International journal of psychiatry in medicine
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Int J Psychiatry Med · May 2017
Childhood abuse in adults in primary care: Empirical findings and clinical implications.
In the healthcare setting, adult patients with histories of childhood abuse are of significant concern and are frequently encountered in the primary care setting. However, there is a dearth of studies investigating the relationships between psychopathology, overall health, healthcare utilization, physician ratings of patient difficulty, and childhood abuse. The present study examines these relationships in primary care patients with (N = 45) and without (N = 129) histories of childhood abuse (physical, sexual, and both). ⋯ Overall, these findings suggest that a history of childhood abuse is associated with a host of negative health outcomes. Findings also suggest that negative feelings about a patient may help physicians identify patients with histories of childhood abuse. It is especially important for physicians to routinely include an assessment of childhood abuse during the psychosocial portion of the medical interview or through screening instruments.
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The concept of cultural humility acknowledges the enormous task of becoming culturally competent by encouraging curiosity about the context within which others live. For physicians, this includes curiosity about the organizations in which they work as Outsiders in settings such as a new hospital or patients' homes. However, efforts to train healthcare professionals in cultural competence are often de-emphasized due to the pressure learners feel to acquire Medical Knowledge and clinical skills. ⋯ Participants in this training have improved their ability to recognize when they are Outsiders where they provide care. They have developed a better understanding that cultural humility in organizations is a gateway to providing quality care. They have begun the process of committing to respectfully learn from the organization's Insiders.
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Int J Psychiatry Med · May 2017
A commitment to health equity: Reflections on why; One journey toward how.
Many health care practitioners and educators feel stymied as to how to address the pervasive and persistent problem of health care disparities between racial and ethnic groups. The closing plenary for the 37th Forum for Behavioral Science in Family Medicine held in September 2016 reminded participants of the urgent need to attend to health inequities and provided both a theoretical framework as well as some sample resources for where to begin.