Presentation on theme: "Integration of Navajo Culture Values in Primary Care Setting by Rose Saltclah, RN/MSN/CFNP School Based Health Clinic Coordinator Crownpoint HealthCare."— Presentation transcript:
1 Integration of Navajo Culture Values in Primary Care Setting by Rose Saltclah, RN/MSN/CFNP School Based Health Clinic Coordinator Crownpoint HealthCare Facility – IHS Crownpoint, NM
2 Disclosure Statements I have no financial arrangements related to the content of this presentation.I have no financial arrangements with the sponsors of this activity.I will not discuss off label use of any medications.
3 ObjectivesBy the end of this presentation participates will be able to:A. Discuss two examples of Navajo ceremoniesB. Discuss at least three unique values of Navajo culture in relation to primary healthcareC. Identify at four ways to integrate ceremonial teachings into primary care setting
7 Kinaalda Ceremony Ceremony performed at puberty; first menstruation Signifies transformation from childhood into womanhoodFour (4) day ceremonyRe-enact changing women 1st ceremony
8 Kinaalda Teachings* Clan System * Exercise * Good Health * Good prosperity * Motherhood * Adequate Nutrition * Sharing * Education
9 Cont’d: Kinaalda Teachings Think positive thoughtsWatch behavior / actionsNegativity must be avoidedTake care of earthEveryone valued, respectEverything valued; animals & plantsEarth is mother of all lifeObedience; keep 4 days holyFuture motherhood, family
10 Process of Kinaalda Running / exercise Mixing of corn mush Blessing Kanaalda girlBlessing of corn mushBlessing othersSharing
11 Process of Kinaalda & Teachings RunningMixing of corn mush
12 Process of Kinaalda & teachings Blessing of corn cakeOpen fire: baking of corn cake
13 Process of Kinaalda & Teachings Blessing othersSharing
15 Definition of Beauty Way Beauty way, blessingway or Ho’zhooji’Beauty Way (Ho’zhooji’) ceremony is performed to re-established balance, harmony and beauty in one’s life.A concept of well-being, worthy, success, pleasant and perfect.
16 Purpose: Beauty Way Ceremony For holistic restoration of beautyA prophylactic approach to well beingReasons>Family>Individual self>Employment>Preventive health>Post medical care (surgery)>Veterans
17 Closure of Beauty Way Prayer With beauty may I walkWith beauty before me may I walkWith beauty behind me may I walkWith beauty above me may I walkWith beauty all around me may I walkIt is finished in beauty, it is finished in beauty, it is finished in beauty, it is finished in beauty
18 Summary of Kinaalda & Ho’zhooji’ Physical: Exercise, strength, endurance, good health. Self care, healthy future children (clan system)Emotional: positive thoughts, mind, language – speak kind words, strong mind, intellect, education.Social: conduct one’s self well; watch actions, help others, share, parenthood, teach children.Spiritual: respect blessings from holy people, diety, prayers, songs, and meditation.
22 Education: 2005 – 06 Navajos graduating from high school 75.5% females annually69.3% males annuallyCollege Education323 females earned bachelor degree / 4,960 enrolled in college102 males earned bachelor degrees / 2, 339 enrolled in college49 females earned master’s degrees17 males earned master’s degrees
23 Navajo High School Students Risk Behavior Navajo Youth Risk Behavior Survey 2000200320052008Sometimes or always wore a seat belt90%89%88%During past month did not ride with a driver who had been drinking alcohol61%66%67%69%During past month did not carry a weapon on school propertyNo Data92%During past YEAR did NOT attempt suicide84%80%82%During past MONTH did NOT drink alcohol57%64%65%During past MONTH did NOT use marijuana32%Never had sexual intercourse60%63%Ate five or more fruits and vegetables per day38%28%
24 Objective #3: Integration of Cultural teachings & Values in Primary Care PhysicalEmotionalSocialSchool Performance
25 Sports Physical Exam17 year old has an appt to see a medical provider for Sports PE. He wants to play basketball and run track.Well appearing with no chief complaint.
27 Safety: car, use of seat belt, no bullying, etc. Cont’d : Sports PE - Anticipatory Guidance Education integrated with Ceremonial TeachingsSafety: car, use of seat belt, no bullying, etc.Smoking, alcohol, Drugs preventionPregnancy PreventionNutritionSexual education, STIsPhysical ActivityOthers
28 Emotional - case scenario Larae, 16 y/o, Navaho girl, comes to teen clinic. Interest in BCM.Tells you she is sexuality active, one partner x 6 mos, does not want to become pregnant.
29 Cont’d: Emotional - Case Scenario Age at menarche; Kinaalda done or attended one.?LMP; regularCycle lengthAny prior experience with OCMPMH: blood clots, headache, DM, HTN. EYE problem, any pain.FMH: blood clots, migraine HA.Social hx: use of any drugs; e.g. smoking, ppd, frequency. Family / home setting, adopted? Lives with boyfriend?ConfidentialityMedications, allergies
30 Cont’d: Emotional - Case Scenario What to do: urine hcgVariety of OCMMethods, what are they, how to use them, side effects, efficiency, back up method (F & C)Kinaalda teachings
31 Cont’d: Emotional - Case Scenario If method not started today; may not:> RTC>have additional unprotected sex> never start a method> potential for unplanned pregnancy / could have been preventedLarue decided to use Depo proveraBusy lifeStart depo todayRe-iterate kinaalda teaching & prevention of pregnancy / STI.Priority - SchoolConfidentiality
32 Integration of cultural teachings in Primary Care Social - Case Scenario Derek, 17 y/o male comes to teen clinic for immunizationA depression form completedResult positive
34 Cont’d: Social Case Scenario Depression form : PHQ-2 VersionOver the past two weeks, how often have you been bothered by the following problems?1. Little interest or pleasure in doing things.2. Feeling down, depressed or hopelessPHQ – score: range 0 – 6.> 0 – 2 is negative> 3 – 6 is positive, further evaluation
35 Cont’d: Social - Case Scenario HEADSSS Head – Home EnvironmentE – Education / Employment, Eating / ExerciseA – Activities & Peer RelationshipsD – Drugs, Cigarettes, AlcoholS – SexualityS – Suicide, Depression, moodS – safetyS – spirituality
36 Integration of Cultural Teachings & Values in Primary Care - School Performance / Education
37 Cont’d: School Performance – cultural values; modern day teachings Good prosperityGood nutritionRespectLanguageBehavior / actionPositive thoughtsGood HealthWork hardExcel academicallyRemember clan systemCareer / life planning
38 Educational student opportunities High School student summer opportunities>Examples: *AISES College Horizon * Nizhoni Academy at NAU * U of A Med. Start Program * INMED: Indians into Medicine * NNAYI: National Native American Youth Initiative *Upward Bound available in every States.Need good grades, good behavior, letters of recommendation from teacher/counselor.Native teachings: good prosperity, good behavior, work hard, respect, life planning.
39 Scholarship availability Web site:Published by: New Mexico State University; Indian Resource DevelopmentTelephone:Title: 2010 Sources of Financial Aid Available to American Indian Students
40 Native Leaders today Dr. Beulah Allen, 1st Navajo woman physician Dr. Lori Arviso Alvord, 1st Navajo surgeonCaudeen Bates-Arthur 1st Navajo Attorney & Chief JusticeVirginia Ballinger; fashion designer
44 ReferencesKinaalda; A Navajo Girl Grows Up. By Monty Roessel, 1993, Lerner PublicationsKinaalda; A Study of Navajo Girls Puberty Ceremony, By Charlotte Johnson Frisbie. University of Utah, SLC, UtahNavajo Women; SAANI, By Betty Reid and Kenji Kawano. Native American Culture Perspectives – Kinaalda: The Navajo Puberty Ritualculture perspectivesBlessingway, By Leland C. Wyman, U of A Press, Tucson. AZ.Getting into Adolescents’ Heads, 1998/99, Contemporary Paediatrics, ppA Pocket Guide to Managing Contraception, 2000.Navajo Nation Facts and Figures, NN Economic Development , NN Scholarship Office and Navajo Election AdministrationNavajo Youth Risk Behavior Survey, 2003 – 08. Four Directions, Northern Navajo Medical Center, Shiprock, NM