322 MIDTERM Flashcards
1
Q
Primary Prevention
A
GOAL: to prevent diseases from occurring
● These activities are implemented while individuals are healthy and have not yet developed disease
○ Interventions that promote health and prevent disease
○ Aimed at individuals who are susceptible but have no discernible disease/pathology
● No one is sick
2
Q
What are some examples of primary prevention?
A
● Healthy eating ● Exercise ● Clean water ● Immunizations ● Adequate sleep ● Bike helmet use ● Education programs ● Safe sexual practices
3
Q
Secondary prevention
A
GOAL: to detect disease in its early stages
● These activities are aimed at:
○ Detection of disease in the early stages before clinical signs appear
○ Reversing or reducing the severity of disease or providing a cure
● The goal is to either reverse the process (cure) or reduce the severity of the disease
4
Q
What are some examples of secondary prevention?
A
EXAMPLES OF SECONDARY PREVENTION ● Vision and hearing screenings ● Blood pressure screenings ● Pap smears ● Testing cholesterol ● Immunoglobulins ○ Immunizations are primary prevention ● Using antibiotics for an infectious disease ● Surgery where complete recovery is expected ● Screening for drug use REMEMBER: WE ARE LOOKING FOR DISEASE!!!
5
Q
What is tertiary prevention
A
GOAL: to improve the course of the disease, reduce disability, or rehabilitate
● Activities are directed towards people with clinically apparent disease
● The expectation is that these individuals will NOT return to their pre-illness level of functioning
● We are trying to limit the amount of diseases or disability a person experiences
6
Q
What are some examples of tertiary prevention?
A
EXAMPLES OF TERTIARY PREVENTION ● Physical therapy ● Speech therapy ● Insulin therapy for a diabetic ● End of life care ● Support groups
7
Q
Trust vs. Mistrust
A
-occurs during infancy (0-18 months)
o If the care the infant receives is consistent, predictable and reliable, a sense of trust develops which is transferrable to other relationships, allowing a sense of security when feeling threatened
-If needs are met in a timely manner –> trust
-If their needs aren’t met –> mistrust & will become apathetic
o A sense of hope develops from successful completion of this stage
8
Q
Sensorimotor Stage
A
o Intelligence demonstrated through motor activity
o Knowing the world is based on physical experience
o Object permanence, memory, and causality begin to develop around 7 months
May experience separation anxiety due to object permanence
• If something or someone is not there they don’t exist
• Object permeance- when kids know that objects continue to exist even though they can no longer be seen or heard
Cannot recognize different people
9
Q
Object premanence
A
the understanding that objects continue to exist even when they are not seen
10
Q
What age group is not applicable with Kohlberg’s stage?
A
infancy
11
Q
Autonomy vs. shame and doubt
A
o Skills and abilities emerge that illustrate the child’s growing sense of independence and autonomy
If children are encouraged and supported in their increased independence become more confident and secure in their own ability to survive in the world
If children are criticized, overly controlled, or not given the opportunity to assert themselves begin to feel inadequate, become overly dependent upon others, lack self-esteem, and feel a sense of shame or doubt in their abilities
12
Q
What age does autonomy vs shame and doubt occur?
A
18-36 months in the toddler age
13
Q
Pre-conventional/obedience and punishment
A
an action is wrong if one gets punished for it
o Sense of morals is externally motivated
14
Q
What age does the pre-conventional/obedience and punishment occur?
A
up till age 9 but is first seen in the toddler stage
15
Q
Preoperational (Piaget)
A
o Children think in images and symbols
16
Q
What age does the preoperational stage occur
A
spans 2-7 years
17
Q
Symbolic play
A
imaginary friends or social play with roles assigned
18
Q
egocentricism
A
unware that other viewpoints exist
“I like Sesame Street, so daddy must like Sesame Street too
19
Q
Animism
A
inanimate objects are capable of actions and have lifelike qualities
ex) stars twinkle in the sky because they are happy
20
Q
Artificialism
A
the belief that environmental characteristics are attributed to human actions or interventions
ex) thunder is angels blowing
21
Q
Transductive reasoning
A
does not understand cause and effect
Reasons from specific to specific, drawing a relationship between separate events that are unrelated
• If the child wishes someone harm, and then something bad happens, the child believes they caused the event
22
Q
initiative vs. Guilt
A
o Child regularly interacts with other children
o Play is pivotal
Plan activities, make up games, and initiate activities with others
o Children develop a sense of initiative and feel secure in their ability to lead others and make decisions
o Conversely, if this tendency is squelched, either through criticism or control, children develop a sense of guilt
23
Q
What is the most important concept in initiative vs. guilt
A
play is pivotal
24
Q
When does initiative vs guilt occur?
A
Preschoolers (3-5 years old)
25
Pre-conventional stage
o Avoids punishment, and has self-interest orientation (self-centered)
o Decisions based on pleasing others and avoiding punishment
Sense of right and wrong is externally motivated by what they think others want from them
26
Industry vs. Inferiority
o Success leads to a sense of competence
-Expanding relationships outside the nuclear family
-Peer groups become important
-Important event is school
Learning to cope with academic and social challenges
• May be excluded from a peer group or sit alone at lunch
o Gaining awareness of their uniqueness
o Success industry; Failure inferiority
27
Concrete operational stage
o Ability to understand conservation
-Can manipulate objects but cannot conceptualize by themselves
o Intelligence is demonstrated through logical and systematic manipulation of symbols related to concrete objects
o Thinking is less ego-centric, and operational (mental actions reversible)
28
What stage can children understand conservation?
Concrete operational stage
29
What age are kids in both the preconventional stage AND conventional stage
School age (ages 6-12 years old)
30
Identity vs Role Confusion
o Learns roles that will be adopted as an adult.
o Self-identity develops
o Body image extremely important – higher suicide rates
31
Formal Operational Stage
o Intelligence is demonstrated through the logical use of symbols related to abstract concepts
o Thinking may be ego-centric in early adolescence due to increased independent thinking
Can project their insecurities onto other people
32
Conventional Stage
o Behavior is guided by approval or disapproval from social norms, rules, and expectations
o Recognizes the importance of obeying laws and social conventions
o Violating a law is morally wrong
Moral development of this group may be what they have for the rest of their lives
33
What are the three public core functions?
1) Assessment
2) Policy Development
3) Assurance
34
What is assessment as the public health core function?
Systematic data collection on the population
- Important to have infrastructure on where to put the data you’re collecting
Monitor the population’s health status to identify existing or potential health problems
- Example: COVID tracing data collection
35
What is policy development?
- Inform, educate, and empower people regarding health issues
- Develop and support local, state, national and international legislation that support and promote the health and well-being of the population
- Use a scientific knowledge base to make policy decisions
- Mobilize partnerships b/w nursing and many other disciplines
36
What is assurance?
- Make sure that essential community oriented health services are available
- Enforce laws and regulations that protect health of population and ensure safety
- Link health services with people
37
Teaching methods for school-age
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o Lecture
o Discussion
o Role modeling
o Role playing
o Demonstration/return demonstration
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38
Teaching strategies for school age
- assess the child's learning styles
- watch for non-verbal feedback-allow questions
- play and group work
- needs concrete, step-by-step info
39
Goal for school age child (harm)
will remain injury-free
40
learning needs for school age
Needs opportunity to make decisions and take responsibility
· Variable rates of physical growth
· Cause and effect (ex. smoking increases risk of cancer)
· Safety, nutrition, sleep, & exercise
41
Learning needs and readiness for adolescents
Needs opportunity to make decisions and take responsibility
· Variable rates of physical growth
· Safety, Sexuality, Nutrition, and Sleep, & Exercise
· Mental health
42
Teaching strategies for adolescents
Assess child’s learning styles and strengths
· Provide for shared decision-making
· One-on-one for privacy
· Work with peers and social groups
· Use respect, avoid confrontation and condescending.
· Role-play and gaming
· Provide rationales
43
Goal for adolescents
alcohol use will decrease in the adolescent population
44
Objectives for adolescents
adolescents will discuss the effect of alcohol on the developing brain
45
Teaching strategies for infants
Instruction through parent and caregiver
· Play and manipulation of objects
· Repetition and imitation
· Allow for variety due to short attention span
46
Learning needs/readiness in Infants
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Feeding and nutrition
· Sleep routine
· Mobility
· Safety
· Hygiene and Immunizations
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47
Goal of the infant
development of trust
48
Teaching methods for infants (their caregivers)
One-to-one Discussion
o Demonstration/return demonstration
§ Teach back method
o Role-playing
49
Objectives for caregiver for infants
o The caregiver will attend to the infant’s cry within 10 minutes
o The caregiver will demonstrate the correct way to feed an infant
o The caregiver will state three ways trust can be established with the infant
o The caregiver will demonstrate proper diapering technique
50
Learning needs and readiness for toddlers
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· Feeding and nutrition
· Sleep routine
· Mobility
· Safety
· Hygiene and Immunizations
```
51
Teaching strategies for toddlers
· Instruction through parent and caregiver
· Stimulate all senses
· Play and manipulation of objects
· Repetition and imitation
· Allow for variety due to short attention span
52
Teaching methods for toddlers
o Parents: discussion, role playing, demonstration/return demonstration
o Toddler: role modeling, demonstration/return demonstration, short lecture (short steps), role playing (using inanimate objects)
53
Objectives for toddlers
o The parent will state three causes of injury for this age group
o The toddler will demonstrate how to brush their teeth
54
Goal of the toddler
toddler will develop a sense of autonomy
55
Learning needs and readiness for pre-schoolers
```
· Routines: eating and sleeping
· Control and choices
· Security
· Safety
· Hygiene and Immunizations
· School readiness
```
56
teaching strategies for preschoolers
· Assess child’s likes/dislikes and weaknesses/strengths
o Allow child to choose by providing several teaching-learning options
· Simple and brief instructions
· Stimulate all senses
· Play and manipulation of objects
· Repetition
· Positive reinforcement
57
teaching methods for preschoolers
o Discussion
o Role modeling
o Demonstration
o Gaming
58
goal for preschoolers
develop a sense of initiative
59
objectives for preschoolers
o The preschooler will successfully use the potty three times each day
Preschoolers potty-trained by ages 2-3
o The preschooler will list three healthy foods
o The preschooler will identify five dangerous situations on a poster board
60
Level 1: PRE-CONVENTIONAL MORALITY (up to age 9)
o Stage 1: Obedience and Punishment Orientation
The child/individual is good in order to avoid being punished
If a person is punished, they must have done wrong
o Stage 2: Individualism and Exchange
At this stage, children recognize that there is not just one right view that is handed down by the authorities
- Different individuals have different viewpoints
61
Level 2: CONVENTIONAL MORALITY (adolescents and adults)
o Stage 3: Good Interpersonal Relationships
- Child/individual is good in order to be seen as a good person by others
- Therefore, answers relate to the approval of others
o Stage 4: Maintaining the Social Order
- The child/individual becomes aware of the wider rules of society, so judgments concern obeying the rules in order to uphold the law and to avoid guilt
62
Level 3: POST-CONVENTIONAL MORALITY (only about 10% of adults reach this stage)
o Stage 5: Social Contract and Individual Rights
- The child/individual becomes aware that while rules/laws might exist for the good of the greatest number, there are times when they will work against the interest of particular individuals
- Issues are not always clear cut
o Stage 6: Universal Principles
People at this stage have developed their own set of moral guidelines which may or may not fit the law
The principles apply to everyone.
63
Stage 1: Obedience and Punishment Orientation
The child/individual is good in order to avoid being punished
If a person is punished, they must have done wrong
64
Stage 2: Individualism and Exchange
At this stage, children recognize that there is not just one right view that is handed down by the authorities
- Different individuals have different viewpoints
65
o Stage 3: Good Interpersonal Relationships
- Child/individual is good in order to be seen as a good person by others
- Therefore, answers relate to the approval of others
66
Stage 4: Maintaining the Social Order
The child/individual becomes aware of the wider rules of society, so judgments concern obeying the rules in order to uphold the law and to avoid guilt
67
Stage 5: Social Contract and Individual Rights
- The child/individual becomes aware that while rules/laws might exist for the good of the greatest number, there are times when they will work against the interest of particular individuals
- Issues are not always clear cut
68
Stage 6: Universal Principles
- People at this stage have developed their own set of moral guidelines which may or may not fit the law
- The principles apply to everyone.
69
Behaviorist Learning Theory
Stimulus-response model of learning
Behavior is either rewarded or punished
Behavior is externally motivated
Changing the reward or punishment after the learner’s response can also modify the learner
Learner is considered passive
Altering the stimulus can modify the learner’s attitudes and responses
Ex. Potty training a toddler using M&MS; behavior could be rewarded by M&M if they use the potty
Ex. Timeout for being disrespectful- child would want to avoid the timeout (punishment) so they change their behavior
Ex. As a student, you have fear/anxiety before taking first quiz. That is the stimulus providing the feat/anxiety. You get success on first quiz and it altered your attitude on future quizzes, now you have less anxiety about future quizzes.
70
Cognitive Learning Theory
• Emphasizes changing the individual’s cognition: perceptions, thoughts, memory, and ways of processing and structuring information
• The individual interprets new information based on what is already known and then reorganizes the information into new insights and understanding
• Learner directs and is actively engaged in the process
o Not passive – something that the learner is doing
• Reward is not necessary for learning
o The learner’s goals and expectations for learning create a disequilibrium which motivates the learner to act
• Past experiences, perceptions, ways of incorporating and thinking about information, expectations and social influences affect learning
o Concept scaffolding: building on past experiences
71
Social Learning Theory
* Perspective on personal characteristics of the learner, behavior patterns, and the environment
* Focuses on the impact of social factors, and the context where learning occurs
* Learner is central – need to identify what the learner is perceiving and how they are interpreting and responding to social situations
* Role modeling = social process from which the learner learns
72
Humanistic Learning Theory
• Holistic approach
• Each individual is unique and has desire to grow in a positive way
• Emphasizes emotions, and learner’s creativity
• Self-concept and self-esteem are necessary considerations for learning to occur
o How they feel about themselves influences their ability to learn
• Learners, not educators, choose what needs to be learned
o Self-responsibility is stressed
o Learner = active
73
concept scaffolding
building on past experiences
74
What are goals?
• Global, overarching statement for the final outcome of your plan and interventions
• Examples:
o If you are doing a program for teen pregnancy, your goal will be to reduce teen pregnancy
o If you are doing a program on hypertension, your goal will be to reduce the incidence of heart attack and cardio-vascular attacks
o If you are doing a program on healthy eating and nutrition, your goal will be…................
Example: reduce incidence of obesity of certain age groups
o Let’s look at Healthy People 2020
75
Behavioral Objectives
• For the purpose of health education – what you want the learner to DO or KNOW
• Don’t confuse learner behavioral objectives with teaching objectives (interventions, strategies, and methods)
o Examples:
Teaching objectives: teacher will lecture using PowerPoint and film
Learner behavioral objectives: student will be able to distinguish between objectives and goals
• Gives the learner a clear statement about what is expected of them
• Assists the educator in measuring learner’s progress
76
Objectives
* Specific and measurable
* Contain a single behavior
* Be client-centered, realistic, and meaningful
* Have a time frame of when you want them to be able to perform the behavior
77
What do objectives include?
1) condition (co)
2) performance (p)
3) criterion (cr)
78
What is a condition?
describes the testing situation or constraints under which the behavior will be observed
79
Performance
what the learner is expected to do or perform
80
criterion
how well or with what accuracy the learner is expected to perform
81
Cognitive domain
o Cognitive: internal process in your thoughts
82
psychomotor domain
muscle memory, hand-eye coordination in learning a new skill
83
affective domain
how you feel and what you value and reflections that you have
84
Economic stability (social determinant)
Poverty
o Defined regularly by federal government
o 2019 definition: 1 person = $13, 860 annual income
Making that or under = poverty level
-Jobs:
o Includes living wage + unemployment rate
If living wage does not keep up with the cost of living it will detrimentally affect economic stability
- Food security
o Do you have the ability to get your next meal?
o Food insecurity = don’t know how/where to get your next meal form
- Housing stability
o Do you have the resources to pay for next month’s rent or mortgage payment?
85
Education (social determinant)
1) high school graduation
2) enrollment in higher education
3) language and literacy
4) early childhood education and development
86
Social and community context (social determinant)
1) social cohesion
2) civic participation: voters
3) discrimination
4) incarceration
87
Health and health care (social determinant)
1) access to health care
2) access to primary care
3) health literacy
88
Neighborhood and built environment
•Access to quality food
o Is there opportunity for fresh food/produce?
• Quality of housing
o What are the types of housing offered to the community
o Example: trailers vs. apartment complexes
o Is there a problem with utilities/heat?
o Are there sanitary conditions?
Ex. infestations
• Crime and violence
o What is the rate of theft/assault?
o Gun violence?
o Rate of deaths as related to violent crimes
• Environmental Conditions--> quality of water or air in the area also the quality of the soil
89
What are the 5 social determinants
1) Economic stability
2) Education access and quality
3) Health care access and stability
4) Neighborhood and Built Environment
5) Social and Community Context
90
Healthy People 2020 Overarching Goals
1. Attain high-quality, longer lives free of preventable disease, disability, injury, and premature deaths
2. Achieve health equity, eliminate disparities, and improve the health of all groups
3. Create social and physical environments that promote good health for all
4. Promote quality of life, healthy development, and healthy behaviors across all life stages
91
Overarching goals for healthy people 1990
-decrease mortality: infants to adults
| Increase independence among older adults
92
Overarching goals for healthy people 2000
1) increase the span of healthy life
2) reduce health disparities
3) achieve access to preventive services for all
93
Overarching goals for healthy people 2010
1) increase quality and years of healthy life
| 2) eliminate health disparities
94
Overarching goals for health people 2020
- attain high-quality, longer lives free of preventable disease
- achieve healthy equity and eliminate disparities
- create social and physical environments that promote good health
- promote quality of life, healthy development, healthy behaviors across life stages
95
Perceived susceptibility
the degree to which a person believes he/she is at risk for a particular disease or health problem
o Example: if you don't believe you’re at risk for getting an STI, you probably won’t use a condom during sex
96
Perceived severity
what a person believes regarding how serious the consequences of getting the disease is
o Might not avoid the behaviors that lead to the outcomes if you believe what is going to happen to you can be fixed
o What consequences you will get from having the disease and whether you think they are significant of not
o Example: you don’t use a condom & get an STI, but just get antibiotic shot
97
Perceived barriers
perceived problems to overcome in changing the behavior or health outcome
o Example: no doctor’s appointments available for a specific day
o Things that prevent us/get in the way from doing the behavior
98
Perceived benefits
perception that there are benefits to be gained from changing the behavior
o Example: if you believe you get the flu shot and you won’t get the flu you are more likely to get the shot
99
self-efficacy
level of a person's confidence to carry out a behavior
100
likelihood of action (hbm)
• Consists of the components of perceived benefits of preventive actions MINUS the perceived barriers to the preventive actions
o Benefits have to outweigh the barriers that might be in our way
• Must take into account interpersonal influences (ex. family, peer groups
101
Premise of HBM: In order for disease prevention and health promotion activities to be successful
1) client has to be WILLING TO PARTICIPATE
| 2) the client has to HIGHLY VALUE HEALTH
102
Core assumptions of health belief model
1) person feels that a negative condition can be avoided
2) has a positive expectation by taking a recommended action, a negative condition can be avoided
3) believes that a recommended health action can be successful accomplished
103
Precontemplation
-trans theoretical model of change
o The subject has no intention of changing behavior in the foreseeable future
o People in this stage tend to be unaware that they have a problem and are resistant to efforts to modify the behavior
o Example: plant based diet = healthier diet
--> People would rather eat the meat than be healthy
104
Interventions to help transition from Precontemplation to Contemplation
1) consciousness raising
2) dramatic relief
3) environmental re-evaluation
105
Consciousness raising
finding and learning new facts, ideas, and tips that support the healthy behavior change
ex) reading researching, watching documentaries
106
Dramatic relief
experiencing the negative emotions (fear, anxiety, worry) that go along with unhealthy behavioral risks
107
Environmental re-evaluation
realizing the negative impact of the unhealthy behavior or the positive impact of the healthy behavior on one’s proximal social and physical environment
Your unhealthy behavior has a negative impact on those around you
Looking at things in your environment and looking at the relationships from your negative health behavior
Example: you are a cigarette smoker but your child has asthma
108
Contemplation
subjects are aware that they have a problem and are seriously thinking about resolving it but they have not yet made a commitment to take action in the near future
ex) alcoholic, obese people
109
preparation
the stage of decision making
- persons have made a commitment to take actiion within the next 30 days** and are already making small behavioral changes
ex) will attend an AA meeting every Thursday night at 10:30
110
Intervention to help transition from contemplation to preparation
self-evaluation: realizing the the behavioral change is an important part of one's identity as a person
111
Action
subjects make notable overt efforts to change
o They are classified in the action stage if they have modified the target behavior to an acceptable criterion
o Actually doing the steps to change the behavior and reach the goal
ex) running 5 miles a day to lose weight
112
Intervention to help transition from preparation to action
self-liberation: making a FIRM commitment to change
113
Maintenance
subjects are working to stabilize their behavior and avoid relapse
-sustaining action for at AT LEAST 6 MONTHS
114
Termination (not a stage)
* Applies to some behaviors especially the addictions like drinking or smoking
* Individual does not have any temptations
* May not be appropriate for some behaviors such as cancer screening and dietary fat reduction
115
reinforcement management
increasing the rewards for the positive behavioral change and decreasing the rewards of the unhealthy behavior
Example: obese patient who doesn’t eat the cake rewards themselves by buying a blender
116
helping relationships
seeking and using social support for the healthy behavioral change
Example: joining a cooking class, attending AA
117
counterconditioning
substituting healthy alternative behaviors and cognitions for the unhealthy behavior
Example: replacing all the unhealthy snacks in the house with fruit
118
stimulus liberation
realizing that the social norms are changing in the direction of supporting the healthy behavioral change
Example: noticing how restaurants have dairy free alternatives
119
relapse
not a stage
• People must learn to treat this as a limited, minor setback rather than a defeat
• Strategies need to be implemented to get the person to return to contemplation, preparation, or action stages
120
intimacy vs Isolation (young adulthood from ages 19-39)
* Important life events are spousal and beginning family relationships
* Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation
121
Teaching methods for Young Adults
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Teaching methods and strategies
• Use problem-centered focus
• Encourage active participation
• Organize materials
• Recognize social roles
• Apply new knowledge through role playing and hands-on practice
```
122
Teaching methods for Older Adults
* Build on past life experiences
* Allow time for processing with verbal exchange and coaching
* Speak slowly and distinctly
* Use analogies
* Face client when speaking
* Use visual aids
* Use large letters
* Provide sufficient light
* Use white backgrounds and black print
123
Teaching Methods for Middle Adult
* Focus on maintaining independence and re-establishing normal life patterns
* Assess potential sources of stress due to midlife crisis issues
* Provide information to coincide with life concerns and problems
