OS Multicultural/Post Trauma

Question 1

AMISH example

Answer 1

hired language speakers
hired a patient advocate
got to know the patients 
made connections to the community
became flexible (provide standard w/ traditional care)
did not make assumptions

Question 2

How to structure a pt visit

Answer 2

create a welcoming environment
speak the language
communicate
understand your goals
examine respectfully
make plans together
allow pt to teach about culture

Question 3

how to create a welcoming environment

Answer 3

exhibit racially & ethnically diverse posters
display media that is culturally relevant
non-discrimination statement
intake forms should be inclusive

Question 4

how to speak the language

Answer 4

arrange for translators
use language that pts understand
use same language as pt (clarify terms & willing to be educated)

train office staff (non discrim verbal & body language)

Question 5

how to communicate

Answer 5

develop specific plan for each pt
understand pt goals of visit
be willing to negotiate non-important items or evaluate the un-known
be willing to educate

Question 6

how to examine respectfully

Answer 6

be aware of pt history (abuse, surgeries, piercings)

put on doctor face (empathy, no judgement)

Question 7

Violence Screening Questions

Answer 7

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?

Question 8

Outcome of violence screen

Answer 8

do NOT accept answer as unalterable truth

pt may lie to protect themselves & others

Question 9

how to make plans together

Answer 9

make sure that the pt:

understands need for plan
is on board w/ plan
needs a plan

Question 10

Somali culture

Answer 10

family & faith are very important
clans are important in social & political structures
majority of population are Sunni Muslims
specific group w/ different health care concern (mistrust, influence of anti-vax groups)

Question 11

Somali Example

Answer 11

involved local faith leaders & Somali-MN physicians to spread info w/ in community

Question 12

Outcome of Somali Example

Answer 12

changed emergency response plan to include cultural response team to help w/ public health emergencies

Question 13

LGBTQIA exam

Answer 13

assess for STIs
do NOT assume
vulnerability to social stresses

Question 14

Individual Trauma

Answer 14

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 individual’s functioning & mental, physical, social, emotional, or spiritual well-being

Question 15

Trauma Informed Care

Answer 15

adoption of principles & practices that promote a culture of safety, empowerment & healing

Question 16

Importance of Trauma

Answer 16

61% of men & 51% of women report exposure to at least 1 lifetime traumatic event

90% of clients in public behavioral health care settings have experienced trauma

Question 17

ACES

Answer 17

10 types of childhood trauma

physical abuse
verbal abuse
sexual abuse
physical neglect
emotional neglect

parent who is alcoholic
mother who victim of DV
family member in jail
family member w/ mental illness
disappearance of parent thru divorce/death/abandonment

Question 18

What does ACES implicate?

Answer 18

survivors of childhood trauma are up to 5,000% more likely to attempt suicide, have eating disorders or become IV drug users

Question 19

Trauma Approach

Answer 19

safety
trustworthiness & transparency
peer support
collaboration & mutuality
empowerment, voice & choice
cultural, historical & gender issues

Question 20

Safety

Answer 20

physically & psychologically safe (interpersonal interactions promote sense of safety)

Question 21

Trustworthiness/transparency in exam

Answer 21

operations & decisions conducted w/ transparency (goal of building & maintaining trust)

Question 22

Peer support for post-trauma patient

Answer 22

safety
hope
build trust
enhance collaboration
promote recovery & healing

Question 23

collaboration & mutuality

Answer 23

partnering
leveling power differences (share power in decision)
everyone has a role to play

Question 24

empowerment, voice & choice

Answer 24

individual’s strengths are recognized & built upon

**foster resilience & facilitate recovery

empower staff/clients

cultivate self-advocacy

Question 25

cultural/historical/gender issues

Answer 25

leverages the healing value of traditional cultural connections

recognizes & addresses historical traumas

Question 26

What is important when seeing pt who had trauma?

Answer 26

permission to touch
control over situation
right to set limits
right to tell the story
right to hear the story

Question 27

SUMMARY of lecture

Answer 27

communicate
be patient
be willing to learn
be willing to accept