322 Midterm review Flashcards
Primary Prevention
Goal: to prevent disease 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
Secondary Prevention
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
Tertiary Prevention
Goal is 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
Examples of primary prevention
Healthy eating Exercise Clean water Immunizations Adequate sleep Bike helmet use Education programs Safe sexual practices
examples of secondary prevention
Vision and hearing screenings
Blood pressure screenings
Pap smears
Testing cholesterol
Immunoglobulins
Using antibiotics for an infectious disease
Surgery where complete recovery is expected
REMEMBER: WE ARE LOOKING FOR DISEASE!!!
Examples of tertiary prevention
Physical Therapy Speech Therapy Insulin therapy for a diabetic End of life care Support groups
overarching goals of healthy people 2020
Overarching Goals:
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature deaths
Achieve health equity, eliminate disparities, and improve the health of all groups
Create social and physical environments that promote good health for all
Promote quality of life, healthy development, and healthy behaviors across all life stages
Community Health Nursing
Community Health Nursing: care of individuals and families in a community setting other than an acute care facility
school , occupational health, parish nursing
Public Health Nursing
Public Health Nursing: care of populations in communities
baccalaureate prepared
specialty within community health nursing
the individual is seen as part of the larger social system
Usually found in government or official agencies
Population or aggregate:
Population or aggregate: a collection of people who share one or more personal or environmental characteristics. Members of a community can be defined in terms of either geography or a special interests.
what is public health?
Public Health is a scientific discipline that includes the study of epidemiology, statistics, and assessment, including attention to behavioral, cultural, and economic factors, as well as program planning and policy development.
what does public health do?
Prevent epidemics and spread of disease Protect against environmental hazards Prevent injuries Promote and encourage healthy behaviors Respond to disasters Ensure accessibility to health services (Public Health Functions Steering Committee, 1994)
Public health assessment
Assessment
Systematic data collection on the population
Monitor the population’s health status to identify existing or potential health problems
Make information available about the health of the community
policy development
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
assurance
Assurance
Make sure that essential community oriented health services are available
10 essential services of public health
Assess and monitor Diagnose and investigate Inform and educate Mobilize community partnerships Provide leadership Promote and enforce public health laws Link individuals to services Assure the capacity of the public health workforce Evaluate the effectiveness, accessibility & quality of personal health and population based services Support research
goal of CDC
“To promote health and quality of life by preventing and controlling disease, injury, and disability”
State public health policy
Every state has a health department
Public Health laws are enacted by state governing bodies
State health departments are charged with enforcing those laws
Learning
A relatively permanent change in mental processing, emotional functioning and/or behavior as a result of experience
behaviorist learning
Stimulus-response model of learning
Behavior is either rewarded or punished
To modify people’s responses or attitudes, can either alter the stimulus or change what happens after the response occurs
With this theory, the learner is considered passive.
Behavior is externally motivated
Cognitive learning
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
Learning is an active process directed by the learner
Reward is not necessary for learning
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
Social Learning
Perspective on personal characteristics of the learner, behavior patterns, and the environment
Focuses on the impact of social factors and the social context within which learning occur
The learner is central to this theory: need to identify what the learner is perceiving and how they are interpreting and responding to social situations
ROLE MODELING is the social process from which the learner learns
Role model demonstrates behavior→ learner observes role model→
Learner processes and represents behavior in memory→
Memory guides performance of model’s actions→
Performing the behavior is influenced by consequences of doing the behavior and covert cognitive activity→
PERFORMANCE OF THE BEHAVIOR (OR NOT!!!)
Humanistic
Each individual is unique and all individuals have a desire to grow in a positive way
Emphasizes emotions and feelings, the right of individuals to make their own choices and human creativity
Self-concept and self-esteem are necessary considerations
Learners, not educators, choose what needs to be learned
self responsibility is stressed
Holistic approach
Motivation to learn is derived from each person’s needs, subjective feelings about self, and the desire to grow
3 domains of learning
COGNITIVE
PSYCHOMOTOR
AFFECTIVE
TEACHING INVOLVES ALL THREE
Cognitive
Knowledge- storing and recording new knowledge or information
(the patient will describe how salt intake affects blood pressure)
Psychomotor
Involves the integration of mental and muscular activity
the patient will demonstrate how to give her/himself an insulin injection
Affective
Changes in attitudes, values, and feelings
the patient expresses renewed self-confidence after physical therapy
Steps in teaching process
Assessment Writing Goals/Objectives Content Teaching Strategies Evaluation
Goals
Global statements for outcomes of your interventions
Final outcomes
Ex: if you are doing a program for teen pregnancy, your goal will be to reduce teen pregnancy
Objectives
Definition- WHAT YOU WANT THE LEARNER TO DO OR KNOW
Give the learner a clear statement about what is expected of them and assist the educator in measuring the learners progress
What should objectives be?
Specific and measurable
Contain a single behavior
Have a time frame
Be client-centered
how to write objectives
First choose what domain of learning you wish to use (Cognitive, Psychomotor, Affective)
Often use psychomotor domain- able to evaluate and measure objective better
Choose a verb in the domain
What should objectives include?
Condition (co):
describes the testing situation or constraints under which the behavior will be observed
Performance (p):
what the learned is expected to do or perform
Criterion (cr):
how well or with what accuracy the learner is expected to perform
Blooms taxonomy
Organizes objectives acc. to the three domains of learning; tool for categorizing learning objectives acc. to a hierarchy of behaviors
Objectives are classified into low, medium, and high levels
teaching strategies
Role Modeling Lecture Discussion One to one instruction Panel discussion Demonstration and return demonstration
Types of evaluation
Formative or process
Summative or outcome evaluation
Program evaluation
Assess your learner
In order to prepare your teaching lesson, you need to know who will be in your audience
be aware of the characteristics of the learner
Are you teaching to a homogeneous or heterogenous group?
You need to assess the learner’s state of readiness to learn:
Physically
Cognitively
Psychosocial maturation
Three phases of learning
Dependence
Characteristic of the infant and young child - totally dependent on others
Independence:
Occurs when the young child develops the ability to physically, intellectually, and emotionally care for self and make choices; takes responsibility for learning
Interdependence:
Occurs when the individual has
achieved self-reliance, self-esteem,
develops respect for others
Psychosocial Development (Erik Erikson) Birth to 18 months
Birth to 18 months Trust VS Mistrust
Psychosocial Development (Erik Erikson) Early Childhood 2-3 years
Early Childhood 2-3 years Autonomy vs. Shame and Doubt
Psychosocial Development (Erik Erikson) Preschool
Preschool 3-5 Initiative vs. Guilt
Psychosocial Development (Erik Erikson) School age
School age 6-11 Industry vs. Inferiority
Can I Make It In The World Of People And Things?
Psychosocial Development (Erik Erikson) Adolescence
Adolescence 12-18 Identity vs. Role Confusion
Who Am I? What Can I Be?
Psychosocial Development (Erik Erikson) young adult
young adult 19-40 Intimacy vs. Isolation
Can I Love?
Psychosocial Development (Erik Erikson) middle adult
middle adult 40-65 Generativity vs. Stagnation
Can I Make My Life Count?
Psychosocial Development (Erik Erikson) maturity
maturity 65-death Ego Integrity vs. Despair
Is It Okay To Have Been Me?
Stages of Cognitive Development (Piaget) sENSORIMOTOR
Sensorimotor stage (Infancy). In this period (which has 6 stages), intelligence is demonstrated through motor activity without the use of symbols. Knowledge of the world is limited (but developing) because its based on physical interactions / experiences. Children acquire object permanence at about 7 months of age (memory). Physical development (mobility) allows the child to begin developing new intellectual abilities. Some symbolic (language) abilities are developed at the end of this stage.
Stages of Cognitive Development (Piaget) Pre-operational stage
Pre-operational stage (Toddler and Early Childhood). In this period (which has two substages), intelligence is demonstrated through the use of symbols, language use matures, and memory and imagination are developed, but thinking is done in a nonlogical, nonreversable manner. Egocentric thinking predominates
Stages of Cognitive Development (Piaget)Concrete operational stage
Concrete operational stage (Elementary and early adolescence). In this stage (characterized by 7 types of conservation: number, length, liquid, mass, weight, area, volume), intelligence is demonstarted through logical and systematic manipulation of symbols related to concrete objects. Operational thinking develops (mental actions that are reversible). Egocentric thought diminishes.
Stages of Cognitive Development (Piaget)Formal operational stage
Formal operational stage (Adolescence and adulthood). In this stage, intelligence is demonstrated through the logical use of symbols related to abstract concepts. Early in the period there is a return to egocentric thought. Only 35% of high school graduates in industrialized countries obtain formal operations; many people do not think formally during adulthood.
Teaching strategies Infancy Toddler
Infancy-Toddlerhood Repetition and imitation of information Stimulate all the senses Provide for physical safety and emotional security Allow play and manipulation of objects
Teaching strategies Early Childhood
Early Childhood Warm, calm approach Build trust Repetition of information Manipulation of equipment and objects Simple and brief explanations Simple drawings and stories Play therapy with dolls and puppets Stimulate the senses Use positive reinforcement
Teaching strategiesMiddle and Late Childhood
Middle and Late Childhood
Encourage independence and active participation
Be honest
Logical explanations
Allow time for questions
Use analogies to make invisible processes real
Use drawings, models, dolls, audio and video tapes
Teaching strategies Adolescence
Adolescence Establish trust and authenticity Address fears and concerns Identify control focus Include in planning Use peers for support and influence Focus on details Make information relevant to their life Ensure confidentiality and privacy
Teaching strategies Young Adulthood
Young Adulthood Use problem-centered focus Encourage active participation Organize materials Recognize social roles Apply new knowledge through role playing and hands-on practice
Teaching strategies Middle-aged Adulthood
Middle-aged Adulthood
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
Teaching strategies Older Adult
Older Adult Build on past life experiences Allow time for processing use 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
Kohlberg: Stages of Moral Development Level 1 (Pre-Conventional)
Level 1 (Pre-Conventional) 1. Obedience and punishment orientation (How can I avoid punishment?) 2. Self-interest orientation (What's in it for me?)
Common in children
The morality of an action is determined by its direct consequences.
Egocentric in nature
Stage one (obedience and punishment driven): individuals focus on the direct consequences that their actions will have for themselves.
An action is wrong if one gets punished for doing it.
The worse the punishment for the act is, the more ‘bad’ the act is perceived to be.
Stage two (self-interest driven)
right behavior being defined by what is in one’s own best interest.
Kohlberg: Stages of Moral Development Level 2 (Conventional)
Level 2 (Conventional) 3. Interpersonal accord and conformity (The good boy/good girl attitude) 4. Authority and social-order maintaining orientation (Law and order morality)
Typical of adolescents and adults.
judge the morality of actions by comparing these actions to societal views and expectations. .
Stage three (interpersonal accord and conformity driven),
Individuals behave according to the approval or disapproval from other people as it reflects society’s accordance with the perceived role.
They try to be a good boy or good girl to live up to these expectations
“golden rule”
judge the morality of an action by evaluating its consequences in terms of a person’s relationships, respect, gratitude
Desire to maintain rules and authority.
Stage four (authority and social order obedience driven)
it is important to obey laws and social conventions
A central ideal or ideals often prescribe what is right and wrong
there is an obligation and a duty to uphold laws and rules.
When someone does violate a law, it is morally wrong
Kohlberg: Stages of Moral Development Level 3 (Post-Conventional)
Level 3 (Post-Conventional)
5. Social contract orientation
6. Universal ethical principles
(Principled conscience)
Also known as the principled level
Realization that individuals are separate entities from society now becomes salient.
One’s own perspective should be viewed before the society.
Stage five (social contract driven)
individuals are viewed as holding different opinionw and values
laws are regarded as social contracts rather than rigid dictums. Those that do not promote the general welfare should be changed when necessary to meet the greatest good for the greatest number of people.
Stage six (universal ethical principles driven)
moral reasoning is based on abstract reasoning using universal ethical principles.
Laws are valid only insofar as they are grounded in justice and that a commitment to justice carries with it an obligation to disobey unjust laws. One
acts because it is right, and not because it is instrumental, expected, legal or previously agreed upon.
General concept of the Health Belief Model
Unless a person sees some value in making a behavior change, there will be no reason to consider the change
What are the four main variables for the HBM?
Perceived susceptibility
Perceived severity
Perceived barriers
Perceived benefits
The degree to which a person believes he/she is at risk for a particular disease or health problem
The degree to which a person believes he/she is at risk for a particular disease or health problem
Perceived Severity
The consequences of getting the disease
Perceived Benefits
Perception that there are benefits to be gained from changing the behavior
Perceived Barriers
Perceived problems to overcome in changing the behavior or health outcome
Modifying factors in the Health belief model
Demographic variables
age, sex, ethnicity
Sociopsychological variables
personality, social class, peer and reference group pressure
Structural variables
knowledge about the disease, prior contact with the disease
Cues to Action
Mass media campaigns advice from others reminder cards from primary care providers illness of family member or friend newspaper or magazine article
Self Efficacy
Theory based on a person’s expectations relative to a specific course of action.
This theory deals with the belief that one can accomplish a specific action
Involves strategies such as modeling, demonstration, verbal reinforcement
What does the Ecological Model do?
Emphasize the environmental and policy contexts of behavior
Incorporate the social and psychological influences of behavior
Views behavior as being affected by, and affecting the social environment
Ecological Models consider multiple levels of influence of health behaviors and thus guide the development of comprehensive interventions
Eliminates victim blaming
What is the purpose of the ecological model?
Provide comprehensive frameworks for understanding the multiple and interacting determinants of health behavior
Used to develop comprehensive and intervention approaches that systematically target mechanisms of change at each level of influence
Ecological models guide comprehensive population wide approaches to behavior change
What are the core principles of the ecological model?
There are multiple influences on health behaviors at the interpersonal, intrapersonal, organizational, community, and public policy levels
Influences on behaviors interact across all of these levels
Ecological models are behavior specific, identifying the most relevant potential influences at each level
Multi-level interventions are most effective at changing behavior
in the ecological model, when is behavior change maximized?
When environments and policies support healthful choices
When social norms and social support for healthful choices are strong
When individuals are motivated and educated to make those changes
Transtheoretical Model of Change Precontemplation
Precontemplation
The subject has no intention of changing behavior in the foreseeable future.
People in this stage tend to be unaware that they have a problem and are resistant to efforts to modify the behavior.
