Case Study: Sara Sara, a 27-year-old Refugee from Somalia, comes to the free clinic today for an appointment with the NP. She slowly enters the examination room with the medical assistant and meets the NP. She sits down as instructed but does not make eye contact. She is very fidgety and wringing her hands. Her appearance is unkempt with a strong body odor. She speaks Somali with very little understanding of the English language. She answers questions with a very soft, almost inaudible voice, and appears confused at times. VS: Blood Pressure 182/94 – Heart Rate116- respiration rate 32- temperature 99.5F / 37.5C . Reading her chart it is discovered that she is homeless and a mother of 2 children ages 18 mos and 3 years old, diagnosed with HIV 6 months ago with a viral load count of 300 copies/mL. Sara has admitted to using IV drugs for 12 years. Sara came to America when she was 16 years old. She lived in a refugee camp for 2 years but left to strike out on her own. She did not attend school and became homeless. She has a history of Bipolar Disease. Sara’s brother died of AIDS in Somalia and she is concerned with beginning treatment because of what she watched her brother go through. What implicit and explicit biases did you experience that could create barriers to care? Why did you experience them? How can these biases be overcome? What Cultural Competence issues do you identify? What model would you deem appropriate? Explain your answer.
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