321 Exam 1 Flashcards
Pre-Interaction Phase
going through available date / med history, getting report, planning the first meeting
Orientation Phase
first meet and getting to know each other, sets tone for relationship, establish trust
Working Phase
you and the client work together to solve problems and accomplish goals, encourage expression of feelings about their health, help client with self exploration
Terminationn Phase
end of the relationship, reminding the pt the end is coming, evaluate achievement
ways messages are conveyed
words = 10%, tone of voice = 40%, body language = 50%
good communication
reduces risk of errors, promotes improved outcomes, competent communication meets legal, ethical, and clinical standards of care, influences client behaviors
motivational interviewing
person centered communication approach to foster behavioral changes; encourages pt to share thoughts/fears/beliefs - nurse then focuses on strengths of the individual and supports them
nurses need to provide what kind of communication to other team members
consistent, accurate, timely and complete information to address risk of possible communication breakdown
what to do if lateral violence is happening
address situation in a calm manner, ask for it to stop, notify manager, document incidents in personal notes
examples of lateral violence
withholding information, being hyper critical, raising blame, making put downs, criticizing without solutions, excluding people, nonverbal expression of disapproval
lateral violence can lead to
job dissatisfaction, decreased sense of value, poor teamwork, poor retention of qualified staff, nurses leaving the profession
elements of professional communication
courtesy, use of names, trustworthiness, autonomy, assertiveness, advocacy, professional boundaries
factors that influence the communication process
developmental level, values, personal space, territoriality, roles & relationships, environment, congruence, interpersonal attitudes
Poor listening behaviors
reacting to appearance rather than what is said, faking attention, failing to eliminate noise, thinking rather than listening
what is good education linked with
shorter hospital stays
what is poor education linked with
increased number of pts, increased demand on nurses time, increased number of pt living with chronic disease
goal of education
achieve optimal health!, maintenance & promotion of health, illness and prevention , restoring health, and coping with impaired functions
definition of teaching
imparting knowledge through a series of directed activities
goal of teaching
impart knowledge so others can gain knowledge, change attitudes, adopt new behaviors and perform new skills
definition of learning
conscious or unconscious permanent change in behavior as a result of a life long, dynamic process by which individuals acquire new knowledge/skills/attitudes
when does learning begin
when the learner identifies need to leaner
steps in the teaching-learning process
assessment, diagnose & development of expected learning outcomes, plan the teaching, implementation of teaching plan, evaluation of teaching plan, achievement of learning outcomes (eval of learning process)
Teaching-Learning Process: Assessment
characteristics of pt (age, developmental stage, level of education, beliefs, motivation, risks) and needs (what the pt needs to now)
Teaching-Learning Process: Planning goals
set priorities and develop w/ the pt, start goals in terms of the pt, board terms (“reducing”, “enhancing”), longer term than objectives
Teaching-Learning Process: Planning objectives
specific statements that can be used to evaluate learning, pt centered, no vague terms, includes only 1 behavior per objective
smart objectives
specific: addresses 1 thing
measurable: how will you know they learns
attainable: pt agrees & able to do it
realistic: something they need to learn + willing
timely: set a timeframe to accomplish
Teaching-Learning Process: Implementation
(key: age appropriate, maintains attention & participation) printed materials, role play, games you’re actively doing the teaching
what grade level should reading level be at for educational materials
5th grade
Teaching-Learning Process: evaluation
has the pt’s learning needs been met? teach back method,
what are the three domains of learning
cognitive, affective and psychomotor ; they are used to organize and evaluate teaching
describe the cognitive domain
memory, understanding, recognition, reasoning, application pyramid bottom to top: remember, understand, apply, analyze, evaluate, create
desired outcome of cognitive domain
pt is able to describe information that is relevant to their behavior change or explain why the information is relevant to the behavior change
teaching methods for the cognitive domain
discussion, lecture, one-on-one, audiovisual materials, printed materials, computer assisted instruction
verbs for cognitive domain
compare, define, describe, design, explain, identify, list, name, write, prepare, categorize
evaluation of cognitive domain
direct observation of behavior, written measurements, & self reporting/monitoring (subjective)
describe the affective domain
changes in attitudes or values, motivation feeling domain including values, beliefs, feelings, and attitudes associated with information received (people need support and encouragement)
affective domain pyramid bottom to top
receiving, responding, valuing, organization, characterization (acting in accordance w/ the internalized values)
teaching methods for affective learning
role play to express feelings, simulation/gaming, discussion (group or 1on1), debate, value clarification exercises
verbs for affective objectives
answer, choose, defend, form, give, participate, help, join, select, share, justify
evaluation of affective domain
role play/simulation to see if values changed, express how learning has changed
describe psychomotor domain
skill performance, demonstration must have physical, mental and emotional readiness & need neuromuscular coordination and motor skills
psychomotor domain pyramid (bottom to top)
perception (use sensory cues to guide motor activity), set, guided response, mechanism, complex overt response, adaption, origination (ability to creat new movement)
teaching methods for psychomotor learning
demonstrate, practice, return demonstration, independent projects/games
verbs for psychomotor objectives
calculate, demonstrate, measure, move, create, construct, shows, work, organize, manipulate, arrange, begin
evaluation of psychomotor domain
return demonstration
basic principles (questions) to evaluate readiness to learn
do they have physical needs at the moment? are they in pain? de they prefer to be with support person when they learn?
factors that influence learning
motivation, ability to learn, learning environment
health literacy
the degree to which individuals have the ability to find, understand, and use information and services to inform health related decisions and actions for themselves and others (cognitive & social skills)
X out of 10 adults struggle to understand and use health information if it is unfamiliar, complex or uses jargon
9 ; 90%
functional illiteracy
inability to read above 5th grade level
what ages are classified as young adult
18 - mid to late 30s
what ages are classified as middle adults
35-65
what ages are classified as older adults
65+
principles and methods of teaching young & middle adults
-practical & relevant (for young, related to them)
-learners must see a need
-use peer education
-motivate w/ social task mastery
-encourage active & independent learning
-sessions under 1 hour
principles and methods of teaching older adults
-give time to process and respond
-teach when alert & rested
-involve discussion or activity (relate to past)
-focus on wellness & person’s strengths
-make adaptations
-simple instruction, 20-30 mins
-teach only what is necessary , give summary
considerations for teaching older adults - coordinate
-start w/ person’s concerns
-plan enough time (may need more than 1 session)
-match your pace w/ person
considerations for teaching older adults - anticipate
-recognize more than one problem
-screen for high prevalence problems
-be aware of any communication barriers, musculoskeletal changes
considerations for teaching older adults - manipulate
modify the environment by reducing nose, making it a comfortable temp, lighting and privacy and always consider person’s comfort
considerations for teaching older adults - validate
check information obtained from older person, review perceptions, read medical record
learning for older adults : challenges
teaching, time, relevance, roadblocks, sensory perceptual deficits, cognitive declines, non compliance
learning for older adults - approaches
visual aids, active involvement, relate to past experiences, peer educators & support groups , simple, support belief that change is good, capitalize on teaching moments
Cognitive Domain - remember
recall facts and basic concepts (define, duplicate, list, memorize, repeat, state)
Cognitive Domain - understand
explain ideas or concepts (classify, describe, discuss, explain, identify, locate, recognize, report, select, translate)
Cognitive Domain - apply
use information in new situations (execute, implement, solve, use, demonstrate, interpret, operate, schedule, sketch)
Cognitive Domain - analyze
draw connections among ideas (differentiate, organize, relate, compare, contrast, distinguish, examine, experiment, question, test)
Cognitive Domain - evaluate
justify a stand or decision (appraise, argue, defend, judge, select, support, value, critique, weigh)
Cognitive Domain - create
produce new or original work (design, assemble, construct, conjecture, develop, formulate, author, investigate)
Affective Domain - receiving
receives the information, passively being aware of ideas, materials, phenomena
Affective Domain - responding
responds to the information received. Actively participating in the learning process, reacting
Affective Domain - valuing
able to see the value / worth of an idea and express it
Affective Domain - organization
puts together different values, ideas, information, and relates them to already held beliefs (creating value system)
Affective Domain - characterization
acting in accordance with the internalized values
Psychomotor Domain - perception
the ability to use sensory cues to guide motor activity
Psychomotor Domain - set
the readiness to act
Psychomotor Domain - guided response
first attempt at a physical skill that involves imitation and trial and error
Psychomotor Domain - mechanism
learned responses have become habitual and the movements can be performed with some confidence and proficiency
Psychomotor Domain - complex overt response
the skillful performance of motor acts that involve complex movement patterns
Psychomotor Domain - adaptation
the ability to modify learned skills to meet new or special requirements
Psychomotor Domain - origination
ability to create new movement for a specific situation or problem
denial
pt avoids discussion of illness, is withdrawn ; nurses should provide support, remain available, explain situation to family and teach in present tense
anger
pt blames and directs anger towards nurse or others ; nurses should not argue w/ pt, teach in the present tense, reassure family that this is normal
bargaining
pt offers to live better life in exchange for promise of better health ; nurses should continue to introduce only reality and teach in present tense
resolution
pt begins to express emotions openly, realizes that illness has created changes and begin to ask question ; nurses should encourage expression of feelings, find out what pt wants to learn and begin sharing info needed for future
acceptance
pt recognizes reality of condition, actively pursues information and strive for independence ; nurses should focus teaching on future skills and knowledge required but continue to teach about present occurrences, involve family in teaching
principles and methods of teaching adolescents
-help them learn about feelings & self expression
-allow them to make decision about health & health promotion (safety, sex ed, substance abuse)
-collaborative activities
-use problem solving
who is at risk for low health literacy
older adults, minority populations, immigrants, people w/ low incomes, people without high school education and people w/ chronic mental and/or physical conditions
