OS Multicultural/Post Trauma Flashcards
AMISH example
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
How to structure a pt visit
create a welcoming environment speak the language communicate understand your goals examine respectfully make plans together allow pt to teach about culture
how to create a welcoming environment
exhibit racially & ethnically diverse posters
display media that is culturally relevant
non-discrimination statement
intake forms should be inclusive
how to speak the language
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)
how to communicate
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
how to examine respectfully
be aware of pt history (abuse, surgeries, piercings)
put on doctor face (empathy, no judgement)
Violence Screening Questions
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?
Outcome of violence screen
do NOT accept answer as unalterable truth
pt may lie to protect themselves & others
how to make plans together
make sure that the pt:
understands need for plan
is on board w/ plan
needs a plan
Somali culture
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)
Somali Example
involved local faith leaders & Somali-MN physicians to spread info w/ in community
Outcome of Somali Example
changed emergency response plan to include cultural response team to help w/ public health emergencies
LGBTQIA exam
assess for STIs
do NOT assume
vulnerability to social stresses
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 individual’s functioning & mental, physical, social, emotional, or spiritual well-being
Trauma Informed Care
adoption of principles & practices that promote a culture of safety, empowerment & healing
Importance of Trauma
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
ACES
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
What does ACES implicate?
survivors of childhood trauma are up to 5,000% more likely to attempt suicide, have eating disorders or become IV drug users
Trauma Approach
safety trustworthiness & transparency peer support collaboration & mutuality empowerment, voice & choice cultural, historical & gender issues
Safety
physically & psychologically safe (interpersonal interactions promote sense of safety)
Trustworthiness/transparency in exam
operations & decisions conducted w/ transparency (goal of building & maintaining trust)
Peer support for post-trauma patient
safety hope build trust enhance collaboration promote recovery & healing
collaboration & mutuality
partnering
leveling power differences (share power in decision)
everyone has a role to play
empowerment, voice & choice
individual’s strengths are recognized & built upon
**foster resilience & facilitate recovery
empower staff/clients
cultivate self-advocacy
