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Unit 1 > integrative care > Flashcards

integrative care Flashcards

1
Q

What are the two components of postural control?

A

postural orientation and postural stability

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2
Q

What is postural orientation?

A

ability to maintain an appropriate relationship between different body segments and between the body and the environment for a task

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3
Q

What is postural stability?

A

the ability to control the center of mass in relationship to the base of support

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4
Q

What is the center of mass?

A

the point at the center of the total body mass

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5
Q

What is the center of gravity?

A

the vertical projection of the center of mass

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6
Q

What is the base of support

A

the area enclosed by the body in contact with the surface

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7
Q

what happens as the COM shifts upward?

A

object becomes more top heavy, tendency to be overthrown increases

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8
Q

how will the center of mass shift with a left unilateral AK amputee

A

COM will shift up and right

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9
Q

what is center of pressure?

A

distribution of total forces applied to the support surface; at static equilibrium COP directly under COM

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10
Q

what is static balance

A

the ability to maintain COG within the supporting base while standing or sitting

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11
Q

what is dynamic balance

A

maintaining an upright position while COG and BOS are moving and COG is outside BOS (ex walking)

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12
Q

what is functional balance

A

the ability to preform daily movement tasks requiring balance and involves static and dynamic balance

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13
Q

what are stability limits

A

refer to the boundaries within which the body can maintain stability without changing base of support

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14
Q

what creates stability limits

A

interactions between position and velocity of COM

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15
Q

what systems are involved in balance

A

vestibular, visual, tactile, proprioception

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16
Q

how can you test anticipatory postural control in the clinic

A

ask them to make typical movements like sit to stand, push up on toes. etc.

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17
Q

how can you test reactive postural control in the clinic

A

have patient lean into hands, remove them and watch how they recover

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18
Q

Where is the balance control center in the brain

A

cerebellum

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19
Q

what is absolute effect?

A

mean difference; reported with units

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20
Q

What is a within group change?

A

comparing pre to post in the same group

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21
Q

What is between group change?

A

comparing the mean change for group 1 and group 2

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22
Q

what is standardized effect

A

compares magnitude of change across different outcome measures - NO UNITS (also expressed at g)

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23
Q

statistical approach vs effect size approach

A

statistical approach reported p values and is useful in research; effect size reports mean changes and confidence intervals; important in applying research

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24
Q

What components are used to calculate a confidence interval

A

standard deviation; sample size; how confident you want to be; mean effect

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25
Q

What is behaviorism?

A

theory of learning that focuses on observable behaviors

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26
Q

What are tools used in behaviorism?

A

simplified tasks, repetition, stimulus and response, reward and punishment

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27
Q

what is the role of the teacher in behaviorism?

A

manipulated environment, reinforces, rewards/punishes

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28
Q

what are external motivations of behaviorism

A

avoid negative consequences, seek rewards

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29
Q

what is classical conditioning?

A

associative learning - pair a natural stimulus with another to get the desired response, results in a conditioned response to single artificial stimulus

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30
Q

what is operant conditioning?

A

use reinforcement and punishment to maintain or change a behavior

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31
Q

what is cognitive learning?

A

theory of learning that focuses on information processing and incorporating new info into existing frame works

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32
Q

what is the role of the teacher in cognitive learning

A

present facts and assist with assimilation of material

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33
Q

what is the role of the learner in cognitive learning

A

actively constructing knowledge, motivation is largely intrinsic

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34
Q

what is experiential learning

A

learning theory that is an extension of cognitive learning; focuses on context and experience and problem solving

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35
Q

what is the role of the teacher in experiential learning

A

present structured opportunities, act as guides

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36
Q

what is social-cultural learning

A

theory of learning that focuses on knowledge being constructed from cognitive process and social experience; community based learning and peer interaction are huge in this.

37
Q

what is the role of the teacher in social-cultural learning

A

structures group interactions and guides discussion

38
Q

what is the role fo the student in social-cultural learning

A

to observe, associate, model and construct meanings from the community of practice

39
Q

what filters are presented by Plack and Driscoll to influence learning

A

perceptions, gender, generational experiences, social role, culture, past experiences, level of expertise, learning styles

40
Q

factors that influence learning presented by Watson & McKinstry

A

age, educational status, volume of information, health status, mode and contest of information, gender, emotional status, perceived importance

41
Q

what is pedagogy

A

the study of teaching, typically applied to children

42
Q

what is andragogy

A

art and science of helping adults learn

43
Q

what do adults bring to a learning experience

A

a need to know, independent self concept, experience, life centered learning, motivation for current life situations.

44
Q

how does a navigator learn

A

with a spelled out list of steps, planned ahead

45
Q

how does a problem solver learn

A

think through scenarios

46
Q

how does an engager learn

A

by giving meaning to the task and being submerged in it

47
Q

what are the learning domains

A

cognitive, psychomotor, affective

48
Q

what is encompassed in the the physiologic stress response

A

sympathetic NS, parasympathetic NS, epi &norepinephrine, cortisol

49
Q

what are protective responses of stress

A

increased arousal increased energy, increased alertness, enhanced performance

50
Q

what are ineffective responses of stress

A

rumination, worry, wandering thoughts, self doubt, negative loop

51
Q

what are the stages of general adaptation syndrome

A
  1. alarm(+) - stressors identified, response initiated
  2. resistance (+/-) - compensatory strategies continue, continues until stressor is overcome or resources depleted
  3. exhaustion (-) - tissue damage, death
52
Q

consequences of chronic stress

A

cortisol dysfunction, inflammatory process, objective changes, disease

53
Q

cognitive and behavioral changes with chronic stress

A

depression, fatigue, burnout, health, life balance, memory impairment, learning, impaired task performance

54
Q

examples of active coping

A

mindfulness, awareness/reflection, positive affect/optimism, purpose/vision, social support, self esteem

55
Q

examples of stress avoidance behaviors

A

distraction, disturbed sleep, poor dietary choices, excessive smoking/drinking, unhealthy levels of physical activity

56
Q

mindfulness is…

A

the awareness that emerges through paying attention on purpose, in the present moment, non-judgmentally to the unfolding of experience

57
Q

why do PT’s document?

A

for insurance, to track progress, for the use of other PT’s/medical professionals, for future planning/research, etc

58
Q

who is the audience of PT documentation

A

3rd party payers, PT’s, medical team, managers, administrators, researchers, patients and families

59
Q

is documentation required for a phone call?

A

yes, documentation is required for every visit/encounter

60
Q

is documentation required for cancellation?

A

yes, documentation should include indication of no shows and cancellations

61
Q

is documentation digital or hand written?

A

both, electronic entries are made with appropriate security and confidentiality measures and hand written entries are made in ink, include original signatures, date and time

62
Q

how should a documentation error be corrected

A

with a strike through and initialing and dating or through similar measures in digital form

63
Q

how is a patient identified on a chart

A

full name, identification number, DOB

64
Q

how is a physical therapist identified on a chart

A

date, full legal name, appropriate designations (SPT/PT/PTA)

65
Q

what is a SOAP note

A

form of documentation including 4 parts; subjective, objective, assessment; plan

66
Q

other than SOAP what framework can be used for documentation

A

patient management model

67
Q

what is a health care delivery system

A

an interplay between access, cost, and quality of healthcare

68
Q

what does financing for a health care system look like

A

the flow of dollars form individuals and employers to health insurance plans

69
Q

what is an accountable care organization (ACO)

A

groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to their Medicare patients

70
Q

what are the % for US health spending

A

private health insurance - 34%
Medicare - 20%
Medicade - 17%
out of pocket - 10%

71
Q

what kind of insurance model is medicare?

A

social insurance model meaning it requires a contribution in order to receive a benefit

72
Q

list the parts of medicare

A

parts A, B, C, and D

73
Q

when did medicare parts A & B originate

A

1965

74
Q

who is eligible for medicare part A

A

65 yrs and eligible for SS; persons under 65 who are totally and permanently disabled after 2 years pd receiving disability benefits; people with chronic renal disease requiring dialysis or transplant; people not eligible for SS can enroll at a cost

75
Q

how is medicare part A financed?

A

SS system & payroll tax (1.45% of wages & salaries from employer and employee each)

76
Q

what hospitalization services are covered under medicare Part A

A

hospitalization - first 60 days covered after deductible; daily cost starting at day 61, cost increases post day 90
- Admission require!!!

77
Q

what SNF services are covered under medicare part A

A

first 20 days covered; requires min 3 days hospital admission; daily cost 21-100days; beyond 100 medicare pays nothing

78
Q

what home health and hospice care is covered under medicare Part A

A

100 home care visits of “skilled care” per benefit period; 6 months or less of hospice care with doctor certified terminal illness, patient only has $5 co-pay per Rx for pan management meds

79
Q

who is eligible for medicare part B

A

anyone eligible for Part A and who opts to pat a monthly premium

80
Q

what does medicare part B cover

A

80% “approved amount” outpatient services deemed medically necessary after deductible, some preventative care at no cost

81
Q

what is a medigap

A

supplemental private insurance to pay for deductibles or gaps in coverage - financed by employer or beneficiaries themselves

82
Q

What is Medicare Part C

A

medicare advantage plans; medicare contracts with private insurance companies to provide coverage for hospitalization, physician services, and some RX

83
Q

what is medicare part D

A

prescription drug coverage; premiums and deductibles apply

84
Q

what type of insurance model is medicade

A

public assistance model; federally funded but administered by state

85
Q

requirements for medicade

A

low income families with children, elderly disabled and blind who receive assistance under supplemental security income, children under 6, adults whose family income is below 150% of federal poverty line; children <19 who’s family income is at or below federal poverty line

86
Q

What is a medicare waiver?

A

gives states more control in program beneficiaries and scope of services and required enrollment in managed care plans and healthcare exchanges under ACA

87
Q

what is SCHIP

A

state children’s health insurance program; companion to Medicaid

88
Q

who is covered under SCHIP

A

uninsured children in families with income at or below the 200% federal poverty line but above medicaid eligibility

Unit 1 (3 decks)

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