Final Quiz Flashcards
1
Q
____ of Do Not Resuscitate orders are written within ____ days of death
A
1/2, 2
2
Q
Need for Palliative Care (late 1800s)
A
- little to offer patients beyond easing symptoms
- most died at home care for by family within days of illness onset
3
Q
Need for Palliative Care (early to mid 1900s)
A
- health care shift from comfort to cure
- death became equated with medical failure
4
Q
Medicine’s focus shifted from _____ (early 1990s) to _____ (current)
A
Comfort; cure
5
Q
Site of death/caregivers shifted from ___/____ (early 1900s) to ____/_____ (current)
A
Home/family; institutions/health care providers (strangers)
6
Q
4 dimensions of dying
A
1) physical
2) social
3) psychological
4) spiritual
7
Q
4 paths to death in Palliative Care
A
- slow decline, periodic crises
- lingering, expected death
- sudden, unexpected death
- steady decline, short terminal phase
8
Q
Barriers to Quality Care at the End of Life
A
- failure to acknowledge the limits of medicine
- lack of training for health care providers in discussing dying
- hospice/palliative care services are poorly understood
- rules and regulations
- denial of death
- inadequate pain/symptom management
9
Q
D- Hospice
A
A delivery system that provides palliative care for patients with limited life expectancy who require comprehensive medical, psychosocial & spiritual support
10
Q
Hospice includes…
A
- interdisciplinary care
- medical appliances and supplies
- drugs for symptom and pain relief
- short-term inpatient and respite care
- homemaker/home health aid to relieve caregiver burden
- counseling, spiritual care, bereavement services
- volunteer services
11
Q
The number of hospices has increased by ____% since 2014
A
13.4
12
Q
General Principles of Palliative Care
A
- patient & family as a unit and they set the goals, their education & support is focus
- attention to physical, psychological, social & spiritual needs
- interdisciplinary team approach
- extends across illnesses and care settings
- continues after death with bereavement support
- both curative and life-prolonging care might be offered with palliative care (unlike hospice)
13
Q
Interdisciplinary team for Palliative Care
A
- volunteers
- physicians
- counselors
- social workers
- spiritual & bereavement counselors
- hospice aides
- therapies
- nurses
14
Q
What does palliative care do?
A
- addresses suffering (physical, psychological, spiritual/existential
- improves quality of life (assess/manage pain and other symptoms)
- provides a team approach to their care (patient and family decide what their goals of care are (not the healthcare team))
15
Q
Impact of Palliate Care (life span)
A
Those who received earlier palliative care lived longer
16
Q
Role of nurse in improving palliative care
A
- some things cannot be “fixed”
- use of therapeutic presence
- comfort care (pain, secretions, wounds, constipation, etc)
- administration of medications, therapies
- patient, family needs
17
Q
Payment for Hospice
A
- medicare
- Medicaid
- most private health
18
Q
Payment for palliative care
A
- philanthropy
- fee-for-service
- direct hospital support
19
Q
Hospice Medicare Benefit Eligibility Criteria
A
- patient’s doctor and hospice medical director us their best clinical judgment to certify that the patient is terminally I’ll with a life expectancy of six months or less, if the disease runs its normal course.
- the patient chooses to receive hospice care rather than curative treatments for his/her illness
- the patient enrolls in a Medicare-approved hospice program
20
Q
Is Palliative care cheaper?
A
Yes, because fewer lab/diagnostic tests & medications were prescribed
21
Q
3 problems preventing the practice of palliative/hospice care
A
1) insufficient attention to palliative care in medical and nursing school criteria
2) educational silos that impede the development of inter professional teams
3) deficits in equipping physicians with sufficient communication skills.
22
Q
Some states allow terminally ill patients decide ____________________________________ if their suffering becomes unbearable (not legal in PA).
A
How and when they will end their life
23
Q
COVID: Quarantines of large cities and home confinement occured even for ___________ persons
A
Unaffected
24
Q
COVID: Despite lack of evidence, _______ demands for buying masks occured _______.
A
Enormous; world-wide
25
COVID: in rare event, some countries ____ their borders and _____ their flights
Closed, restricted
26
COVID: one of the most important consequences of coronavirus is the creation of _________ _________ world-wide
Social anxiety
27
D- risk society
A systematic way of dealing with hazards and insecurities induced and introduced by modernization itself
28
Coronavirus outbreak shows that risk society leads to a ______ _______
Vulnerable society
29
COVID cause vulnerable society because (3 reasons)
- social interactions
- institutions
- cultural values
30
Why was the COVID outbreak different from any other disease outbreak?
It caused a world-wide sense of fragility of human biological life and created demands for “sterile society” (safe from any hazards)
31
“Sterile society” is founded in human demand for _____ and _______.
Eternity, perfection
32
COVID responses in some countries were ________ _________ policies
Rediculous; nonscientific
33
COVID: Fouchi said ___% of cases were mild in the beginning of the pandemic
85
34
COVID: What is needed to have a change in both behavior to environment and actions in facing crisis
A new interdisciplinary approach with cooperation of sociologists, philosophers, anthropologists, virologists, epidemiologists, and public health experts.
35
COVID: current societies are vulnerable both __________ and _________, so resilience needs to be improved on the _____, ______, ________, and _______ level.
Biologically; mentally; biological; mental; social; spiritual
36
The US had the worst records of ______ and ________ to COVID
Response; spread
37
Sweden did not lock down (accepted high _____) in response to covid because they wanted ________.
Risk; Heard immunity
38
D- heard immunity
Form of indirect protection from infectious disease that occurs when a sufficient percent of a population has become immune to an infection, whether through vaccinations, or previous infection, thereby reducing likelihood of infection for individuals who lack immunity.
39
COVID: There is ______ evidence that masks & lockdowns stopped the spread
No
40
COVID: ________ is not equipped to handle the pandemic, despite its ideas circulating in public discussions
Sociology
41
3 Factors of Medicalization
1) powerful medical authority
2) social movements
3) organizational/professional activities (competing authority for defining/treating problems)
42
Historical evolution of the Sociology of Deviance and Social Control
Sin —> crime —> illness
43
D-Medicalization
The process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness and disorders
44
Growth of medical jurisdiction (where/when it mainly happened)
20th century in the West
45
Conrad’s point is to understand the ______ _______ of the expansion of _______ ________ and the ________ __________ of this development, so it is the ________ of the designation rather than the ________ of the diagnosis that is of greater sociological concern.
Social underpinnings; medical jurisdiction; social implications; viability; validity
46
Agents of social control
Police officer
Priest
Physician
Judge
* more people today can exercise social control
47
Where do agents of social control get their power
They are able to define something that people don’t know (knowledge is power)
48
Social factors that contributed to the process of medicalization
- faith in science, rationality and progress
- increased prestige of the medical profession
- Americans’ love of individual and technological solutions
- the humanitarian trend (take blame of ppl’s bad deeds off them and place it on their “illness”)
49
Medicalization is not a ________ process, its _________.
Unidirectional; bidirectional
50
_______ _______ and _______ _______ are often considered steps towards the "De-medicalization" of a condition or illness
Holistic health; alternative medicine
51
Masterbation
Was medicalized in the 19th century until being de-medicalized
52
Medicalization is profitable for ________ and ________ companies
Pharmaceutical; biotechnology
53
By the 1980s, ______ _______ had eroded, and health policy shifted from ______ to ____ ______ and ______ _______
Medical authority; access; cost control; Managed care
54
In the 1980s, doctors remained dominant in the process of medicalization, and were joined by…
- patients
- pharmaceutical companies
- insurance companies
55
“Third Party Payers”/Insurance companies ______ but don’t _______ medicalization
Limit; undermine
56
Medical Markets as a model
- advertising designer drugs (DTC)
- standardization of medical services into “product lines”
- patients = consumers
57
Cosmetic psychomarmacology
Cosmetic surgery (medicalization + medical markets)
- not covered by insurance
- many take out loans for it (nose job or car?)
- lots of advertising
- makes you feel better about yourself/improves mental well-being --> illness
58
SSRIs
- selective serotonin reuptake inhibitor
- among most perscribed psycho-active drugs, include Paxil and Prozac
59
What began the beginning of the “depression market” of drugs?
Paxil
60
DSM-IV (anxiety)
Recognized Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) as “illnesses/disorders,” leading to a new era where Medicalization begins to market diseases.
61
“Post-Prozac” Era
Marketing diseases and then selling drugs to treat those diseases in now common
62
DTC ADs for Paxil…
Promote validity of a condition and explained it could happen to anyone (was common but wrong)
63
Backlash of Paxil
2002- Federal judge ordered temporary halt to Paxil ads over the claim that Paxil is not habit forming
64
“The case of Paxil demonstrates how ________ _________ are marketing _____ not just _____.”
Pharmaceutical companies; diseases; drugs
65
“Ask your doctor if [x] is right for you”
Physicians role in medicalization decreases and pharmaceutical influence increases.
66
Food and Drug Administration Modernization Act of 1997 (FDAMA)
When a drug is not FDA approved, doctors can recommend it to anyone, so commercials can advertise off-label uses and include less risk information
67
Social Anxiety Disorder Prevelance
3-13% of Population - American Psychiatric Association
3.7% - National Institution of Mental Health
68
Male bodies are ________ but _________ medicalized
Increasingly, partially
69
Women’s bodies (medicalization
- more medicalized than men
- b/c their processes are more visible —> higher vulnerability
70
Increased _______ _______ __ ___ _____ as a realm of inquiry, considering demand for products dealing with the Aging process and the body as an “artifact”
Sociocultural construction of the body
71
Bodily production of testosterone ______ ________ with advancing age
Naturally declines
72
1889 - endocrinologist Charles Edouard Brown Sequard does what?
Makes the connection between testosterone and aging by injecting himself with testicular fluids from animals
73
Researchers are more interested in ______ than ______.
Masculinity; femininity
74
While _____ includes the lists of fertility as the primary pathological event in its definition, ________ does not include declines in fertility in its definition
Menopause; andropause
75
Researchers are working to prevent the “_____” decline in Testosterone with age in order to preserve _____.
Abnormal; masculinity
76
Decline in testosterone causes…
- lower libido
- depression
- fatigue
- loss of gonad function (NOT UNIVERSAL)
77
ADAM (acronym)
Androgen Deficiency in Aging Males
78
Doctors are _____ if andropause exists
Unsure
79
Testosterone (T) Therapy (pros/cons)
Pros:
- provides hope for men
- provides media interest
- provides potential profit
Con:
- can cause liver failure
- not sure about safety/efficacy
80
~ _________ American men take Testosterone supplements
1.5 million
81
Losing one’s hair, or “__________ ______” is a _______ or ______ bodily occurrence
Androgenic alopecia; normal; common
82
Who is the standard studied for measuring health
White, European, middle-class, heterosexual, males
83
Dihydrotestosterone
Hormone that causes hair follicle to produce fine, unpigmented hair common in baldness
84
“Androgenic Alopecia” becomes a medical condition when hair loss is ______.
Excessive
85
Possible cures for baldness
- hair transplants
- medications (Rogaine & Propecia)
86
Rogain (baldness)
- $300/year
- medication initially made to lower heart rate
- causes thick hair to grow
- 1996: FDA approved OTC use
87
Propecia
- $600/year
- stops progress of balding (must take for rest of life to prevent balding)
88
In 1992, erectile dysfunction was officially recognized as ____ and not _______.
Biogenic; psychological
89
ED treatments before viagra
Penile surgery, implants, injections
90
March 1998 - FDA approves _____ as a treatment for ED
Viagra
91
Market for viagra
Aging “baby-boomers”
92
~___________ men have ED in the US
10-20 million
93
Keys to Viagra (and other ED meds) success
- DTC advertising
- focus on sexual enhancement
- focusing on ED
94
Viagra __________ ED through advertising
De-stigmatized
95
Insurance companies ____ __ ____ ___ cover viagra
May or may not
96
Most criticism of ADHD comes from ______ and ______ of middle-aged men.
Overdiagnosis; treatment
97
___% prevelance of ADHD in adult men
44
98
Media prevalence (lay groups) and influence caused adults to ______ ________ with ADHD —> medicalization
Self-diagnose
99
Forces behind medicalization
Biotechnology, consumers, and managed care
100
Every $_ spent on DTC advertising, pharmaceutical industry makes $___ in sales
$1, $4.20
101
Managed care came to dominate the US healthcare delivery system because of _______ _____
Market-driven costs
102
Physicians have ___ power but are the ______ of medicalization; big pharma is the new _____ ______ in the process
Lost; gate-keepers; major force
103
3 most widely recognized medicalization drugs
Paxil, Viagra, Claritin
104
Pharmaceutical companies BOTH _____ __ and ____ ___ medicalization
Invest in; profit from
105
Socialized medicine (unlike managed care)
- no preapprovals
- no constraints on docs/patients
- frees limits on all types of care
106
Managed care: ____ over patient
Profits
107
Managed care/insurance affects Medicalization by…
What is not covered
108
Medicalization driven by _______ and _____ interests, not professional claim-makers
Commercial; market
109
Lifestyle orientation arguments have included:
- LGBT
- anorexia
- obesity
110
Medicalization has ______, and ______ ______ involved are fueling its _______.
Increased; powerful forces; expansion
111
Conrad is concerned about _____-medicalization with _____ _______.
Over; no end
112
Conrad two important points about his work
1) doesn’t argue if problems are really medical (not qualified), but that not inherently medical problems are medicalized
2) does not deny the possibility of biological & physiological bases for problems
113
Benefits of medicalization
- harm reduction
- blame reduction
- increased life opportunities
114
Critical concern with widespread medicalization
The transformation of many human differences into pathologies
Any difference is at risk of being medicalized, which erases tolerance and appreciation with the diversity of human life
115
No matter how much _____ __ _______, the reporting of ______ ______ continues to rise
Health is improved; health problems
116
Americans have increased advocacy for medicalization because they have decreased…
Tolerance for uncomfortable body states
117
Medical definitions of normality
- should medicine define “normal”?
- should we maintain prime (youthful) body functions until death?
- reasonable to treat kids for acting up/being energetic/challenging authority?
- should big pharma be able to make and produce medications for these markets?
118
D-“Medical surveillance”
Increased monitoring of individuals for illness/potential illness/genetic susceptibility
119
Social medical control is _____.
Expanding
120
D-“The medical excuse”
More forms of behavior are no longer deemed the responsibility of the individual
121
D-“the individualization of social problems”
Where the focus is on the individual rather than the social context
122
___ _____ Movement and ___ _______ movement fought for demedicalization
Gay rights; disability rights
123
Conrad: unlikely that DTC advertising will ______.
Subside
124
D- current risk society
Characterized by obsessions with insurance and security— people may not have symptoms, but their condition may still be medicalized
125
Forces of medicalization (companies, docs, insurance, patients, etc) ____ recognize aging as inevitable and untreatable my medicine
DON’T
126
There _____ agreement among medical professionals, physicians, and scientists around the world about Conrad’s POV on medicalization
ISN’T
