15 th Annual Conference of the Union North America Region

Transcription

1 15 th Annual Conference of the Union North America Region The Following course faculty members have indicated that they have mot had any financial arrangements or affiliations with Commercial sponsors which have direct interest in the subject matter. Nursing Assembly: Ms. April MacNaughton Ms. Andrea Warman Ms. Shawna Buchholz Ms. Avril Beckon Ms. Karen Martinek Mr. Jerry Cyr Ms. Kim Field Ms. Linda Thomas Ms. Constance Robertson

2 IUATLD, Vancouver 2011 Presenters: Shawna Buchholz, RN, BSN, MPH, BC Centre for Disease Control April MacNaughton, RN, BSN, First Nations & Inuit Health

3 1. Provide nurses with an overview of incorporating and utilizing i "story telling" " and narratives for teaching health promotion in Aboriginal communities. 2. Nurses will understand how historical perspectives p on TB control measures have impacted on today's TB program design. 3. To understand the role of culture in the care of 3. To understand the role of culture in the care of individuals with TB.

4 TB and Aboriginal Populations of BC TB Programming: current situation & challenges Engaging the Community Culture in the context of TB care Culture and storytelling for TB Awareness Resource video Tuberculosis: The Timeless Disease Lessons learned Conclusions

5 The Canadian Constitution recognizes three groups of Aboriginal people, the Indian, Inuit and Métis peoples of Canada. These are three separate peoples with unique histories, languages, cultural practices and spiritual beliefs. The term First Nations has evolved through the political process and refers to Status Indian peoples of Canada. Source: Indian and Northern Affairs Canada inac.gc.ca/ap/tln eng.asp

6 Total Aboriginal Population at 2006 was 196, Indian Bands in BC The youngest and fastest growing population in Canada

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8 25 Canadian-born Aboriginal Foreign-Born 20 Non-Aboriginal Proportio on Age group

9 TB Services for Aboriginal i Communities (TBSAC): The BC Centre for Disease Control (BCCDC) partners with First Nations and Inuit Health (FNIH) and First Nations communities to provide TB care for all on reserve Aboriginal populations of BC. Centralized Program: Services include screenings, diagnosis, treatment, consultation by physicians/nurses, pharmacy, lab, education & resources, x ray. Emphasis on those communities deemed at higher risk, criteria being 1 infectious case of TB in the past 5 years. Provide enhanced surveillance for these communities.

10 When examining current TB programming, we ask: To what extent are current community screening activities t occurring? Are Nurses and communities actively participating in the program? What are the key elements to implementing and providing an Aboriginal TB program?

11 Identified d gaps in local l TB programs: Low screening uptake, (0 to 80% range) Limited roles and responsibilities for other Community Healthcare Workers Limited community involvement Minimal knowledge of the role of culture in TB health care

12 1. Community Engagement Nurses note very little community participation in scheduled TB programming. 2. Team Approach to TB Programming TB programming delivered by nurses in isolation, very little participation of local Community Health Workers. 3. An Understanding of the Historical Impacts of TB Gaps in knowledge of historical impacts of TB in Aboriginal communities.

13 To understand TB in the community context, nurses need to learn about how it has impacted individuals, families...all integral parts of community. Building trust relationships with Community Healthcare Workers and community members > personal meaning > understanding of why community engagement is important. Community needs to participate and help guide nurses in the development and implementation of the TB program.

14 Setting the Stage for Community Engagement: Where to Start Need to go back to the beginning: Role of culture what do people currently believe and know about TB? How history impacts current programming How to incorporate traditional i learning

15 Community Engagement Process Building a dialogue about TB. Engagement must be thought of as a process that evolves over time.

16 TB historically decimated a large proportion of Indigenous peoples in BC and across Canada. With this tragedy came distinct perceptions, attitudes and beliefs about TB. The age of sanatoriums also brought separation from family and community. Historically, people had limited control and knowledge of TB and treatments. Limited knowledge led to fear, stigma and distrust of health care system and medical model used at that time.

17 Cultural norms may influence our perception of health and illness, and may also impact the following aspects of our decision to seek care: When to seek care Where to seek care From whom to seek care *Source: Cultural Competency and Tuberculosis Care; A guide for self study and self assessment. The New Jersey Medical School Global Tuberculosis Institute.

18 Knowledge Transfer in Community Aboriginal communities share extensive kinship ties, history, cultures, values, attitudes and beliefs. Each is connected and interdependent on the other. THIS facilitates information transfer, attitudinal change, behavior, awareness and/or compliance. People influence the direction and continuity of your health h care program * Source: Priyadarshini S. Bokil Engaging. Mobilizing and sustaining community involvement in health care. Evidence based strategies of synergizing interventionists and stakeholders with special reference to infectious diseases

19 Knowledge Transfer in Community Once people get involved in an intervention activity, they are more likely to engage with the health care activity, including reducing risk behaviors or seeking out screening Community members can play a role in transfer of knowledge to others in a culturally acceptable manner. *Source: Priyadarshini S. Bokil Engaging. Mobilizing and sustaining community involvement in health care. Evidence based strategies of synergizing interventionists and stakeholders with special reference to infectious diseases

20 The most effective way to reach learners with educational messages is in, and through, narrative stories and experiences. Learners connect old and new knowledge with lived experiences and create personal meaning or new understanding. Source: Narratives and Stories in Adult Teaching and Learning. Educational Resources Information Centre Digest. Marsha Rossiter, 2002.

21 Stories and Use of Narratives Stories, like education itself, draw us out and lead us beyond ourselves. Oral narratives are traditionally used by most Indigenous peoples to teach, connect generations, and carry forward life messages. *Source: Narratives and Stories in Adult Teaching and Learning. Educational Resources Information Centre Digest. Marsha Rossiter, 2002.

22 Many of these experiences have never been shared with family members or community members. Example: mother > child Dialogue and sharing of these lived experiences may reveal myths, misconceptions & fears that t are blocking effective community participation. Example: having a dialogue about TB with elders in our video uncovered many teaching and learning moments to transfer knowledge

23 Planning for the future incorporating culture, history and traditional knowledge into TB programming: g TB Education Sessions ducat o Sess o s (Community and Health Care Workers) TB Resources TB Resources (e.g. Tuberculosis: The Timeless Disease)

24 Tuberculosis: The Timeless Disease History of TB

25 Permission, respect and acknowledgement of these stories. Educational a opportunities t to address past myths about TB, transmission, treatment. Working with and investing in Aboriginal people to develop appropriate educational tools from an Aboriginal perspective. Prevention starts with education and it is an Prevention starts with education, and it is an ongoing process

26 TB continues to be a serious issue in Canada, particularly in Aboriginal populations. Historical TB treatment has resulted in a culture of fear and distrust that affects our treatment success in the present. Embracing the strengths of culture, traditional learning, and recognizing history is critical.

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28 Indian and Northern Affairs Canada inac.gc.ca/ap/tln ca/ap/tln eng.asp Cultural Competency and Tuberculosis Care; A guide for self study and self assessment. The New Jersey Medical School Global Tb Tuberculosis Institute. t Narratives and Stories in Adult Teaching and Learning. Educational Resources Information Centre Digest. Marsha Rossiter, Priyadarshini S. Bokil Engaging. Mobilizing and sustaining community involvement in health care. Evidence based strategies of synergizing interventionists and stakeholders with special reference to infectious diseases. BCCDC, TB Annual Multi Report