Incorporating Cultural Competence into Clinical Care of Children and Adolescents

2020 ◽  
pp. 357-367
Author(s):  
Armando A. Pina ◽  
Hardian Thamrin ◽  
Skyler H. Mendes ◽  
Lindsay E. Holly ◽  
Ryan D. Stoll
Keyword(s):  
Cultural Competence ◽  
Children And Adolescents ◽  
Clinical Care

scholarly journals Culturally competent, safe and equitable clinical care for Ma¯ori with bipolar disorder in New Zealand: The expert critique of Ma¯ori patients and Wha¯nau

2021 ◽  
pp. 000486742110314
Author(s):  
Tracy Haitana ◽  
Suzanne Pitama ◽  
Donna Cormack ◽  
Mau Te Rangimarie Clark ◽  
Cameron Lacey
Keyword(s):  
Bipolar Disorder ◽  
New Zealand ◽  
Cultural Competence ◽  
Health System ◽  
Clinical Care ◽  
Clinical Work ◽  
Culturally Competent ◽  
Structured Interviews ◽  
Clinical Culture ◽  
Competence Framework

Objective: Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system. Methods: A qualitative Kaupapa Māori Research methodology was used. A total of 24 semi-structured interviews were completed with Māori patients with bipolar disorder and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Results: Three themes were evident from participants’ critique of clinical components of the health system. Theme 1 established that the efficacy of clinical care for bipolar disorder was dependent on Māori patients and whānau having clear pathways through care, and being able to access timely, consistent care from clinically and culturally competent staff. Theme 2 identified the influence of clinical culture in bipolar disorder services, embedded into care settings, expressed by staff, affecting the safety of clinical care for Māori. Theme 3 focused on the need for bipolar disorder services to prioritise clinical work with whānau, equip staff with skills to facilitate engagement and tailor care with resources to enhance whānau as well as patient wellbeing. Conclusion: The standard of clinical care for Māori with bipolar disorder in New Zealand does not align with practice guidelines, Māori models of health or clinical frameworks designed to inform treatment and address systemic barriers to equity. Research also needs to explore the role of structural and organisational features of the health system on Māori patient and whānau experiences of care.

scholarly journals Clinical characterization of children and adolescents with NF1 microdeletions

2020 ◽  
Vol 36 (10) ◽  
pp. 2297-2310 ◽  
Author(s):  
Hildegard Kehrer-Sawatzki ◽  
Lan Kluwe ◽  
Johannes Salamon ◽  
Lennart Well ◽  
Said Farschtschi ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Developmental Delay ◽  
Clinical Care ◽  
Severe Disease ◽  
Autism Spectrum ◽  
Whole Body ◽  
Global Developmental Delay ◽  
Disease Manifestation ◽  
Tumour Load ◽  
The Mean

Abstract Purpose An estimated 5–11% of patients with neurofibromatosis type 1 (NF1) harbour NF1 microdeletions encompassing the NF1 gene and its flanking regions. The purpose of this study was to evaluate the clinical phenotype in children and adolescents with NF1 microdeletions. Methods We retrospectively analysed 30 children and adolescents with NF1 microdeletions pertaining to externally visible neurofibromas. The internal tumour load was determined by volumetry of whole-body magnetic resonance imaging (MRI) in 20 children and adolescents with NF1 microdeletions. Furthermore, the prevalence of global developmental delay, autism spectrum disorder and attention deficit hyperactivity disorder (ADHD) were evaluated. Results Children and adolescents with NF1 microdeletions had significantly more often cutaneous, subcutaneous and externally visible plexiform neurofibromas than age-matched patients with intragenic NF1 mutations. Internal neurofibromas were detected in all 20 children and adolescents with NF1 microdeletions analysed by whole-body MRI. By contrast, only 17 (61%) of 28 age-matched NF1 patients without microdeletions had internal tumours. The total internal tumour load was significantly higher in NF1 microdeletion patients than in NF1 patients without microdeletions. Global developmental delay was observed in 28 (93%) of 30 children with NF1 microdeletions investigated. The mean full-scale intelligence quotient in our patient group was 77.7 which is significantly lower than that of patients with intragenic NF1 mutations. ADHD was diagnosed in 15 (88%) of 17 children and adolescents with NF1 microdeletion. Furthermore, 17 (71%) of the 24 patients investigated had T-scores ≥ 60 up to 75, indicative of mild to moderate autistic symptoms, which are consequently significantly more frequent in patients with NF1 microdeletions than in the general NF1 population. Also, the mean total T-score was significantly higher in patients with NF1 microdeletions than in the general NF1 population. Conclusion Our findings indicate that already at a very young age, NF1 microdeletions patients frequently exhibit a severe disease manifestation which requires specialized long-term clinical care.

scholarly journals Incorporating genetic counseling into clinical care for children and adolescents with cancer

2016 ◽  
Vol 12 (7) ◽  
pp. 883-886 ◽  
Author(s):  
Jessica N Everett ◽  
Rajen J Mody ◽  
Elena M Stoffel ◽  
Arul M Chinnaiyan
Keyword(s):  
Genetic Counseling ◽  
Children And Adolescents ◽  
Clinical Care

Cross-Cultural Competence as a 21st Century Skill

2017 ◽  
Author(s):  
Jennifer Klafehn
Keyword(s):  
Cultural Competence ◽  
Children And Adolescents ◽  
21St Century ◽  
Critical Role ◽  
Cross Cultural ◽  
Cultural Performance ◽  
21St Century Skill ◽  
The Cross ◽  
The Military

Cross-cultural competence (3C) is one 21st century skill that employers have deemed important for employees to develop prior to entering the workforce. Despite the relevance of 3C to pre-professional populations, however, research in this area has primarily focused on the influence of 3C as it pertains to professional populations, such as expatriates and the military, for whom cross-cultural performance plays a critical role. Similarly, research exploring the development of 3C has been directed almost exclusively toward validating the effectiveness of interventions, many of which are implemented only after individuals are hired. The aim of this chapter is to address this gap in the cross-cultural literature by exploring how 3C may be developed in individuals prior to their entering the workforce. This chapter presents four 3C-relevant skills and discusses how the development of these skills may be facilitated in children and adolescents via activities or strategies that are readily incorporated into classroom curricula.

Childhood and Adolescence

2017 ◽  
Author(s):  
Suad Kapetanovic ◽  
Lori Wiener ◽  
Lisa Tuchman ◽  
Maryland Pao
Keyword(s):  
Mental Health ◽  
Children And Adolescents ◽  
Mental Health Professionals ◽  
Clinical Care ◽  
Health Needs ◽  
Childhood And Adolescence ◽  
Mental Health Needs ◽  
The Family ◽  
Health Objectives ◽  
Hiv Aids

Mental health professionals need to understand how the psychosocial and mental health needs of HIV-infected youth evolve over time and to be able to identify salient clinical challenges that present with each developmental stage. It is also important to understand that HIV/AIDS affects children’s lives indirectly, by the presence of HIV/AIDS in a family member, even if the child is not HIV infected. This chapter uses a developmental perspective to introduce key mental health objectives in the lives of developing HIV-infected children and adolescents and provides an overview of epidemiological, psychosocial, and clinical parameters to be considered in their clinical care and management. The chapter also addresses issues facing perinatally and behaviorally HIV-infected children and adolescents. Separate sections of the chapter discuss biopsychosocial factors salient to children and adolescents who are affected by HIV infection in the family.

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