CPI Flashcards
Define cultural competency
Refers to the need for professional Al’s to honor cultural diversity of families in the provision of services. It refers to the ability to respect those beliefs, interpersonal styles, attitudes and behaviors of the families receiving service.
Describe appropriate care for patients suffering from coma
Atmosphere Breathing Introduction Touch Observation with interpretation Feedback Copying Amplifying Resisting Enabling expression
Four areas in which cultural competency is NB when counseling RE TOP
Religious beliefs
Language
Cultural background
Informed consent
Three sections of GCS
Best verbal response
Motor response
Eye response
Define locked in syndrome
Patient is aware and awake but unable to communicate due to complete paralysis of voluntary muscles (except eyes)
Define vegetative state
Absence of responsiveness and awareness due to overwhelming cerebral hemisphere dysfunction. Autonomic and motor reflexes are often sparred and sleep wake cycle is often intact. May also have complete reflexes (yawn, eyes) but has no awareness of self or environment.
Biological factors that may contribute to depression
Genetic
Neurochemical
Neuroendocrine
Neurophysiological
Four theories of aetiology of depression
Psychodynamic theory
Cognitive theory
Learned helplessness theory
Life-event theory
Factors that may cause people not to present to HCW with depression
Lack of awareness
Stigma, fear, shame
Cost
Sign and symptoms to diagnose depression
Depressed mood Markedly diminished interest/ pleasure Weight loss Insomnia/ hypersomnia Psychomotor agitation Fatigue Feelings of worthlessness, guilt Diminished ability to think, concentrate Recurrent thoughts of death
Define attachment
The disposition of a child to seek proximity to and contact with a specific figure. Including the tendency to do so in stressful situations (tired, scared, ill)
Three types of attachment
Secure attachment
Anxious resistant attachment
Anxious avoidant attachment
Approach to care of stoke patient’s caregivers
Family centered approach.
False hope and unrealistic expectations dealt with.
Transition out of hospital and all care related to that.
Disability grants etc.
Reconcile HCW goals for patient and family’s.
Four communication elements of cultural competency
Communication repertoire
Situational awareness
Adaptability
Knowledge (of culture)
Define cultural relativism
Individuals beliefs and activities should be understood in the context of their culture
Define kinship
Relationship between any entities that share a genealogical origin (decent or marriage)
The basic principle of organizing individuals into social groups, roles and categories.
Define stigma
An attribute linking a person to a set of undesirable characteristics that may produce prejudice or discrimination
Reasons for not leaving a violent relationship
- Fear leaving > staying
- Economic factors
- Perceived needs of children
- Self blame
- Expectations of others
- Hope that abuse will stop
- Concern for spouse
- Learned helplessness
- Beliefs
Approach to helping those in abusive relationship
Identify abuse Not alone/ blame Right to live without fear Listen and believe her Encourage other sources of help Safety plan Support her decisions
Risk factors for injury/death in abusive relationship
Increasing severity of abuse Available weapon Threats to kill Previous attempts to kill Suicide attempt by abused Stalking
Define unnatural death
Death causes by: External factors Acts of omission / commission Sudden unexpected death (until proven otherwise) Procedure related death
Doctors obligations regarding death
Aware of process of dying Able to diagnose death Distinguish natural vs unnatural Complete DNF Know when autopsy needed
Autopsy legislation
Inquest act
National health act
Criteria for alcohol abuse
Failure to fulfill major obligations
Recurrent alcohol use that is physically harzardous
Legal problems
Continued use despite social and interpersonal problems
(PHLO)
Criteria for alcohol dependence
Tolerance (increased amount needed, diminished effect)
Withdrawal (symptoms, or taken to avoid symptoms)
Larger amounts for longer periods
Unable to cut down despite trying
Time spent (obtaining, recovering)
Give up on social, occupational and recreational activities
Continued use despite having adverse effects
Factors that caused a delay in seeking TOP
Sociodemographic Pregnancy recognition, confirmation & response Contraceptive use Personal and emotional factors No knowledge of legislation Difficulty accessing service Stigma Religious views
Rights of disabled
Equality before law Non discrimination Equal opportunity Independent living Full integration Personal freedom Security of person
Effects of language barrier
Decreased work efficiency Concern about accuracy of interpretation Enhanced by lack of training Medico-legal dilemmas Neg influence on attitudes between staff and pts Decreasing quality of care Decreasing satisfaction with care Cross cultural misunderstandings
Levels of consciousness
The cortex : contents of consciousness
The brainstem : level/state if consciousness
Extended consciousness
Emotion and consciousness
Four basic emotions
Seeking - ventral tegmental
Fear - amygdala
Rage - amygdala
Panic - anterior cingulate gyrus
Pathologies that potentially alter consciousness
Stroke TBI Epilepsy/seizures Encephalitis Space occupying lesions Hydrocephalus Metabolic defs
Describe extended consciousness
Consciousness of consciousness Relies on Lang, association, inhibition of pre-frontal lobes, memory. Reflect on conscious experience Enables use of function words Builds sense of self
Brainstem system if consciousness
ERTAS
Extended reticular and thalamus activating system
Medical definition of coma
State much like sleep where patient is unarousable and unresponsive to external stimululation and their own inner needs.
Purposes of GCS
Depth and changes in level of consciousness. A drop would alert medical staff to take action.
Effect of deafness on individual
Inclusion vs isolation (stigma, hard to socialize)
Has to adapt (communication skills, frustration)
Access vs barriers to social resources (school, equipment to function, telephone etc.)
Effect on family of deaf person
Communication
Change in relationships (incl between parents)
Economic strain
Stress -> depression etc
Impairment
Problem in a body function or structure
Disability
Functional limitation
Aspects of the innocence paradigm
- disabled person is an eternal child
- disabled person is sexually dangerous
Coma states
Coma
Open-eyed coma
Vegetative state
Acquired brain injury
4 basic emotions
- seeking
- fear
- rage
- panic
Functions of the hypothalamus
- autonomic control
- emotional responses
- regulation of body temp
- regulation of food intake
- regulation of water balance and thirst
- Regulation of sleep-wake cycles
- secretion of hormones
Define core consciousness
Content of consciousness combined with levels of consciousness
Awareness of how one currently feels in relation to what is happening around one
Parts of the brain responsible for generating levels of consciousness
- brainstem nuclei
- ascending activating system
- extended reticular and thalamic activating system
4 basic emotions
- seeking
- fear
- rage
- panic
Define ethnocentrism
Viewing others ways of life exclusively through ones own cultural perspective
How to be less ethnocentric
- be open to others world views
- be respectful
- be self-aware
- have a sense of humor
- learn about people’s cultures
Guidelines for communicating with a deaf person
- ensure interviewers face is well lit
- establish eye contact before speaking
- make sure mouth is not obscured
- use expression
- do not shout
- speak clearly
- state topic changes clearly
- ask about quality of communication
- rephrase if not understood
Psychosocial impact of a stroke
- May become dependent (guilt and anger)
- lessened interpersonal skills
- loss of abilities (Grief and mourning)
- loss of ability to work and parent
- reduced sexual functioning
- loss of communication
Attachment
Disposition of a child to seek proximity to and contact with a specific figure and to do so in certain situations (when tired, frightened or I’ll!
Types of attachment
- secure
- anxious resistant
- anxious avoidant
