage eye contact it may be fine for you to.

- Generally be wary of using too much eye contact as it can be seen as rude

- Eye contact rules vary, so be mindful of local practices

- Having conversations at an angle with a person may be preferable to face-to-face

What might be a good approach regarding eye contact in a new environment with Aboriginal culture?

- be mindful of local norms, such as elders speaking first

- accept silences may be a normal part of interacting and shouldn't always cause unease

- silence from patients can be due to shyness and feeling out of place

- be mindful patients may be silent despite severe pain or other symptoms

What are some things to keep in mind regarding silence in ATSI cultures?

- where you are from

- who you are related to

What are some topics/information often covered in introductions in ATSI cultures?

these may determine:

- who people can marry

- who people need to avoid

- who people can share resources with

- who people have authority over

What are some of the things determined by skin groups?

- may affect two patients in the facilty

- may affect a worker and a patient

- people may not be able to be in the same room or say each others name

- effects can be subtle

What are some of the clinical implications of skin groups?

In-laws may avoid each other or not use each other's name

What is the relationship between in-laws often in TI cultures?

- avoid saying names in some Aboriginal cultures and even changing the name if it is the same as the deceased person

- openly use name in honour of the person in TI culture

What are typical practices around using deceased people's names?

People who feel vulnerable may agree or say "yes" simply to avoid conflict and not because they actually agree. It is important to look out for subtleties in body language, tone, etc.

What are some things to consider when gaining consent or affirming agreement or understanding?

- introducing self and naming place of origin

- acknowledging you are a visitor

- finding common ground (family, sports, fishing, whatever)

What are some useful strategies in a new environment with an Aboriginal and or Torres Strait Islander culture?

- Lay language over medical terminology

- Utilise local Aboriginal Health Workers expertise to communicate

- Learning a few words of language or creole shows a sign of respect

What kind of language is best used with ATSI populations?

- honeymoon

- disenchantment

- beginning resolution

- effective functioning

- reverse culture shock

(not always all present and happening linear)

What are the 5 phases of culture shock?