Multicultural and Post-traumatic Patients Flashcards
What are the 6 steps in the plan to promote Amish people to visit local hospital?
- Hired language speakers
- Taught staff to speak language - Hired Patient Advocate
- Coordinates hospitals self pay program (amish don’t use commercial health insurance) - Got to Know the Patients
- Provided head coverings to women - Made Connections to the Communiy
- Communicated with community on “home remedies and adopted/allowed part of the processes - Became Flexible
- Hospital Became felxible to provide Standard care with “Traditional” care - Didn’t assume
- Amish women frequently don’t usually make eye contact with men, and men frequently speak for the woman
- However, behind closed doors, men and women have equal standing
What are the 7 parts of Structuring a Patient Visit?
- Create a welcoming environment
- Speak the language
- Communicate
- Understand your goals
- Examine respectfully
- Make plans together
- Allow patient to teach about their culture
What can you do to create a welcoming environment?
Exhibit racially and ethnically diverse posters
Display media which is culturally relevant
Disseminate or visibly post a non-discrimination statement
Alter intake forms to be inclusive
- Relationship (instead of marital status
- Partnered as a status
- Add transgender to male/female
What can be done to ensure communication in patient’s own language?
Arrange for translators
Use language that patients understand (no jargon)
Use same language as patient
Train front office staff to use non-discriminatory verbal and body language
What can done to improve communication?
Develop a specific plan for each patient
Understand the patient’s goals of the visit
- Patient’s goal x= Doctor’s goal
- Patient’s goal is >= doctor’s goal
What can be done to understand your own goals?
Be willing to negotiate non-important items or evaluate the unknown
Be willing to educate
- Sometimes patients may use remedies that are not harmful, and may even be beneficial.
- Sometimes patients may use remedies that are bad for them (Black cohosh, plant based estrogen to treat hot flashes in menopause, can lead to uterine bleeding and cancer)
What can done to promote Respectful Examination?
Make yourself aware of the patient’s history
- Abuse
- Surgeries or Procedures
- Piercings or Tattoos
Put on your doctor face
- Show empathy, not shock, horror, or disgust
What is violence screening?
Done in a 1:1 setting
Ask all patients, men and women, in a gender neutral way:
- Have you ever been hurt (physically or sexually) by someone you are close to or involved with, or by a stranger?
- Are you currently being hurt by someone you are close to or involved with?
- Have you ever experienced violence or abuse?
- Have you ever been sexually assaulted/raped?
DO NOT ACCEPT the answer as unalterable truth
- Patients may lie to protect themselves and others
How do you make plans together with your patient?
Make sure that the patient
- Understands the need for a plan
- Is on board with the plan
- Needs a plan
What should you consider doing in the exam room for LGBTQIA+ patients?
Consider introducing yourself with your preferred pronouns
- Hi I am Colin, I go by He and Him. How may I address you?
Ask relevant questions, but not overly probing questions
- Consider phrasing questions to help patient understand the reason for the question.
Remember that LGBTQIA+ people may have had a previous bad experience with a health care provider
- May be more difficult to establish rapport
What should consider when DEcision-Making with LGBTQIA+ patients?
Assess risk for STIs
DONT ASSUME
Vulnerability to social stresses
- 50% more GBT men smoked than other men
- 200% LGT women smoked than other women
- Explore drug/alcohol self-treatment for social stress
What is trauma?
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
Trauma-Informed Care (TIC)
- Adoption of principles and practices that promote a culture of safety, empowerment, and healing
What is important to know about substance abuse and mental health services?
In US, 61% of men, 51% of women report exposure to at least one lifetime traumatic event
90% of clients in public behavioral health care settings have experienced trauma
What are the 10 types of childhood trauma?
Five are personal
- Physical abuse
- Verbal abuse
- Sexual abuse
- Physical neglect
- Emotional Neglect
Five are related to other family members
- Parent whos an alcoholic
- Mother whos a victim of domestic violence
- Family member in jail
- Family member diagnosed with a mental illness
- Disappearance of a parent through divorce, death, or abandonment
Survivors of childhood trauma are to 5,000% more likely to attempt suicide, have eating disorders, or become IV drug users
How do you approach patient care, when patient has had trauma?
Safety
Trustworthiness and Transparency
Peer Support
Collaboration and Mutuality
Empowerment, Voice, and Choice
Cultural, Historical, and Gender issues
