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Discover the beauty of Ukrainian art and culture in this captivating video.

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Reflection on Clinical Practice (Domain 1: Clinical Expert)

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Reflection on Clinical Practice (Domain 1: Clinical Expert)

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In the "Clinical Expert" domain as it relates to assessing and addressing refugee needs in a culturally and trauma-informed manner, I would also take into consideration evidence-based allied tools. A cross-sectional study by Kordel et al. (2024) noted that 93.5% of Ukrainians from the war experienced acute stress in the weeks following their displacement, which indicates the need to address trauma-informed care (Kordel et al., 2024). In addition, a study on the neurobiology of war, and not just about the experience of stress, noted that brain structures were altered from war stress, which contributed to psychological symptoms forming among Ukrainian refugees. This emphasized the use of not only screening and assessment in clinical presentation, but also ensuring culturally sensitive work. in order to provide clinically effective, evidence-based, and culturally respectful trauma-informed care for my Ukrainian clients, I can utilize sustained and validated frameworks and tools, as well as structured reflections and trauma-informed practice (Rektor et al., 2024).

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References

1. Kordel, P., Rządeczka, M., Studenna-Skrukwa, M., Kwiatkowska-Moskalewicz, K., Goncharenko, O., & Moskalewicz, M. (2024). Acute stress disorder among 2022 Ukrainian war refugees: A cross-sectional study. Frontiers in Public Health, 12, 1280236. https://doi.org/10.3389/fpubh.2024.1280236

2. Rektor, I., Fnaskova, M., Berezka, S., Gajdos, M., & Riha, P. (2024). Acute war stress in Ukrainian refugees: Neurobiological and psychological impact. Ann Case Report, 9, 1881.

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Social Determinants of Health – Social Inclusion & Non-discrimination

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Social Determinants of Health – Social Inclusion & Non-discrimination

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Social inclusion is an important factor in the health outcomes for refugees from Ukraine. One study showed that displaced people had high levels of PTSD, which was associated with injuries from blasts and exposure to trauma, suggesting that the social environment strongly influences the mental health of refugees (Brackstone et al., 2024). Also, a study of Ukrainian female refugees in Germany found that 43% presented with anxiety and 21% presented with depression and that, while language barriers and social isolation were seen as contributing to their stress, involvement in volunteering and community, looked to improve their coping strategies. It is important to note that mental health problems are not experiencing trauma by definition, but part of a larger social context. Therefore, interventions should not only include medical treatment, but also ways for refugees to belong and use language and aspects of their culture (Khailenko & Bacon, 2024).

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References

1. Brackstone, K., Head, M. G., & Perelli-Harris, B. (2024). Effects of blast exposure on anxiety and symptoms of post-traumatic stress disorder (PTSD) among displaced Ukrainian populations. PLOS Global Public Health, 4(4), e0002623. https://doi.org/10.1371/journal.pgph.0002623

2. Khailenko, O., & Bacon, A. M. (2024). Resilience, avoidant coping and post-traumatic stress symptoms among female Ukrainian refugees and internally displaced people. International Journal of Social Psychiatry, 70(6), 1164–1174. https://doi.org/10.1177/00207640231211379

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Common Health Issues & Evidence-Based Treatment

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Common Health Issues & Evidence-Based Treatment

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For those who have been displaced by the war, and faced with violence, loss, and displacement, mental health issues are a significant issue for Ukraine's affected populations. Evidence points to levels of post-traumatic stress disorder (PTSD) as high among both internally displaced persons and refugees, highlighting the all-too-common trauma experienced for those affected (Ben-Ezra et al., 2023). A systematic review looking at studies among Ukrainian civilians reported very high levels of PTSD and moral injury among various groups, particularly among women, the elderly, and under occupation - indicating that specific social groups are at disproportionate risk. according to this findings, there is an urgent need for trauma screening as a part of refugee health assessments. Culturally sensitive, evidence-based approaches, such as trauma-informed cognitive behavioural therapy (CBT), is a valuable approaches, targeting intrusive features, building resilience, and empowering survivors (Zasiekina et al., 2023).

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References

1. Ben-Ezra, M., Goodwin, R., Leshem, E., & Hamama-Raz, Y. (2023). PTSD symptoms among civilians being displaced inside and outside the Ukraine during the 2022 Russian invasion. Psychiatry Research, 320, 115011. https://doi.org/10.1016/j.psychres.2023.115011

2. Zasiekina, L., Zasiekin, S., & Kuperman, V. (2023). Post-traumatic stress disorder and moral injury among Ukrainian civilians during the ongoing war. Journal of Community Health, 48(5), 784–792. https://doi.org/10.1007/s10900-023-01186-4

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In Ukraine, traditional herbal medicine, and natural therapies more generally, remain a valued part of health culture. Natural therapies and remedies are available, and often used, in conjunction with biomedical care. An ethnobotanical study of indigenous traditional herbalists and their family members in Western Ukraine has documented the ritualized and everyday use of both wild and cultivated plants, particularly in the Bukovina and Roztochya regions, while adding a new dimension to the ecological knowledge as cultural identity (Stryamets et al., 2021). Qualitative research has also been conducted to explore the use of herbal remedies with Ukrainian pharmacists and physicians. It revealed that there was a strong reliance on herbal products and that this accorded with cultural belief systems that traditional medicine and its remedies are safe (Franic & Kleyman, 2012). For nurses, recognizing and respecting longstanding beliefs is important in meeting the intent of providing culturally safe care, but also allows for the successful integration of safe, traditional practices with evidence-based biomedical practices.

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References

1. Stryamets, N., Fontefrancesco, M. F., Mattalia, G., Prakofjewa, J., Pieroni, A., Kalle, R., ... & Sõukand, R. (2021). Just beautiful green herbs: Use of plants in cultural practices in Bukovina and Roztochya, Western Ukraine. Journal of Ethnobiology and Ethnomedicine, 17(1), 12. https://doi.org/10.1186/s13002-021-00437-3

2. Franic, D. M., & Kleyman, K. (2012). A qualitative study of herbal medicine use in the Ukraine: Implications for US pharmacy practice. Journal of Pharmacy Practice, 25(1), 96–100. https://doi.org/10.1177/0897190011418515