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What are the key elements to accurately obtaining the needed information for effective treatment?

What are the key elements to accurately obtaining the needed information for effective treatment?

What are the key elements to accurately obtaining the needed information for effective treatment?
NUR 643 Week 1 DQs Health assessment

Week 1 DQ 2 While completing a health assessment, you notice that there are indications that the patient may have been cutting herself. You inquire about the marks and she indicates that she scratched her wrist when she tried to break her fall. How do you handle this information? How can you incorporate your Christian worldview to help in providing quality care? What are the key elements to accurately obtaining the needed information for effective treatment?

Knowing the history of Indigenous peoples is critical in implementing best practices. Here are a few best practices to keep in mind when working with Indigenous people:

Given the significant trauma, PTSD should be high on your differential diagnosis, which is often missed or misdiagnosed as depression or borderline personality.
Acknowledge the “intergeneration trauma” including the loss of sacred lands, forced assimilation, and family ruptures. Emphasize and validate the strength of the survivors.
As a psychiatrist, remember the importance of a receptive environment that is inviting and welcoming. Engage patients with support and facilitate completion of forms in a receptive environment. If culturally appropriate, you may want to consider decorating your office with art, pottery, baskets, or rugs from the local area. Intake forms may also need to be translated to the language of the indigenous people in the area. Staff should not impose a form if the person is not ready for it. Be mindful that there has been mistrust of clinics run by the federal government, which have a history of ulterior motives.
NUR 643 Week 1 DQs Health assessment
NUR 643 Week 1 DQs Health assessment

Improving the care indigenous peoples receive can help so more Indigenous people will seek out the health care they need and improve outcomes.

The Evaluation should be thorough to avoid stereotypes and misdiagnosis. Allow the patient to tell their story, and encourage them to share their cultural identity. Stereotypes psychiatrists should avoid include assuming that Indigenous people do or don’t practice their native religion or that those who don’t speak their native language are less Indigenous. As an example of the complex religion of indigenous peoples, on the Navajo reservation there have been churches established in the heart of the reservation where the Navajo people have been converted to that religion, yet they speak only Navajo and wear traditional clothing. Anotherreligion stereotype is that all Indigenous people practice the same religion. While spirituality is practiced by many Indigenous peoples, each native group has their own ceremonies and practices. Know that some will be more willing to discuss their religious practices with a nonindigenous person than others.
The cultural formulation interview is very helpful in addressing these issues and approaching the patients from where they are coming from. Allow the patient to tell their story, Native American history is often passed down orally rather than in written format.
A transition from evaluation to therapy and treatment should be a soft hand off to the therapist and psychiatrist. A soft handoff is an integrative practice where the psychiatrist and primary care provider work closely together. Therapeutic process should be tailored to the individual person and not the clinic or federal facility. While there is not much research on the ethnopsychopharmacology of indigenous peoples, in my experience starting slowly and in lower doses works best to avoid negative effects from polypharmacy.
The discharge process should be thoughtful with ongoing accessibility for care made explicit.

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