Midterm Flashcards
What are the steps to success?
1) Screening
2) Testing
3) Eval
4) Programming
5) Supervision
To avoid legal liability and by knowing standard of care
Why screen?
Minimize risk assoc. with PA and testing
Identify who to exclude from exercise (med. CI)
Identify those who need medically supervised program
Known disease require clearance before exercising
Special needs for safe and effective exercise plan
People can begin traditional ex. Programs
Benchmarks for goal setting
What are the 3 screening methods?
1.
General screening
2.
Specific screening interpreted by qualified professional
3.
Aware of known disease or self disclosed medical concern, advise to consult with healthcare provider
PARQ means
P
A
R
Questionnaire
HHQ
establish medical/health risks for both activity assessment and activity participation. At minimum, should address: o Family history o History of various diseases and illnesses including cardiovascular disease o Surgical history o Past and present health behaviors/habits o Current use of various drugs/medications o Specific history of various signs and symptoms suggested of CVD and other chronic or metabolic diseaSE
Risk Factors
Age Family History Inactivity Smoking Obesity Hypertension Hyperlipidemia Prediabetes
HIGH RISK:
KNOWN DISEASE or
S&S of CV, pulmonary or metabolic
≥ 2 RF :
MODERATE RISK
LOW RISK
Signs & Symptoms of CPM Diseases
Pain in chest, neck, jaw etc. Dyspnea Syncope Orthopnea Ankle edema Palpitations Intermittent claudication Heart murmur Unusual fatigue or SOB
Contraindications to PA or testing
Do risks outweigh benefits?**
Absolute Non-negotiable; consult Dr. Relative ‘It depends’; unique situation, check with Dr. What are we trying to do here?
Absolute
Non-negotiable; consult Dr.
Relative
‘It depends’; unique situation, check with Dr.
What are we trying to do here?
Signs & Symptoms for stopping exercise
Signs of confusion or inability to concentrate Dizziness or syncope Convulsions Physical injury Physical or verbal manifestations of severe fatigue Patient/client request to stop
What are the 5 stages of change?
Pre-contemplation Contemplation Preparation Action Maintenance
Theory based interventions
provide strategies to incorporate exercise into their daily routines.
Assessing readiness for change is of greater importance providing ‘how to change’. (On test)
Use specific skills and strategies to aid clients in moving through SOC process.
- Pre-contemplation
o‘
GOAL for stage:
Begin thinking about becoming PA/exercising
I won’t’ or ‘I can’t’
o Not exercising or thinking about starting w/in 6 mo.
oWon’t: disinterested, don’t believe there is a problem
oCan’t: dispirited, low self efficacy
- Pre-contemplation
o‘
GOAL for stage:
Begin thinking about becoming PA/exercising
- Contemplation
GOAL for stage: take steps to become PA and think about setting goals
“I might”
Inactive, intends to start taking action within 6 months
Aware of benefits, more dissatisfied with inactivity
Ex. Thinking of changing a healthy diet to go along with exercise
May be in this stage a while.
- Contemplation
GOAL for stage:
take steps to become PA and think about setting goals
- Preparation
GOAL for stage: increase PA to recommended level.
‘I will’
Exercising, but not meeting PA guidelines
Planning to make that change within 30 days
Experimenting with changes
- Preparation
GOAL for stage:
increase PA to recommended level.
- Action
GOAL for stage: continue to make PA regular part of life.
‘I am’
meeting physical activity goals, but for less than 6 months.
Greatest risk of relapse
- Action
GOAL for stage:
continue to make PA regular part of life.
5 Cognitive Processes
Change the way we THINK about PA
Most efficient for early stages
1.Consciousness raising –increase awareness, knowledge
2.Dramatic relief- warning of risks, arouse emotion
3.Environmental reevaluation –caring about consequences to self & others
4.Self Reevaluation – comprehending benefits. Importance in life.
5.Social Liberation –increasing healthy opportunities in their lives, society can support healthy behavior.
7 Behavioral Processes
Change/initiate the actual behavior Best for later stages 1.Decisional balance 2.Stimulus control 3.Self monitoring 4.Goal setting 5.Contract 6.Social Support 7.Relapse Prevention
Self Efficacy
Confidence in ones ability to perform desired behavior
Assess/measure with questionnaire
Tailor feedback to each client
You believe in his/her ability
Identify perceived obstacles
Develop realistic strategies to overcome
What went wrong during previous attempts?
Use as learning experience
Rewards
Provide motivation through change process
Two Main Types:
- INTRINSIC
2. EXTRINSIC
Intrinsic:
pleasure from achieving/completing a task or goal
More sustainable over time
2.Extrinsic:
tangible things earned by completing a task or accomplishing a goal.
rely on an outside source, and are therefore less likely to be sustained
A common theme that binds all types of social support is
that the individual must share his/her goal with family and friends to allow them to provide support to the individual.
Age
Men: ≥ 45 years old(y/o)
Women: ≥ 55 y/o
(and Family History)
Family History: Biological parents, siblings, or children
Myocardial infarction, coronary revascularization (bypass surgery or angioplasty), or sudden cardiac death
Ages:
Men: before age 55
Women: before age 65
(Pre)Diabetes
Impaired Fasting Glucose(IFG) ≥ 100 but ≤ 125 mg/dL Cannot eat before Two separate occasions A fasting blood glucose ≥126 mg dL−1 would indicate diabetes. Impaired Glucose Tolerance(IGT) ≥ 140 but
HTN
Systolic blood pressure of 140mmHg and diastolic bp of 90mmHg on at least 2 separate occasions or on antihypertensive medications
LDL’s (Hyperlipidemia)
LDL’s: ≥ 130 mg/dL
HDL’s:
Obesity
BMI For both genders: ≥ 30 kg/m2 Waist Circumference: Men: > 102cm (40in) Women: > 88cm (35in)
Sedentary lifestyle
Not participating in at least 30 minutes of moderate intensity (40-
smoking
Current cigarette smoker or quit within the last 6 months or have had over exposure to tobacco smoke
Occupational Safety and Health Administration (OSHA) is
the principal federal agency charged with the enforcement of safety and health laws in the workplace.
Bloodborne Pathogens
*HIV, Hepatitis B and Hepatitis C
Universal precautions:
always treat as if contaminated for BBP
Why test?
Data for developing a program design
Collecting baseline and follow-up data
Motivating the participant by establishing individualized fitness goals
Educating about concepts of fitness
Stratifying risk and limiting potential for litigation
*Minimize by starting at a
low intensity and gradually increasing intensity as one becomes accustomed.
STEPS stands for what?
Screening Testing Eval Programming Supervision
Emergency Management
Key:
being prepared! Having a plan
Components of Emergency Plans
Life threatening vs. non-life threatening Posted in strategic locations Activation Code Phone numbers Location of phones Location identification & accessibility Locked doors or gates Location of supplies Information to share Directions for personnel Call for member assistance Incident/accident reports Non-medical (fire, bomb, weather
Emergency Plan: Training
Ongoing is best, at least 2-3 times per year
Liability:
legal responsibility, duty or obligation
Contract law:
regulates the rights and obligations or parties that enter into a contract. A contract is an agreement between two or more parties that creates an obligation to do, or not to do, something that creates a legal relationship. If the agreement is broken, the parties have the right to pursue legal remedies. A contract can be written or verbal. The important elements of a contract include an offer and acceptance, also referred to as “meeting of the minds” and the exchange of something of value.
Duty of Care: Refers to the level of
responsibility that one has to protect another from harm. In general, the legal standard is reasonable care under the circumstances, which is based on an examination of factual details.
Release or waiver:
An agreement by a client before beginning participation, to give up, relinquish, or waive the participant’s rights to legal remedy (damages) in the event of injury, even when such injury arises as a result of provider negligence.
Civil Law
Determines liability
Scope of practice
Avoid negligence
Tort law
Tort Law
A tort is a Breach of
legal duty; civil wrong, whether intentional or accidental, from which an insult, injury, or death occurs to another person
- Intentional misconduct
- Negligent conduct
- No Fault
*Negligence
an unintentional tort; people are required to act in a way that avoids creating an unreasonable risk to others
N.
*Negligence
Reasonable person test:
Do not create unreasonable risk
Protect from foreseeable risk
Standards of care based upon guidelines of AHA, ASCM, NSCA, APTA etc.
Include these standards in employee manuals, job descriptions, training= DOCUMENTATIO
Standard of Care
Identify & manage potential danger areas
Care of facility and equipment
Product Liability
Some things VOID the liability
Don’t change product or allow to deteriorate
Use product in a way NOT intended by mfctr
Apply warning labels
Inspect continually
Do not allow to use unsupervised
*Documentation of Standards
Documentation:
Written & detailed records of Facility & Equipment repairs Maintenance Injury/treatment reports Can demonstrate reasonable action Enforce policies or do not have them
Informed Consent
conveying complete understanding to a client or patient about option to choose to participate in a procedure, test, service, or program.
*Assumption of Risk
Not liable for injuries b/c risks are inherent to activity
Not to minors
Waiver**
Contract where person agrees not to
sue in event of injury caused by negligence of provider
Laws vary state to state
Clear, conspicuous, unambiguous
Doesn’t cover GROSS negligence
Basics include:
Proper title
At least 10 font
Clear language & in language spoken!
1 page
Separate from other documents
MUST use the term ‘negligence’ in document
Insurance is
The easiest way to protect yourself and your organization from the legal liability and financial loss.
Types of Insurance
*Should have
- general liability insurance
2. Professional liability insurance
*Independent contractor liability :
General insurance doesn’t cover!
Require to provide own
List company as additionally insured
