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Public Health > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is health policy?

A

Decisions, plans, and actions

A set course of action to obtain a desired health outcome for an individual, family, group, community, or society

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2
Q

Governmental Role in U.S. Health Care

A

1) Provide for the general welfare
2) Regulate commerce among the states
3) Raise funds to support the military
4) Provide spending power

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3
Q

Healthy People 2030: Five Overarching Goals are

A

1) Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death
2) Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all
3) Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all
4) Promote healthy development, healthy behaviors, and well-being across all life stages
5) Engage leadership, constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all

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4
Q

A policy is

A

guiding principles

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5
Q

A program is

A

translation of policy into action

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6
Q

Economic Opportunity Act of 1964:

A

Includes programs such as: Job Corps, Urban/Rural Community Action, VISTA, Project Head Start and many more.

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7
Q

Head Start Program Performance Standards (1975):

A

First performance standards that detail guidelines for serving children ages 3 to 5.

Head Start’s idea of establishing performance standards spreads to a federal standards initiative for public schools.

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8
Q

What is the Program Planning Process?

A

· Formulating – defining the problem
· Conceptualizing – identifying potential solutions with literature review
· Detailing – consideration of potential solutions
· Evaluating (the plan) – choosing an option from the potential solutions
· Implementing – putting the chosen solution into place

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9
Q

The “goal” of a policy is

A

the overall aim leading to policy

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10
Q

The “objectives” of a policy is

A

measurable actions toward goal

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11
Q

The “action steps” of a policy is

A

program including steps to accomplish objective

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12
Q

Program implementation: What are the action steps?

A

Develop a general plan – describe the evidence-based intervention (program)

Determine whom to approach first - Approach stakeholders, recipients – what level?, potential supporters, possible opposition, funding sources

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13
Q

From Assessment to Program Implementation

A

1) Identify needs and priority populations
2) State population diagnosis
3) Review and evaluate EBI
4) Develop a policy and implement a program

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14
Q

Evaluation of Outcomes

A

· Collecting data
· Identify if outcomes are intended or unintended
· Adjust and make changes accordingly

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15
Q

Advocacy as it applies to health policy is

A

the act of influencing others (i.e., political activity) to adopt a specific course of action (i.e., a health policy) to solve a societal problem.

Advocacy is about relationship-building and ways that nurses (to include PHNs) can do this is through letters and visits to lawmakers to give their expert viewpoint on a particular issue, or through contributions to campaigns and political action groups, by volunteering time and expertise and through grassroot actions; to include collective action such as these nurses who are marching on their state capital.

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16
Q

Methods of building relationships

A

· Letter or visits to lawmakers
· Contributions of money
· Contributions of labor, expertise, or influence
· Grassroots network development

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17
Q

Set of common beliefs, values, and assumptions about life

A

Culture

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18
Q

Biologic variation within a population

A

Race

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19
Q

Shared feeling of peoplehood. Relates to cultural factors.

A

Ethnicity

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20
Q

Degrees of variation represented among populations based on race, ethnicity, lifestyle, across place, and place of origin across time.

A

Cultural diversity

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21
Q

Cultural Variations Among Selected Groups

A

Biologic variations, Personal space, Perception of time, Environmental control, Social organization, Communication, Nutrition, Religion

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22
Q

Growth in diverse populations in US

A

-Projected by 2045 racial/ethnic diverse persons will makeup > 50% of US population
-Future without a majority group
-Growth of the >65 age group- will exceed children by 2034

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23
Q

Generational Diversity

A

Baby Boomers, Gen X, Millennials, Generation Z

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24
Q

A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

A

Health

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25
Q

A state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community

A

Mental health

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26
Q

Refers to a higher burden of illness, injury, disability, or mortality experienced by one group relative to another.

A

Health disparities

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27
Q

Are reflected in differences in length of life; quality of life; rates of disease, disability, and death; severity of disease; and access to treatment.

A

Health inequalities

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28
Q

Income, educations, or other factors

A

Socioeconomic status

29
Q

Capacity to obtain, process, and understand basic health information

A

Health literacy

30
Q

Excluded from the mainstream in social, economic, educational, and/or cultural life.

A

Marginalization (exclusion)

31
Q

The self-examination and in-depth exploration of one’s own beliefs and values as they influence behavior

A

Cultural awareness

32
Q

Culturally aware nurses are

A

· Conscious of culture as an influencing factor between themselves and others
· Understand the basis of their own behavior
· Recognize that health is expressed differently

33
Q

Combination of culturally congruent behaviors, practice attitudes, and policies that allow nurses to use interpersonal communication, relationship skills, and behavioral flexibility to work effectively in cross-cultural situations.

A

Cultural competence

34
Q

NIH defines this as “a lifelong process of self-reflection and self-critique whereby the individual not only learns about another’s culture, but one starts with an examination of her/his own beliefs and cultural identities.”

A

Cultural humility

35
Q

Culturally Sensitive Nursing Interventions:

A

Cultural preservation - patients of a particular culture retain and preserve traditional values so they can maintain, promote, and restore health

Cultural accommodation - patients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes

Cultural repatterning- people of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial

Cultural brokering- between the patient’s culture and the biomedical health care culture on behalf of patients

36
Q

7 Steps Nurses Can Take to Provide Culturally Sensitive Care

A
  1. Awareness
  2. Avoid making assumptions
  3. Learn about other cultures
  4. Build trust and rapport
  5. Overcome language barriers
  6. Educate patients about medical practices
  7. Practice active listening
37
Q

Aim to improve health care quality and advance health equity by establishing a framework for organizations to serve the nation’s increasingly diverse communities.

A

National Standards for Culturally and Linguistically Appropriate Services in
Health and Health Care (The National CLAS Standards)

38
Q

Stereotyping, Prejudice, Racism, Ethnocentrism, Cultural imposition, Cultural conflict, Culture shock

A

Barriers

39
Q

Lack of cultural competence causes-

A

barriers to care, inhibits communications, creates obstacles, and increases the gap in disparities

40
Q

The Healthy People initiative is designed to guide national health promotion and disease prevention efforts to improve the health of the nation.

What is Healthy People 2030?

A

Sets of data-driven national objectives to improve health and well-being over the next decade.

41
Q

Conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

A

Social Determinants of Health (SDOH)

42
Q

What are the five categories of SDOH?

A

Economic Stability- In the United States, 1 in 10 people live in poverty, and many people can’t afford things like healthy foods, health care, and housing.

Education Access & Quality- People with higher levels of education are more likely to be healthier and live longer.

Healthcare Access & Quality- Focuses on improving health by helping people get timely, high-quality health care services. About 1 in 10 people in the United States don’t have health insurance.2

Neighborhood & Built Environment- The neighborhoods people live in have a major impact on their health and well-being

Social & Community Context- People’s relationships and interactions with family, friends, co-workers, and community members can have a major impact on their health and well-being.

43
Q

SDOH impacts

A

health, well-being, and quality of life

44
Q

Health Equity is achieved when

A

every person has the opportunity to “attain their full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.”

45
Q

Providing impartiality and objectivity at a systems or governmental level

A

Social justice

46
Q

Bioethical principles

A

Respect for autonomy, non-maleficence, beneficence, distributive justice, fidelity, and veracity

47
Q

Addresses questions such as the following: How should I behave? What actions should I perform? What kind of person should I be? What are my obligations to myself and to fellow humans? Ethical judgments are concerned with values. The goal of an ethical judgment is to choose that action or state of affairs that is good or right in the circumstances.

A

Ethics

48
Q

The decision is based on outcomes or consequences. The right action is the one that produces greatest amount of good or least amount of harm in a given situation.

A

Consequentialism

49
Q

A well-known consequentialist theory that appeals exclusively to outcomes or consequences in determining which choice to make.

A

Utilitarianism

50
Q

May conclude that the action is right or wrong in itself, regardless of the amount of good that might come from it.

A

Deontology

51
Q

Based on human dignity and respect for individuals, autonomy requires that individuals be permitted to choose those actions and goals that fulfill their life plans unless those choices result in harm to another.

A

Respect for autonomy

52
Q

Do no harm. It is impossible to avoid harm entirely, but this principle requires that we act according to standards of due care, always seeking to produce the least amount of harm possible.

A

Nonmaleficence

53
Q

This principle is complementary to nonmaleficence and requires that we do good. We are limited by time, place, and talents in the amount of good we can do. We have general obligations to perform those actions that maintain or enhance the dignity of other persons whenever those actions do not place an undue burden on health care providers.

A

Beneficence

54
Q

Requires that there be a fair distribution of the benefits and burdens in society based on the needs and contributions of its members. This principle requires that, consistent with the dignity and worth of its members and within the limits imposed by its resources, a society must determine a minimal level of goods and services to be available to its members.

A

Distributive justice

55
Q

The view that everyone is entitled to equal rights and equal treatment in society.

A

Egalitarianism

56
Q

View of justice holds that the right to private property is the most important right.

A

Libertarian

57
Q

Individual rights need to be balanced with social responsibilities; individuals do not live in isolation but are shaped by values and culture of their communities. Theories with communitarian focus: virtue ethics, ethic of care, feminist ethics.

A

Dominant themes of communitarianism

58
Q

Goal of virtue ethics

A

Enable persons to flourish as human beings

59
Q

Goal of care ethics

A

Contribute to the preservation of humanity

60
Q

Goal of feminist ethics

A

Equitable distribution of power - economic, social, and political

61
Q

Ethical Decision-Making Framework

A
  1. Identify ethical issues and dilemmas
  2. Find meaningful context
  3. Obtain all relevant facts
  4. Reformulate, if needed
  5. Consider appropriate options
  6. Decide and take action
  7. Evaluate decision and action
62
Q

Four situations for consideration:

A
  • No reason to exempt groups from accepted ethical and moral standards of the larger community
  • If no harm, no mandate to intervene
  • If greater community values are jeopardized, may require intervention
  • No reason to intervene; nonthreatening traditions and values but may be burdensome to others
63
Q

Unable to act in way one thinks is morally right; Due to either internal or external constraints

A

Moral distress

64
Q

How to manage moral distress-

A

– Identify situations that lead to distress.
– Communicate concern and examine ways to address the stressor
– Seek support from colleagues.

65
Q

Ethical Actions include

A

*Act in client’s best interest
*Act in accordance with client’s wishes & instructions
*Keep client informed
*Carry out instructions with diligence & competency
*Act impartially; offer frank, independent advice
*Maintain client confidentiality

66
Q

Two ethical tenets of assessment:

A

– Beneficence
– Nonmaleficence

67
Q

Three ethical tenets of policy development:

A

– Achieve the public good
– Service to others over self (a necessary condition)
– What is ethical is also good policy

68
Q

Two ethical tenets of assurance:

A
  • All persons should receive essential personal health services
  • Providers of public health services are competent and available

Public Health (5 decks)

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