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Teb los ntawm Tus Neeg Tau Kev Tu (ACEs Aware)

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Hmong&2020&
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Kev Ntsuas Me Nyuam Tau Ntsib Xwm Txheej Phem thiab Cov Kev Muaj Feem Xyuam Rau Lub Neej
(Pediatric ACEs and Relevant Life Events Screener) (PEARLS) – Neeg Hluas (Tus Kheej Ceeb Toom) (Teen (Self
Report))
&
Teb los ntawm Tus Neeg Tau Kev Tu Xyuas Mob
Hnub Tim Hnub No: Hnub Yug:
Koj Lub Npe:
Ntau cov tsev neeg ntsib kev ntxhov siab hauv lub neej. Ntev mus cov kev ntxhov siab no puas tau rau koj txoj
kev noj qab haus huv thiab kev noj qab nyob zoo. Peb xav nug kom peb pom qab pab kom koj noj qab haus huv
li tsim nyog.
Txij li thaum yug koj los, koj puas tau pom los yog nyob ntawd thaum cov xwm nram no tshwm sim? Thov xam
cov m
uaj yav dhau los thiab cov muaj tam sim no. Thov faj seeb, qee cov lus nug muaj ntau tshaj ib ntu uas yog cais los
ntawm lo lus "LOS YOG"." Yog ib ntu ntawm nqe lus nug muaj lo lus teb “Tau/Muaj,” ces teb tag nrho nqe lus nug ntawd
ua “Tau/Muaj.”
Ntu 1 Thov kos “Tau/Mauj/Xav” rau nqe uas raug.
Koj puas tau nyob nrog tus niam txiv/neeg tu xyuas uas raug mus kaw txim/kaw qhov taub dhau los?
Tau
☐
Tsis tau
☐
Koj puas tau muaj kev xav tias tsis muaj kev txhawb, tsis muaj kev hlub/los yog tsis muaj kev tiv thaiv rau koj?
Muaj
☐
Tsis muaj
☐
Koj puas tau nyob nrog tus niam txiv/neeg tu xyuas uas muaj cov teeb meem kev puas siab ntsws/puas hlwb?
(piv txwv, kev nyuab siab, schizophrenia (lub hlwb coj ob tug yam ntxwv), bipolar disorder (chim taus heev
heev, zoo siab heev heev), PTSD, los yog ib yam kev ntxhov siab)
Tau
☐
Tsis tau
☐
Tus niam txiv/neeg saib xyuas puas tau thuam, rhuav ntsej muag los yog txoj hwm chim ntawm koj?
Tau
☐
Tsis tau
☐
Koj niam koj txiv yug los yog txhua tus neeg tu xyuas puas tau muaj teeb meem kev quav dej caw, quav tshuaj
yeeb los yog quav tshuaj sau yav dhau los los sis tam sim no?
Tau
☐
Tsis tau
☐
Koj puas tau ntsib kev tu xyuas tsis zoo tsim nyog los ntawm ib tug neeg tu xyuas twg (piv txwv, tsis tiv thaiv
nws ntawm cov xwm txheej tsis nyab xeeb, los yog tsis saib xyuas thaum muaj mob los yog raug mob txawm
tias yeej muaj tej kev pab nyob nrog ncig)?
Tau
☐
Tsis tau
☐
Koj puas tau pom los yog hnov niam txiv/neeg saib xyuas qw, nthe lus dev, thuam los yog rhuav lwm tus neeg
laus ntsej muag? LOS YOG Koj puas tau pom los yog hnov tus niam txiv/neeg saib xyuas raug ncuav pias,
ncaws, ntaus los yog raug ib yam khoom ua mob rau nws?
Tau
☐
Tsis tau
☐
Puas muaj ib tug neeg laus hauv lub tsev tau muab los yog nquag tau muab koj thawb, ntsiab, rho ncuav pias
rau los yog txawb dab tsi rau? LOS YOG Puas muaj ib tug neeg laus hauv lub tsev tau ntaus koj sib zog heev
uas nws nqaij siav doog los yog raug mob? LOS YOG Puas muaj ib tug neeg laus hauv lub tsev tau hawv yuav
ua mob rau koj los yog coj tus yam ntxwv ua rau koj ntshai tsam koj raug mob?
Muaj
☐
Tsis muaj
☐
Koj puas tau ntsib kev ua dev ua npua? Piv txwv, puas muaj leej twg tau chwv koj los yog hais kom koj chwv
tus neeg ntawd yam koj tsis nyiam, los yog tsis xis, los yog puas muaj leej twg sim los yog yeej tau deev koj
ntawm qhov ncauj, qhov quav los yog qhov chaw mos?
Tau
☐
Tsis tau
☐
Puas tau muaj kev hloov loj heev rau txoj kev txij nkawm sib txheeb ntawm us (cov) neeg tu xyuas koj? Piv
txwv, tus niam txiv/neeg saib xyuas sib nrauj los yog sib cais, los yog ib tug khub tsiv los los sis tsiv tawm?
Muaj
☐
Tsis muaj
☐
Koj teb pes tsawg nqe “Tau/Muaj/Xav” hauv Ntu 1?
Thov txuas mus rau sab nraum qab rau cov nqe lus nug ntxiv.
Teen (Self Report) - Identified
&
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Ntu 2 Thov kos “Tau” rau nqe uas raug.
Koj puas tau pom, hnov los yog raug ib txoj kev ua phem rau nyob hauv koj ib puag ncig chaw nyob, lub
zej zog neeg, los yog lub tsev kawm ntawv? (piv txwv, kev txhob txwm thab plaub, ntaus los yog coj yam
ntxwv ua phem, tsov rog, los yog kev lim hiam rau pej xeem)
Tau
☐
Tsis tau
☐
Koj puas tau ntsib kev ntxub ntxaug (piv txwv, raug zes los yog txo hwj chim los yog raug cais vim yog koj
haiv neeg, hom neeg, zeej xeeb, kev yeem nyiam poj niam los txiv neej, kev cai dab qhuas, cov kev kawm
txawv, los yog cov kev tsis taus)?
Tau
☐
Tsis tau
☐
Koj puas tau ntsib cov teeb meem vaj tse nyob (piv txwv li tsis muaj vaj tse nyob, tsis muaj qhov chaw ruaj
nyob rau, tsiv tsev ntau tshaj ob zaug hauv rau lub hlis twg, raug ncaws tawm tsev los yog vaj tse poob them
tsis taus nqi txais, los yog raug nyob nrog ntau yim neeg los yog nyob nrog cov txheeb ze)?
Tau
☐
Tsis tau
☐
Koj puas tau txhawj tsam koj tsis tau noj haus txaus los yog cov khoom noj khoom haus rau koj tas ua
ntej koj niam koj txiv/neeg saib xyuas muas tau ntxiv?
Tau
☐
Tsis tau
☐
Koj puas tau raug cais tawm ntawm koj niam koj txiv los yog tus neeg saib xyuas vim yog txoj kev muab mus
rau niam qhuav txiv qhuav tu los yog kev tsiv teb chaws?
Tau
☐
Tsis tau
☐
Koj puas tau nyob nrog tus niam txiv/neeg saib xyuas uas muaj ib tug mob los yog ib txoj kev tsis taus loj
heev?
Tau
☐
Tsis tau
☐
Koj puas tau nyob nrog ib tug niam txiv los yog neeg saib xyuas uas tau tuag lawm?
Tau
☐
Tsis tau
☐
Koj puas tau raug txhom, ntes los yog kaw?
Tau
☐
Tsis tau
☐
Koj puas tau raug cem phem los yog ntaus los yog hawv yuav ua phem rau los ntawm tus koj hlub (piv txwv
li tus hluas nraug los yog tus hluas nkauj)?
Tau
☐
Tsis tau
☐
Koj teb pes tsawg nqe “Tau” hauv Ntu 2?
Teen (Self Report) - Identified
&
&
Hmong&2020&
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Teb los ntawm Tus Neeg Tau Kev Tu (ACEs Aware)

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Completed 19 May 2021

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