Subeq Yi-Maun
PhD, RN, NP, Associate Professor, Department of Nursing, National Taichung University of Science and Technology, Taiwan, ROC.
Hu Li Za Zhi. 2021 Apr;68(2):4-5. doi: 10.6224/JN.202104_68(2).01.
Residing across this island for over 8,000 years, Taiwans indigenous people represent the worlds northernmost population of Austronesian islanders. Although Taiwans more than 500,000 indigenous citizens today account for only 0.11% of the 300 million Austronesians worldwide, Taiwan and Taiwans long-thriving Austronesian culture played an indispensable role in the historical migrations of ancient Austronesian peoples from Mainland Asia and their proliferation throughout the Pacific (Council on Indigenous Peoples, n.d.). The cultural diversity of Taiwans indigenous people allowed their many ethnic groups to adapt to the islands climatic and environmental diversity, ranging from high, temperate mountains to tropical coastlines, for thousands of years. These groups have adapted well to local conditions, developing living habits, livelihood patterns, life customs, and ceremonies suited to their lives. Traditional wisdom and knowledge, like a colorful rainbow, have shone from ancient times up through the present and are woven deeply through the unique life values of the 16 ethnic tribal groups on Taiwan Island. However, the modernization and transformation of Taiwan`s economy during the past three decades have left indigenous citizens significantly behind mainstream society in many important aspects, including average lifespan, income, education level, and access to medical resources, with mainstream society enjoying more social advantages and a longer average life span (Health Promotion Administration, 2017). Thus, social determinants have promoted various inequalities in health, and the rainbow is no longer beautiful under the impact of modern values. The inequitable distribution of healthcare resources and inadequate human resources have cast a shadow of sadness over this originally beautiful rainbow. Some scholars have raised the cultural security model as a possible framework for formulating policies and regulations to protect the health rights of disadvantaged groups (Coffin, 2007). Using knowledge and values to emphasize cultural safety in the health field and cultural awareness holds the potential of reversing the role of traditional wisdom and knowledge transmitters to gain a deep understanding of the health needs of ethnic groups and of implementing related strategies in acute, chronic, and long-term medical care. This issue is rooted in the current, inequitable deployment of long-term care resources and provision of policy recommendations. In this paper, we discuss strategies for considering and actualizing the main concerns and priorities of ethnic groups, cultivating long-term care 2.0 cultural safety seed tutors, and employing ethnically indigenous nurses in their hometowns / communities. Furthermore, in terms of caring for minorities, we also discuss the long-term care needs of disadvantaged groups such as individuals with mental health needs to achieve the goal of holistic care. We look forward to seeing the bright and colorful rainbow once again. From systemic, educational, and practice perspectives, we will jointly promote public health for all and work to let the beauty of the rainbow surpass the traces of sorrow.
台湾原住民在这座岛屿上居住了8000多年,是世界上最北部的南岛语系岛民群体。如今,台湾50多万原住民仅占全球3亿南岛语系人口的0.11%,但台湾及其长期繁荣的南岛语系文化在古代南岛语系民族从亚洲大陆的历史迁徙以及他们在太平洋地区的扩散过程中发挥了不可或缺的作用(原住民族委员会,未注明日期)。台湾原住民的文化多样性使他们的众多族群能够在数千年的时间里适应该岛从高海拔温带山区到热带海岸线的气候和环境多样性。这些族群很好地适应了当地环境,形成了适合他们生活的生活习惯、生计模式、生活习俗和仪式。传统智慧和知识犹如一道绚丽的彩虹,从古至今闪耀着光芒,并深深融入了台湾岛上16个族群独特的生活价值观之中。然而,在过去三十年里,台湾经济的现代化和转型使原住民在许多重要方面明显落后于主流社会,包括平均寿命、收入、教育水平以及获得医疗资源的机会,主流社会享有更多的社会优势和更长的平均寿命(卫生福利部国民健康署,2017)。因此,社会决定因素加剧了各种健康不平等现象,在现代价值观的冲击下,这道彩虹不再美丽。医疗资源分配不均和人力资源不足给这原本美丽的彩虹蒙上了一层悲伤的阴影。一些学者提出文化安全模式,作为制定保护弱势群体健康权利的政策和法规的可能框架(科芬,2007)。利用知识和价值观强调健康领域的文化安全以及文化意识,有可能扭转传统智慧和知识传播者的角色,从而深入了解族群的健康需求,并在急性、慢性和长期医疗护理中实施相关策略。这个问题源于当前长期护理资源的不公平配置,并提出了政策建议。在本文中,我们讨论了考虑和实现族群主要关切和优先事项的策略,培养长期护理2.0文化安全种子导师,以及在其家乡/社区聘用原住民护士。此外,在照顾少数群体方面,我们还讨论了弱势群体(如心理健康需求者)的长期护理需求,以实现全面护理的目标。我们期待再次看到那道绚丽多彩的彩虹。我们将从系统、教育和实践的角度,共同促进全民公共卫生,努力让彩虹的美丽超越悲伤的痕迹。