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Chronic > Health Disparities, Disabilities, Chronic Pain and Adherence > Flashcards

Health Disparities, Disabilities, Chronic Pain and Adherence Flashcards

1
Q

Health Inequities in Canada

Influences

A
  • influenced by SDH
  • lower education, employment, income, more likely to have chronic physical and mental health conditions
  • lower education = shorter lives on average
  • food insecurity - first nations, latin communities, bisexuals
  • poor housing = immigrants
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2
Q

Indigenous inequities

List 4

A
  • forced displacement
  • banning of language and practices
  • creation of RSS
  • unaddressed intergenerational trauma
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3
Q

Define:

Health inequality

A
  • differences in health status or the distribution of health determinants between different population groups
  • differences can be due to biological factors, individual choice, or chance
  • public health evidence suggests that many differences can be attributed to unequal distribution of social and economic factors that influence health and exposure to societal conditions and environments largely beyond the control of individuals
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4
Q

Define:

Health inequity

A
  • subset of health inequality that are deemed to be unfair or unjust
  • arise form systematic and intentional or unintentional marginalization of certain groups, and that are likely to reinforce or exacerbate disadvantage and vulnerability
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5
Q

Define:

Health Equity

A
  • absence of unfair and avoidable or remediable differences in health among population groups
  • defined socially, economically, demographically, or geographically
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6
Q

Inequality highlights:

Life expectancy

5 low, 1 high

A

Lower life expectancy:
* Men
* Indigenous (lower life expectancy at birth)
* Less than high school education
* Low income
* Live in areas of high social and material deprivation

Higher life expectancy
* Immigrants live more years in good health

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7
Q

Inequality highlights:

Asthma

A

higher among:
* permanently unemployed adults
* lesbian women
* bisexual adults
* adults less than highschool education
* First natinos off reserve and Metis adults
* low income

lower among:
* recent immigrants

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8
Q

Inequality highlights:

Arthritis

A

Higher among
* adults permanently unable to work
* adults with less than highschool education
* first nations off reserve and Metis
* women
* lesbian women
* adults in unskilled occupations

lower among:
* recent immigrants

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9
Q

Inequality highlights:

Diabetes

A

higher among:
* adults permanently unable to work
* prevalence of diabetes among south asian and black adults
* adults who have not completed high school
* adults living low income
* inequalities by low income, education and employment are greater among women

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10
Q

Inequality highlights:

Disability

A

Higher among
* unemployment
* adults unemployed but still in labor force
* women, but inequality in disability prevalence is higher among men when comparing unemployed adults with employed adults
* adults with less than highschool education
* low income
* indigenous peoples (excl. those living on reserve and in northern communities)

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11
Q

Inequality highlights:

Obesity

A

Highest among
* adults who have not completed highschool education - esp women
* first nations off reserve
* people with severe and moderate functional health impairment
* women in lowest income group
* people permanently unable to work

Less prevalent among
* immigrants
* East/Southeast Asian Canadians

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12
Q

Canada’s Annual Report on SDG #3: Good Health and Wellbeing

ambitions, chronic illness perspective, inequities d/t COVID, actions

A
  • ambitions: Canadian’s adopt healthy behaviours, have healthy and satisfying lives, and prevent causes of premature death
  • chronic illness perspective: improvement in death rates d/t cancer, reduced number of smokers, higher vaccination rates
  • health and social inequities: disproportionate impact due to COVID - esp indigenous people who have higher rates of communicable and chronic disease
  • decline in perceived mental health - increase in symptoms of depression, anxiety and PTSD
  • actions: Wellness Together Canada, Substance Use and Addiction Program, Canadian Drug and Substance Strategy
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13
Q

Define:

Intersectionality

A
  • theoretical perspective regarding influence of different social characteristics on a particular phenomenoa
  • by examining the intersections of social relationships, dominance, and oppression; we can explore deeper insights into one’s health
  • provides a way to think about complexities of the human experience and make sense of them
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14
Q

Health Disparities and Chronic Illness

A
  • disease burden disproportionately distributed with marginalized groups having highest risk of poor outcomes
  • nursing mandate to reduce health inequalities and take action on social conditions that contribute to inequities

what do you see and what do you do?
* access to care - elderly waiting for LTC in hospital setting; not enough LTC facilities on reserve; not going to be in community close to home d/t policy changes
* alot of acute exacerbations of chronic illness d/t acute care model
* lack of staff -time and quality of care diminished
* lack of home care and support - people end up in hospital

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15
Q

Cultural Diversity

A
  • major psychological consideration when supporting people with chronic illness
  • delivery of culturally appropriate care involves an acknowledgement of this cultural diversity and the need to respond appropriately to people from diverse cultures
  • background also influences the way in which some peolpe view health professionals
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16
Q

Define

Cultural Appropriate Care

A

being sensitive to cultural needs and experiences

17
Q

Culturally appropriate care delivered when a nurse:

A
  1. understands their own values and beliefs
  2. acknowledges that there is no ‘one size fits all’ approach in delivering health services
  3. exploring how to work collaboratively with the person form another culture to consider interventions that best fit with their world view
18
Q

Cultural Competence: Antecedents to

A
  • cultural diversity
  • interaction and encounters - helps develop competence
  • humanistic competencies - empathy, communication, etc.
  • cultural desire
  • cultural humility
  • educational preparation - learning from diverse communities or people with experience with cultural competence in education settings
  • organizational support - helping patients carry out cultural practices while in care
19
Q

Cultural Competence: Attributes

A
  • cultural awareness - assessing own culture, biases, and understanding
  • cultural knowledge
  • cultural sensitivity
  • skill
  • proficiency - new knowledge, reflect and develop committment for change
  • dynamicity - nurse becomes culturally competent through ongoing and frequent encounters and interactions between self and another - not an outcome, but an ongoing process
20
Q

Cultural Competence: Consequences to care receivers

A
  • reduction in inequalities
  • receiving holistic care
  • greater trust in systems
  • closer adherence to treatment regimens
  • express greater satisfaction with care services
  • better QOL
  • cultural safety
21
Q

Cultural Competence: Consequences to care providers

A
  • greater knowledge and awareness of different cultures
  • develop greater cultural skill
  • feelings of respect
  • self-empowerment
  • develops personal and professional values, relationships, and performance
22
Q

Cultural Competence: Health related consequences

A
  • address inequities
  • public health
  • reducing healthcare costs
  • reduce fears
  • lower morbidity and mortality
23
Q

Define

Disability

A
  • any condition of the body or mind that makes it difficult for the person to do certain activities and interact with the world around them
  • many types such as those that affect: vision, movement, thinking, remembering, learning, mental health, social relationships, communicating, hearing
  • results from interaction of a person with a health condition with personal and environmental factors, inclusive of social factors (WHO)
24
Q

List

Dimensions of Disability

A
  • impairment
  • activity limitation
  • participation restrictions
25
Q

Disability and Chronc Illness: Can be…

A
  • present at birth and affect function later in life
  • associated with development of conditions that become apparent in childhood
  • related to injury
  • associated with long standing conditions
  • progressive, static, or intermittent
26
Q

Research indicates that peolpe with ___(1)_____ disabilities are more likely to report poorer adjustment and self-concept than people with _____(2)_______ disabilities

A

(1) visible
(2) invisible

27
Q

Disability: principles for nursing practice

A
  • working with people within their contexts and environments - esp when it comes to care, activities, and proposed interventions
  • recognize and value expertise and resourcefulness.- experts in their experience
  • support rights to self-determination
  • be aware of potential for social isolation
28
Q

Chronic pain

relevance, effects

A
  • major leading cause of physical and psychosocial disability
  • clinical significance of chronic pain in the context of a disabling disease is underscored by negative impact of pain on level of functioning
  • can cause severe physical, emotional, social, and economical problems for affected individuals and their significant others
  • recognized as a health condition and a disorder as well as a symptom that is secondary to underlying disease
29
Q

Chronic Pain Secondary to Disability

A
  • limited evidence about experience of chronic pain secondary to disabling disease, despite chronic pain being a prominent characteristic of chronic disease
  • need to consider how pain contributes to: disability, stress, QOL
  • influences level of resilience
30
Q

Define

Adherence

A
  • used on the global stage of healthcare delivery for how well the patient manages the treatment plan
31
Q

List

Factors for nonadherence

7

A
  • individual characteristics
  • psychological factors
  • social support
  • prior health behaviours
  • regimen characteristics
  • economic and sociocultural factors
  • patient-provider interactions
32
Q

Define

Compliance

A
  • adherence was formerly known as compliance
  • patients previously classified as noncompliant
33
Q

Explain

Adjustment

A
  • chronic illness necessitates adjustment in multiple domains
  • adjustment involves both positive and negative outcome dimensions
  • adjustment is a dynamic process
  • can be viewed only from within context of individual
  • individual experience - person’s uniqueness shapes adjustment and adaptation
34
Q

Labelling “Non-Compliance”

ethical challenges, nursing actions

A

Ethical challenges
* take away autonomy - taking holistic route and being labeled as noncompliant for using self-determination leaves no room for shared decision making
* beneficence at individual level -need to consider what is best for the person; esp with chronic illness, it is important to consider and treat the whole person

Nursing Actions
* work through having conversations with patient and family to figure out together how they can make treatment plan work

Chronic (3 decks)

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