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113 Cards in this Set
- Front
- Back
- 3rd side (hint)
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2 definitions of health
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1. A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO 1947)
2. A state of being that people define in relation to their own values, personality, and lifestyle |
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Assessments in the Health Belief Model
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1. Perceived severity of illness
2. Perceived susceptibility to illness 3. Likelihood of action |
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Definition of illness
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A state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
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Two types of illness
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Acute Illness
Chronic Illness |
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Prevention level that includes includes health promotion, wellness education programs, immunizations, hearing protection in occupational settings, training to develop good body mechanics, health screening for prostate, breast, colon cancer. Before illness occurs
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Primary prevention
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Prevention level found in the home, health care facility, or SNF. Includes diagnosing illness and restoring health.
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Secondary prevention
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Prevention level where clients achieve as high a level of functioning as possible. rehab and maintenance after disability or during chronic illness.
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Tertiary prevention
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The following are leading health indicators from what government initiative?
Physical Activity, Overweight and Obesity, Tobacco Use, Substance Abuse, Responsible Sexual Behavior, Mental Health, Injury and Violence, Environmental Quality, Immunization, Access to Health Care |
Healthy People 2010
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Helps maintain or enhance present level of health. Ex. Exercise program, good nutrition
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Health Promotion
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Teaches people to care for themselves in a healthy way
Ex. Stress mgmt program |
Wellness
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Protects clients from potential or actual threats to health
Ex. Immunization |
Illness prevention
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5 internal variables that influence health beliefs
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Developmental
Intellectual Perception of function Emotional Spiritual |
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Who developed the health belief model?
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Becker and Miriam.
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External variables in the Health Belief model
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Family practices
Socioeconomic Factors Cultural background |
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Transtheoretical model 5 stages of change
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Pre-contemplation, Contemplation, Preparation for Action, Action, Maintenance
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Model that includes the 5 stages of change
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Prochaska's Transtheoretical Change Model
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Expressions of pain vary socially, traditional _____________ may be very verbal and expressive, while ____________ are more stoic.
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Puerto Ricans; Filipinos
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Two cultures, that believe a child is one year at birth
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Vietnamese and Korean Cultures
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A right of passage valued by all cultures. Promotes continuity of family and community.
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Pregnancy
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Significant social markers of changes in a persons life
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Rights of passage
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Non westerners see this as period of vulnerability for the mother, with specific dietary and physical needs
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Postpartum period
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A systematic and comprehensive examination of the cultural care values, beliefs, and practices of individuals, families, and communities. Nurse Gathers information to provide culturally competent care
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Cultural Assessment
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Care that fits the person’s valued life patterns and set of meanings.
Requires specific knowledge, skills, and attitudes. |
Culturally Congruent Care
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Self-examination and in-depth exploration of one's own cultural background. Involves the recognition of one's biases, prejudices, and assumptions about individuals who are different.
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Cultural awareness
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The ability of the nurse to bridge cultural gaps in caring, work with cultural differences and enable families to achieve meaningful and supportive caring.
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Cultural competency
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Leinenger's theory
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Theory of Transcultural caring
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Theory that states that caring is an essential human need that helps an individual or group improve a human condition and helps to protect, develop, nurture, and sustain people
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Lienengers Theory of Transcultural Caring
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Model of caring that:
•Promotes healing and wholeness •Rejects the disease orientation to health care •Places care before cure •Emphasizes the nurse-client relationship |
Watson's Theory of Transpersonal Caring
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Defines caring as a nurturing way of relating to a valued other, toward whom one feels a personal sense of commitment and responsibility
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Swanson’s Theory of Caring
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Swanson's 5 caring processes
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Knowing
being with doing for enabling maintaining belief |
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Concerned with the relationship between the client and nurse, places the nurse as the client’s advocate, sees client as a unique being
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Ethic of Care
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An example of contact touch
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Physical touch such as hand holding
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An example of noncontact touch
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Eye contact
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An example of protective touch
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Catching a falling client
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Example of task oriented touch
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Touch during proceedures. Ex. Transfers
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Caring process of striving to understand an event as it has meaning in the life of the other
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Knowing
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Subdimensions:
Avoiding assumptions Centering care on the one cared for Assessing thoroughly Engaging the self or both |
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Caring process that involves being emotionally present for the other
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Being with
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Subdimensions:
Being there Conveying ability Sharing feelings Not burdening |
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The caring process of doing for the other what he or she would do for the self if it were at all possible
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Doing for
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Subdimensions:
Comfortin Anticipating Performing skillfully Protecting Preserving dignity |
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Caring process defined as sustaining faith in the other's capacity to get through an event or transition and face the future with meaning
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Maintaining belief
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Subdimensions
Believing in/holding in esteem Maintaining a hope-filled attitude Offering realistic optimism "Going the distance" |
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Caring process that facilitates the other's passage through life transitions (birth, death, etc.) and unfamiliar events
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Enabling
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Subdimensions:
Informing/explaining Supporting/allowing Focusing |
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Develops over time and is the core process of clinical decision making
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Knowing the client
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3 aspects of knowing the client
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–Responses to therapy, routines, and habits
–Coping resources –Physical capacities and endurance |
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3 contemporary challenges to providing care
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•Trend toward task-oriented care
•Technology •Nurse-to-client ratios |
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Creates trust, opens lines of communication, creates a mutual relationship
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Listening
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A model of care that occurs outside of traditional health care facilities, with unique challenges
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Community-Based Health Care
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Goals of this initiative are to increase life expectancy and quality of healthcare through improved access
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Healthy People Innitiative
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Vulnerable populations in community healthcare
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–Immigrants
–Poor and homeless –Abused –Substance abusers –Mentally ill –Older adults |
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3 areas of community assessment
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1. Structure
2. Population 3. Social systems |
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Type of greif that peaks by 6 months after the loss, then gradually subsides
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Normal grief
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Chronic grief that is, delayed, excessive, exaggerated, concomitant. More frequent in cases of violent or unexpected death, or when relationsip with deceased was unresolved
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Complicated grief
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Grief that is felt before a loss, common with degenerative disease
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Anticipatory grief
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Grief over a non-sanctioned loss, such as the loss of a pet or gay partner
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Disenfranchised grief
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Kübler-Ross’s Stages of Dying
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–Denial
–Anger –Bargaining –Depression –Acceptance |
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Who is eligible for hospice care?
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People with a diagnosed life expectancy of 6 months or less
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Requirement for home hospice care
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Must have a 24/7 caregiver in the home.
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Model for the care of the terminally ill that is family centered. Acceptance into a program based on need, rather than ability to pay.
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Hospice model of care
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Common hospice settings
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Home, hospital, LTC facility
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Hospice resources include
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Social workers, Physicians, Nurses, Therapists, Pastoral, Respite, Pain management, Durable medical equipment, Access to available hospital and nursing home beds
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This list, published in the "American Journal of Nursing," can be used as a guideline for those who are dying and who care for a loved one who is dying.
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The Dying Patient's Bill of Rights
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4 categories of health risk factors
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1. Genetic and physiological
2. Age 3. Environment 4. Lifestyle |
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Risk Factor Modification and Changing Health Behaviors include what two steps?
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1. Identify risk factors in health promotion, wellness education, and illness prevention.
2. Implement risk modification, health promotion, or illness prevention activities. |
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3 guidelines for assessing members of vulnerable populations and groups
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1. Setting the stage
2. Nursing history of an individual or family 3. Physical examination or home assessment |
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The overall goal of this association is to address the challenge of preparing future nurses with the knowledge, skills and attitudes (KSA) necessary to continuously improve the quality and safety of the healthcare systems in which they work.
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QSEN
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What does KSA stand for?
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Knowledge, Skills, Attitude
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6 QSEN KSAs
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Patient-centered Care
Teamwork and Collaboration Evidence-based Practice (EBP) Quality Improvement (QI) Safety Informatics |
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The nation's oldest and largest standards-setting and accrediting body in health care. Evaluates and accredits more than 18,000 health care organizations and programs in the United States
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The Joint Commission
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Association with the 21 competencies that focuses on public service, caring for health communities and ethical behaviors
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Pew Health Professions Comission
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Area of community assessment that might include the following: geographical boundies, name of neighborhood,housing, transportation, sanitation
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Structure
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Area of community assessment that might include the following: growth trends, age distribution, sex distribution, predominant cultural and religous groups, education levels
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Population
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Area of community assessment that might include the following: schools, clinics, hospitals, government, welfare, health
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Social systems
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A woman says to her doctor, "If you could just keep me healthy past Christmas, I'll accept whatever else comes." What stage of grief is she experiencing.
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Bargaining
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A man who is in end stage renal failure appears sad and is voicing regrets about never taking his relationship with his daughter. What stage of grief is he experiencing?
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Depression
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When the hospice worker contacts Karen about end-care for her daughter, who has a recently diagnosed life-expectancy of 4 months, she tells the worker that her daughter is not dying, and that they will not be needing hospice care. What stage of grief is Karen experiencing?
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Denial
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Mr Green, who has end-stage COPD, has become very short tempered with his home care nurse and yelled at her when she was helping him dress yesterday. What sage of grief might Mr. Green be experiencing?
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Anger
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Your client seems to be enjoying visits from her family and sharing life stories with you. She is selecting songs for her memorial service and asks for your opinion. What stage of grief is your client experiencing?
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Acceptance
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Name three collectivist cultures, where traditional adults may rely upon family and kin to make decision and provide care.
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Hispanics, Africans, Asians
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Practice folk remedies such as coining, cupping, pinching and burning for pain relief and removal of bad wind
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Southeast Asian Cultures
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Use cupping for respiratory ailments
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Easter European Cultures
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This culture views pregnancy as a hot state and encourage cold foods such as milk, yougurt and sour fruits and vegatables
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Hindus
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A woman's infertility could be grounds for divorce in this culture.
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Arab
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A couple from this culture may refuse prenatal testing, believing the outcome of the pregnancy is God's will.
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Filipino
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Women for these cultures may refuse to be examined by a male healthcare provider out of modesty.
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Arab cultures
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Religions that prohibit the presence of males in the delivery room
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Muslims, Hindus, Orthodox Jews
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Traditional Arabs can be _______ physically and verbally expressive when experiencing pain.
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more
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Parents from this culture keep the newborn inside the home until baptism to ensure the baby's health and protection
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Catholic Filipino
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In non-Western cultures, the postpartum period is much ________ than in Western cultures.
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Longer
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Mother's from non-Western cultures may refuse a ___________ after birth and ask for a ___________ to restore balance.
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shower, sponge bath
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To restore balance after giving birth, _____________ mothers prefer soups, rice, wine and eggs while __________ mothers opt for pistachios and eggs.
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Chinese, Iranian
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These cultures use an abdominal binder to prevent air from entering the woman's uterus and to promote healing
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Filipino, Mexican, Pacific Islanders
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Bleeding is associated with polution in these cultures. A woman goes into a ritual bath after bleeding stops before resuming relations with her husband.
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Orthodox Jewish, Islamic, Hindu
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In these cultures, the woman will not resume sexual relations with the husband until the baby is weaned
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African cultures, such as Ghana and Sierra Leone
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In these cultures, dying is a step toward rebirth. Care of the dying focuses on providing a good death.
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Hindu and Buddhist
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A dying male from this culture may refuse medication and nourishment to focus his energy on the spiritual aspects of moving to the next cycle
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Hindu
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Devout members of this culture may refuse autopsy or organ donation for fear of desecrating the dead.
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Muslims
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White is the symbolic color of grief in this culture.
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Hindu
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In this culture, a person may be paid to lead open grieving. Loud crying and screaming is common.
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Korean
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Cultural healers from these groups include herbalists, acupuncturists, fortune tellers and shaman
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Chinese and Southeast Asians
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The culture uses Ayurvedic practitioners
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Asian Indians
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Old Lady, granny midwife, spiritualist and Voodoo practitioners (Hougan, Mambo) are types of healers in which culture?
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African American
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Healers from this culture include Pareteras (Lay midwives), Yerbro (Herbalist), Sabador (bonesetter), Espiritista (spiritualist)
Rituals include Curandero and Santero |
Hispanic
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In this stage of health behavior change, the client will not be interested in information about the behavior and may be abusive whe confronted with information.
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Precontemplation
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In this stage of health behavior change, the client may be ambivalent but he is more likely to accept information. He is developing belief in the value of change.
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Contemplation
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During this stage of health behavior change, the client believes the advanttagesnof change outweigh the disadvantages. May neednassistance planning change.
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Preparation for Action
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In this stage of health behavior change, your client is engaged in strategies to change behavior. Can last up to 6 months. You should help client identify barriers and facilitators of change.
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Action
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This stage of health behavior change begins 6 months after action has started and lasts indefinitely.
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Maintenance
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5 types of loss
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–Necessary
–Maturational –Situational –Actual –Perceived |
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5 Life transitions common to all cultures
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•Rights of passage
•Pregnancy •Childbirth •Newborn •Postpartum period •Grief and loss |
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3 guidelines for cultural assessment
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1. Ask open ended questions
2. ask for details 3. be sensitive |
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Caring Beliefs and Practices
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•Respect
•Concern •Attention to details •Active listening •Comfort measures •Presence • Understanding |
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Roles of the community based nurse
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–Caregiver
–Case manager –Change agent –Client advocate –Collaborator –Counselor –Educator |
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3 examples of nurse sensitive outcomes
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Pressure ulcers, UTIs and falls
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Nursing discipline that requires an understanding ot the needs of a population who have one or more personal or environmental characteristics in common. (high risk infants, older adults, cultural group)
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Public health nursing
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Nursing practice in the community with primary focus on the health of individuals, families and groups in a community
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Community health nursing
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