African American Women in Neuropsychological Rehabilitation:
Middle Aged Woman with Multiple Sclerosis as a Case Study

Rosalie J. Ackerman, Ph.D.

ABackans Diversified Computer Processing, Inc.
Research and Development Division
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Akron, OH 44320-1116

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Ethnic minorities are at increased significant risk for traumatic brain injury, stroke and spinal cord injury. Many factors contribute to this increased risk of injury for ethnic minorities including: lack of appropriate health care, less emphasis on preventive care; less trust in the health care system; lower economic status include less funding for health care, less access to healthy eating habits; more dependence on unhealthy stress related behaviors; increased frequency of violence in ethnic minority communities; and decreased access to appropriate medical care. Recent research, however, suggests that ethnic minorities have poorer outcome after rehabilitation discharge. Factors such as lack of funding to access appropriate outpatient services, loss of job income, and transportation problems may contribute to poorer outcome. Poor outcome may also be related to differences between the services offered by rehabilitation settings and the needs of ethnic minority patients, and inappropriate treatment goals for patients. When the therapist is of a different ethnicity or cultural group than the patient, there can be miscommunication about treatment options due to differing cultural priorities.

Rehabilitation with African American Women was a rare situation in my service of more than 1000 patients in rehabilitation assessment and treatment. In one inpatient setting, no African American woman was admitted in over 750 patients serviced by the rehabilitation health care professionals. This number represents 156 weeks of service performing neuropsychology assessment and neurocognitive rehabilitation therapy on a 24 bed unit in a hospital for brain injury rehabilitation with an average patient length of stay of 5 weeks.

Case: A 47 year-old African American woman with Multiple Sclerosis was treated for stroke in hospital inpatient setting. She had a master's degree in counseling, as well as course work that was equivalent to a doctorate in ministerial studies. She was a pastor in her geographic region and oversaw several churches.

Cultural bias in referral and treatment patterns still are evident in hospital patient census. Discussion will include avenues to increase appropriate treatment to diverse ethnic groups.
 

This paper was presented at the 1996 convention of the American Psychological Association in Toronto, Ontario, Canada. 


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