see also [ACEM Close the gap questions](x-devonthink-item://2AC640BA-2A6B-40D5-A4AC-103BE9CFC97F?page=0) # Strategies to deliver culturally-appropriate care - *cultural sensitivity*: demonstrate respect for pts cultural background, acknowledging potential differences in health beliefs and practices - *communication*: use clear and open communication, considering language barriers and using *interpreters* if necessary.  mindful that can be perceived as disrespectful - involve ED *aboriginal liaison officer* - [[Capacity and consent|Informed consent]]: ensure pt understands and consents to any diagnostic or therapeutic interventions, provide information in a culturally sensitive manner - *family involvement*: recognise importance of family in Aboriginal communities, involve them in decision-making process when appropriate - take *cultural history* - Knowledge of the patient’s ethnicity and resulting health challenges - An *understanding of the beliefs* and structures present in different cultures - A *non-judgemental* / empathetic / respectful approach to other cultures - Ability to integrate cultural concerns into management plans - *Self-awareness* of one’s own culture and its impact on practice. # Specific diseases of note see also: [MJA - neglected tropical diseases in australia](x-devonthink-item://F167DB8F-966C-4BF9-BFBF-3A7A7027C920) ![[Pasted image 20240203113903.png]] - [[meliodosis]] - [[Acute Otitis Media]] - [[Rheumatic fever]] - Strongyloides stercoralis and other soil-transmitted helminths - DM2 - [[Eye infections#Conjunctivitis|bacterial conjunctivitis]] - Hepatitis A - Chlamydia and gonorrhoea → [[Pelvic inflammatory disease|PID]] and trachoma (causing blindness) - syphilis - scabes - echinococcosis - [[Buruli Ulcer]] - leprosy - [[Snakebite]] - [[Dengue]] - [[glomerulonephritis|post-strep glomerulonephritis]] - [[Necrotising infections|necrotising fasciitis]] - [[leptospirosis]] - [[Bronchiectasis]] - [[Pericarditis|S aureus pericarditis]] # Other issues ## Alcohol see [[Alcohol-related disease]] - ~2% of indiginous hospitalisations involve EtOH - indiginous males hospitalised with dx related to EtOH 5x non-indiginous males - 5x rate of liver disease > **SBIRT** – Screening, Brief Intervention and Referral to Treatment > CAGE > *C*ut down > *A*nnoyed > *G*uilty > *E*ye opener ## Violence / assault victim > "payback injuries" common ; not a justifiable excuse for family violence offer police report. Make sure to document clearly what the patient describes as having happened, whether injuries are c/w this description, and who they allege did it. Consider mandatory reporting requirements in state or territory ## Stress and emotional well-being most prevalent stressors: - death of a family member - Racism - serious illness - work-related stressors - Unemployment - mental illness ## department strategies for culturally-safe care - Ensure a cultural history is taken from all patients/families - Policy development considers the diverse health beliefs of the population - Develop prompts so that management plans account for cultural obligations - Ensure availability of cultural/religious consultants - Professional interpreter servicesare available at all times for languages in the ED catchment - Create strong links with healthcare providers of local minority populations - Consumer feedback mechanisms allow culturally diverse input - There is a system for non-judgmental reflection of cultural issues - Cultural training workshops/education sessions - Design of department with cultural sensitivity in mind - Some examples: outdoor space, segregated gynae rooms, meeting space