Trauma is broadly comprehending as a personwho experienced vital dreadful circumstance while its intensely distressing ordisturbing personal physical and mental health (1). Consequently, the level of stressis excessively high and incapable to overcome it. In particular,transgenerational trauma, that is the survivors or witness who experienced or observedcatastrophic events in the first place was transferred from the firstgeneration to the second and further generation, it could also known ashistorical trauma or intergenerational trauma (2).
Indeed, people who experiencedtrauma can have a lasting psychological impact which could pass down via parentingpractices, behavioral problems, violence, harmful substance abuse and mentalhealth issues (3). According to a study, it shows that people who areuncovered to grief additionally experience mental and physical health issues. Aswell as there is a literature supported that how trauma displays for colonised peoplesin Australia. For instance, alcohol and substance abuse, interpersonalviolence, homelessness, physical illness, criminal activity, and disruption in networksocial relations. Suicide, especially one of the influence to the culturaldisruption because of colonisation.
In addition, lateral violence, family andsexual violence are acknowledged as a final result of historical oppression andviolence towards Indigenous peoples. Colonisation has had numerous undesirableconsequences, since then Aboriginal and Torres Strait Islander people haveexperienced trauma. For instance, subsequent policies which forcibly removechildren from their families, loss of land and resources as well as violence. Whereas,this trauma remains overwhelming outcomes and transmitted in major Aboriginaland Torres Strait Islander families and communities. Also, it has been shown tobecome normalized within the cultural memory of Indigenous people and transmittedacross generation.
Moreover, there are research demonstrate that Indigenous peoplewho experience trauma are tend to experience significant poorer physicalhealth, domestic violence, addiction, psychological health issue, self-harm andsuicide. During 2015, the rate of suicide among Aboriginal and Torres StraitIslander people was 2.1 times greater than non-Indigenous people.
It was a vitalissue for Aboriginal and Torres Strait Islander communities experiencing lossand grief. Evidence has displayed that the life expectancy between Indigenouspeople and Non-Indigenous people in Australia was estimated to be ten years lower.Around 65 per cent of Aboriginal and Torres Strait Islander people deaths beforethe age of 65, which rate 1.6 times higher than non-Indigenous people with 19per cent of deaths through 2008-2012. Furthermore, traumatic events not only distresspeople who experienced but also people has relationship with or those nearby. Infact, traumatic events can may be one off or contain a chain of distressingexperiences through the years.
In terms of Aboriginal and Torres StraitIslander communities, lots of bureaucracy caused transgenerational trauma duringcolonisation. For example, the colonisation trigger conflicts and massacres.Also the invaders dispossessed the conventional lands and resources from Ingenuouspeople while after the massacres, due to a high mortality rate and lack ofresources, new diseases were added and starvation occurred over the land.
Likewise,Indigenous forms of governance and network were destructed as a result ofcolonisation. In the meantime, since Aboriginal and Torres Strait people havedifferent skin color, language and spirituality, Indigenous people eventually experiencediscrimination and racism, it led to lack of societal resources such as medicalcare, education, job opportunity and housing. Hence, multiple life stressorsand anxiety affect their mental well-being. The stolen generation, referred as Aboriginalchildren who pressured to bring apart from their family under the policy ofAssimilation from Federal and State and Territory governments during colonization,in order to break and end Aboriginal culture. Therefore, children were harmedphysically, emotionally and sexually abused because stolen girls and boys becameorphan and domestic servants, while malnourished and starving were happeningdue to unpaid or cheap wages. Also, stolen children taught to cast-off their Indigenousheritage, it caused them to feel ashamed of their culture and forced to adopt withwhite families which living conditions were extremely controlled, such as lowlevel of education as they expected to work as domestic servants. Approximatelyone out of twelve of Indigenous people are group of the Stolen Generations,while there are 8 per cent (26,900) of Indigenous people aged 15 years or over,who removed from their original family. Health assessed as fair or poor andexperienced elevated levels of psychological distress was accounted by 35 percent and 39 per cent respectively.
Yet some of the stolen families or children arestill looking for their parents, while others who disconnect from family orchildren turned to substance abuse. Thus, stolen children have a high occurrenceof depression, anxiety and suicide between the Stolen Generations. In addition, trauma for indigenous children might happenthrough bearing witness of the previous traumatic encounters for their family andcommunity as an aftereffect for colonisation, constrained removals and otheradministration strategies. Also, interact with the victim of colonisation orothers has relationship nearby, and talking about historical trauma from their familyencountered through massacre, dispossession, slavery, rape and violence. Besides,a large number of children and adolescent in indigenous communities encountertrauma straightforwardly because of the exposure to family violence, childabuse and neglect and substance misuse, which may be original traumaexperienced by parent or care giver.
As shown above, Aboriginal and Torres Strait Islanderpeople colonisation and policy of Assimilation have generated unresolved traumawhich has been surpassed down from era to era. Despite the fact that Indigenouspeople were experiencing disadvantage, there are two strategies could implementwhen caring patient as a registered nurse. Trauma informed care play a significant role in order toclose the gap among Aboriginal and Torres Strait Islander people and non-Indigenouspeople. It is a practice that realize different aspect of trauma and impacts onindividual, families and society, then recognize the signs of trauma and respondto the effects and service needs of all types of trauma. While it brings beneficialon caring patient as a registered nurse, for example, it is a practice is to supportchildren to express their story and thought.
Children not able to have avocabulary to talk about what they have experienced after they had a trauma. However,it is helpful to children if they tell their story to others about what theyhave experienced and invention meaning in it. Nonetheless, trauma informed care contain principles toapproach, including patient’s physical and emotional safety, trustworthiness andchoice which allow patients to have decision-making, collaboration and empowerment.Under trauma-informed care system, for example, Aboriginal and Torres StraitIslander people who have a different cultural, belief and thoughts, so it isimportant that understanding patient’s traumatic stressor and how it impactspatient, such as patients who suffered from the Stolen Generation might tend tohave transgenerational trauma and it would be part of the stressor for patient.
Hence, it is essential that value patients in every level and aspects of carewhile providing primary and considerate diagnostic progress with attentive concernof trauma in people with complex, treatment resistant disease. On the other hand, communication is asignificant key in order to build up a trust relationship between patient andnurse. Therefore, ABCD cultural assessment is a useful tool while working as aregistered nurse. It includes attitudes, nurses should spend time to be attentiveand understand what the patient told, such as traditional healing practices isdiffer from western healthcare, then determine and explain healing practice aspossible.
Beliefs, approach patient and address needs and practices withconsideration of spiritual and religious, for instance recognize the importanceabout patient’s faith or spiritual needs. Context, which determine the past andpolitical background of patient’s life, such as place of birth and languagespoken. Decision-making style, make decision with patient and their family underclear communication. In summary, ABCD cultural assessment allow health workerprovide consistent and clear communication in order to achieve understandingand trust relationship among indigenous people and health workers. In conclusion, transgenerational trauma referredas people experienced significant dreadful event, while they unable to overcomethe high level of stress as a result of trauma formed and transferred fromgeneration to generation. Aboriginal and Torres Strait Islander people haveexperienced trauma due to major event, including colonization and Stolen Generation,decline pattern of life expectancy and affection of Indigenous Australianshealth and well-being are the most concern issues. However, to achieve closingthe gap among Indigenous people and non-Indigenous people, nurse can implementand caring patient by using ABCD cultural assessment and trauma-informed careto improve Aboriginal and Torres Strait Islander people physical and psychologicalwell-being.