(3) OS Approach to Multicultural and Post-Traumatic Patients

Question 1

Discuss the “Amish example” given in class

Answer 1

In early 2000s, Amish groups avoided going to the hospital

New CEO in 2005 at hospital met with community leaders to develop a 6 point plan to integrate their cultural values into the way the hopsital practiced medicine

Question 2

What was the 6 point plan that was established by the CEO of the hospital accomodating the Amish population?

Answer 2

1. Hired language speakers
2. Hired a patient advocate
3. Got to know the patients (provided head coverings)
4. Made connections to the community (home remedies)
5. Became flexible
6. Didn’t assume

Question 3

What are the ways to structure a patient visit

Answer 3

• Create a welcoming enviornment
• Speak the language
• Communicate
• Understand your goals
• Examine respectfully
• Make plans together
• Allow patient to teach about culture

Question 4

How do you create a welcoming enviornment?

Answer 4

• Exhibit racially and enthinally diverse posters
• Display media which is culturally relevant
• Disseminate or visibly post a non-discrimination statement
• Alter intake forms to be inclusive

Question 5

What are considerations for speaking the language?

Answer 5

• Arrange for tanslators
• Use language that patients understand
• Use the same language as the patient
• Train front office staff to use non-discriminatory verbal and body language

Question 6

How do you effectively implement “communication”?

Answer 6

Develop a specific plan for each patient

Understand the patient’s goals of the visit

Be willing to educate

Question 7

How do you apply examining respectfully?

Answer 7

• Make yourself aware of the patient’s history (abuse, surgeries/procedures etc.)
• Put on your doctor face (show empathy, not shock, horror or disgust)

Question 8

How do you attempt a violence screening?

Answer 8

1 : 1 setting

Ask all pts in gender neutral way:

1. Have you ever been hurt (physically or sexually) by someone you are close to or involved with, or by a stranger?
2. Are you currently being hurt by someone you are close to or involved with?
3. Have you ever experienced violence or abuse?
4. Have you ever been sexually assaulted/raped?

Question 9

How do you effectively make a plan together?

Answer 9

Make sure that the patient…

• understands the need for the plan
• is on board with the plan
• needs a plan

Question 10

What are some considerations you should make with LGBTQIA+?

Answer 10

Consider this introduction: “Hi, I’m Kelley Joy, and I go by she and her. How may I address you?”

Ask relevant but not overly probing questions

Assess risk for STIs

DON’T ASSUME

Vulnerability to social stresses

Question 11

Define Trauma

Answer 11

“Individual trauma results from an event, series of events or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well being”

Question 12

What is the breakdown for the 10 types of childhood trauma?

Answer 12

5 are personal = physical abuse, verbal abuse, sexual abuse, physical neglect and emotional neglect

5 are related to other family members = a parent who’s an alcoholic, a mother whos a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment

Question 13

Survivors of childhood trauma are up to _______ percent more likely to _____________

Answer 13

5,000%

Attempt suicide, have eating disorders or become IV drug users

Question 14

What are the pillars for trauma approach?

Answer 14

Saftey

Trustworthiness and transparency

Peer support

Collaboration and mutuality

Empowerment, voice and choice

Cultural, historical and gender issues