Midterm Study Guide Flashcards
1
Q
Health
A
The ability to “realize aspirations, to satisfy needs, and to change or cope with the environment.
2
Q
Fundamental conditions and resources for health:
A
Peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity”
3
Q
Community
A
“Noninstitutional aggregations of people linked together for common goals or other purposes” The WHO (1998) defines a community as “a specific group of people, often living in the same geographical area, who share a common culture, values and norms, are arranged in a social structure according to relationships, which the community has developed over a period of time”
4
Q
Community-Based Practice
A
-Includes a broad range of health services
Prevention and health promotion, acute and chronic medical care, habilitation and rehabilitation, and direct and indirect service provision, all of which are provided in community settings.
-Community in this framework “means more than a geographic location for practice, but includes an orientation to collective health, social priorities, and different modes of service provision”
Field trips to the community are NOT community based practice, they are community outreach
5
Q
Community Health Promotion
A
Any combination of educational and social supports for people taking greater control of, and improving their own or the health of a geographically defined area
6
Q
Community Level Intervention
A
- Attempt to modify the socio-cultural, political, economic and environmental context of the community to achieve health goals
- Initiated by health-care and government agencies and involve community organization strategies
- Decisions are often based on the source of funding, and planning is done by a “lead” agency.
7
Q
Community centered initiatives/interventions
A
Often generated by leaders and members of the community and typically utilize existing community resources. Community coalitions form to identify common concerns and needs and to design approaches to solve community problems.
8
Q
Population
A
An aggregate of people who may or may not know each other but share at least one common characteristic such as age, race, ethnicity, gender, health habit or condition, geographic location, cultural identity, socioeconomic status, or education level.
9
Q
Population Health
A
“the health outcome of a group of individuals, including the distribution of such outcomes within the group”
A collaborative, interdisciplinary approach that includes advocacy; program development, implementation, and evaluation; and policy revision and development to maximize health equity and occupational justice in a population based on the social and health determinants and priorities of that population.
10
Q
Community health advocate
A
Practitioners identify the social, physical, emotional, medical, educational, and occupational needs of community members for optimal functioning and advocate for services to meet those needs.
11
Q
Consultant
A
Provide information and expert advice regarding program development and evaluation, supervisory models, organizational issues, and/or clinical concerns. Consultation is “an interactive process of helping others solve existing or potential problems by identifying and analyzing issues, developing strategies to address problems and preventing future problems from occurring”
12
Q
Case manager
A
A practitioner coordinates the provision of services; advises the consumer, family, or caregiver; evaluates financial resources; and advocates for needed services. Case management requires a professional who has ample clinical experience, understands reimbursement mechanisms, and has good organizational skills.
13
Q
Private Practice Owner
A
An occupational therapy entrepreneur is “an individual who organizes a business venture, manages its operation, and assumes the risks associated with the business”
The entrepreneur may own private practice, provide services on a contractual basis, and/or function as a consultant.
14
Q
Supervisor
A
- Typically manage and are responsible for all the activities of their team members.
- A supervisor sets up work schedules, delegates tasks, recruits and trains employees, and conducts performance appraisals. In occupational therapy practice, supervision “is a process aimed at ensuring the safe and effective delivery of occupational therapy services and fostering professional competence and development”
15
Q
Program Managers
A
Responsible for the overall design, development, function, and evaluation of a program; budgeting; and staff hiring and supervision. Many occupational therapists have served as program managers in community settings (SWOT)
16
Q
Community-based therapists exemplify the following characteristics:
A
- A sense of positive hopefulness
- An understanding of individuals in their specific personal circumstances
- The creativity to envision a variety of possibilities
- The ability to set aside one’s cultural, personal, and professional biases and respect individual choices rather than passing judgment
17
Q
Standards for Continuing Competence
A
- Knowledge required for multiple roles
- Critical reasoning necessary for decision-making in those roles
- Interpersonal abilities to establish effective relationships with others
- Performance skills and proficiencies necessary for practice
- Ethical reasoning required for responsible decision-making
A sixth category—traits, qualities, and characteristics
18
Q
Paradigm
A
-Universally recognized scientific achievements that for a time provide model problems and solutions to a community of practitioners
Two essential characteristics:
-Sufficiently unprecedented scientific achievements that draw many constituents from competing areas of inquiry
-Adequately open-ended enough to allow for the exploration of solutions to a variety of problems.
19
Q
Paradigm Shifts
A
-Dramatically change in the existing rules, create new trends, and trigger innovations. Occur in four stages: -Preparadigm -Paradigm -Crisis -Return to paradigm.
20
Q
Competencies and Characteristics Needed for Emerging Practice Areas
A
- Knowledge Competencies
- Performance Skill Competencies
- Critical Reasoning Competencies
- Ethical Reasoning Competencies
- Interpersonal Abilities Competencies
- Traits, Qualities, and Characteristics
21
Q
Characteristics of the CPHP
A
- Client-centered
- Occupation-based
- Supported with evidence
- Based on dynamic systems theory
- Ecologically sound
- Strengths-based
22
Q
Dynamic Systems Theory
A
-Looks at the world in terms of the inter-relatedness and interdependence of all phenomenon, and in this framework an integrated whole whose properties cannot be reduced to those of its parts is called a system
23
Q
Dynamic Systems Approach
A
Recognizes the complexity of the social history of health and provides a framework for assessment and intervention at various levels of systems, including individual, interpersonal, organizational, community, and public policy levels.
24
Q
Occupational justice
A
“Access to and participation in the full range of meaningful and enriching occupations afforded to others, including opportunities for social inclusion and the resources to participate in occupations to satisfy personal, health, and societal needs”
25
The CSDH proposed three overarching recommendations:
- Improve daily living conditions
- Address the inequitable distribution of power, money, and other resources
- Measure the problem and evaluate outcomes of intervention
26
Healthy People 2020 (HP 2020) has four goals:
- Attain high-quality, longer lives free of preventable disease, disability, and premature death.
- Achieve health equity, eliminate disparities, and improve health of all groups.
- Create social and physical environments that promote good health for all.
- Promote quality of life, healthy development, and healthy behaviors across all life stages.
27
Social Determinants of Health
- Economic Stability
- Education
- SOcial and Community Context
- Health and health care
- Neighborhood and Built Environment
28
Economic Stability
Employment
Food insecurity
Housing instability
Poverty
29
Education
Language and literacy
Early childhood education and development
High school graduation
Enrollment in higher education
30
Social and Community Context
Civic participation
Social cohesion
Discrimination
Incarceration
31
Health and Health Care
Access to health care
Access to primary care
Health literacy
32
Neighborhood and Built Environment
Access to healthy goods
Crime and violence
Environmental conditions
Quality of housing
33
Public Health
The critical functions of state and local health departments such as preventing epidemics [ex. infectious disease outbreaks], containing environmental hazards [ex. drinking water contamination], and encouraging healthy behaviors [e.g., smoking cessation]
34
Population Health
A collaborative, interdisciplinary approach that includes advocacy; program development, implementation, and evaluation; and policy revision and development to maximize health equity and occupational justice in a population based on the social and health determinants and priorities of that population.
35
Epidemiology
The study of the distribution, frequencies, and determinants of disease, injury, and disability in human populations
36
Incidence
The number of new cases of disease, injury, or disability within a specified time frame, typically a year.
37
Prevalence
The total number of cases of disease, injury, or disability in a community, city, state, or nation existing at one point in time
38
What is the most effective approach to reducing overall prevalence?
Combining the two strategies of prevention and early detection
39
Risk Factors
Precursors that increase an individual’s or population’s vulnerability to developing a disease or disability or sustaining an injury
40
Resiliency factors
Precursors that appear to increase an individual’s or population’s resistance to developing a disease or disability or sustaining an injury
41
Community Health
The physical, emotional, social, and spiritual well-being of a group of people who are linked together in some way, possibly through geographical proximity or shared interests.
42
Community health interventions
Any combination of educational, social, and environmental supports for behavior conducive to health
43
Health Promotion
any planned combination of educational, political, regulatory, environmental, and organizational supports for actions and conditions of living conducive to the health of individuals, families, communities, and populations
44
Prevention
anticipatory action taken to reduce the possibility of an event or condition from occurring or developing, or to minimize the damage that may result from the event or condition if it does occur
45
Primary prevention
Focuses on healthy individuals who potentially could be at risk for a particular health problem.
46
Secondary prevention
Focuses on early detection and intervention in the case of disease, injury, or health hazards that have already occurred.
47
Tertiary Prevention
- Measures used in the advanced stages of disease to limit disability and other complications.
- Implemented when a person is already ill or impaired, and the initial damage has already occurred.
48
Preventive Occupation
Characterized as the application of occupational science in the prevention of disease and disability and the promotion of health and well-being of individuals and communities through meaningful engagement in occupations.
49
Occupational Risk Factors
- Occupational Alienation
- Occupational Delay
- Occupational Deprivation
- Occupational Disparities
- Occupational Imbalance:
- Occupational Interruption
50
Occupational Alientation
Sense of isolation, powerlessness, frustration, loss of control, and estrangement from society or self as a result of engagement in occupation that does not satisfy inner needs
Tasks that are perceived as stressful, meaningless, or boring may result in an experience of occupational alienation.
51
Occupational Delay
Occupational development that does not follow the typical schedule for the acquisition of occupational skills and is associated with occupational performance deficits
52
Occupational deprivation
- Deprivation of occupational choice and diversity because of circumstances beyond the control of individuals or communities
- Conditions that lead to occupational deprivation may include poor health, disability, lack of transportation, isolation, and homelessness.
53
Occupational disparities
Inequalities or differences in occupational patterns among populations that are often the result of occupational injustice
54
Occupational imbalance:
A lack of balance or disproportion of occupation resulting in decreased well-being.” Occupational patterns that fail to meet an individual’s physical and/or psychosocial needs, resulting in stress and a negative impact on health.
55
Occupational interruption
A temporary interference with occupational performance or participation as a result of a change in personal, social, or environmental factors
56
Occupational Resiliency Factors
- Occupational Adaptation
- Occupational Coherence
- Occupational Continuity
- Occupational Competence
- Occupational Identity
- Occupational Orchestration
- Occupational Self-Efficacy
57
Occupational Adaptation
The ability to adjust and respond to challenges and changes in circumstances that require modifications in occupational performance or participation
58
Occupational Coherence:
Engagement in occupations that are integrated, consistent, and congruent with one’s current and aspirational occupational roles.
59
Occupational Continuity
Engagement in valued and meaningful occupations that provide a continuous sense of occupational identity throughout one’s life.
60
Occupational Competence:
The degree to which one is able to sustain a pattern of occupational participation that reflects one’s occupational identity
61
Occupational identity:
A composite sense of who one is and wishes to become as an occupational being generated from one’s history of occupational participation
62
Occupational orchestration
The capacity of individuals to enact their occupations on a daily basis to meet their own needs and the expectations of the many environments in which they are required to function
63
Occupational self-efficacy
The belief in one’s capacity to perform occupations to meet one’s own needs and the demands of the environment.
64
3 Roles of OT in Community and Population Health
1. Promote healthy lifestyles for all clients, their families, communities, and populations.
2. Infuse occupation into existing health promotion efforts developed by experts in areas such as health education, nutrition, and exercise.
3. Develop and implement occupation-based community and population health promotion interventions, targeting a variety of constituencies, including individuals (both with and without disabilities), groups, organizations, communities, populations, and governmental policies.
65
Organizational-level interventions
* Consultation with industrial managers regarding the benefits of ergonomic workspace design and worksite injury prevention strategies
* Disability awareness training for service industry personnel, such as those who work for airlines, hotels, restaurants, etc.
66
Community-level interventions
Modification of community recreational facilities to increase accessibility for persons with disabilities
Staff and volunteer training for special-needs shelters during disasters
67
Population-level interventions
Implementation of a depression-screening program for new mothers for the purpose of developing prevention and early intervention programs
Development and implementation of chronic disease self-management programs addressing obesity, diabetes, and other chronic health conditions to reduce health disparities within local public health clinics
68
Governmental policy interventions
- Promotion of barrier-free, universal design environments to enable full community participation for persons of all ages and abilities
- Lobbying for public funds to support community based
69
A well-constructed theory satisfies four basic criteria:
Fit
Understanding
Generality
Control For a theory
70
Transactional perspective of occupation
Focus on holism and the interconnections of people, places, mind, body, and contexts.
Posits that occupations are part of the transaction of persons and environments (part of the connective relationships that join people and their environments)
Defines occupation as “a type of relational action through which habit, context, and creativity are coordinated toward a provisional yet particular meaningful outcome that is always in process”
71
Four Key concepts from the TPO that lay a foundation for application to community practice are:
Problematic situations, functional coordination, creativity, and growth.
72
Wilcock doing being becoming individualism in therapy
A view of individuals as containers of meaning and motivation who exist inside various contexts and act and react with these contexts through their own agency—that was prevalent in many theories and frameworks within occupational therapy in the late 20th century.
73
Commutative justice
Fairness and agreements between individuals and groups
74
Distributive justice
Allocation of income wealth and power in community
75
Social justice
Right to be members of society and be active in it closest to occupational justice
76
Social inequalities
- Health disparities exist due to inequalities in health care access, ability to obtain treatment, and health outcomes.
- Increases a person’s risk for poor health.
- Socioeconomic status is the number one predictor of health status
- Social inequality is a local, national and international issue.
77
Health disparities
African Americans- lower life expectancy and higher infant mortality
Hispanic Women are less likely to receive preventative cancer screenings.
Access to healthcare is considered the biggest factor for health disparities in the elderly and certain ethnic groups.
Global health disparities include- Millions of refugees, caste systems, human trafficking (not just international).
78
Occupational justice
```
People are occupational beings
Focus on health and quality of life
People should be able to access a wide and individualized variety of opportunities and resources
Focus on enabling people
Focus on individual differences
```
79
Social justice
```
People are social beings
Focus on social issues
People should have the same opportunities and resources
Focused on possession
Focus on group differences
```
80
Occupational alienation
Lack of self identity
81
Occupational Deprivation
Limited ability to participate in occupation uncontrolled
82
Occupational Marganilaization
Cannot make choices or have autonomy
| Imbalance-no equal opportunity to pursue occupations
83
Apartheid
Systematic segregation
84
Occupational justice or injustice comes from
Structural factors
Contextual factors
Occupational outcomes
85
Barriers to occupational justice
```
Values and beliefs of all involved.
Scope or practice
Funding and restrictions
Cultural norms are difficult to change
Collaboration with others
Unified terminology
Skills and time
```
86
Poverty and Health
Poverty can cause health issues and be a consequence of poor health
87
Increased chance of illness is due to:
Poor nutrition
Overcrowding
Lack of clean water
Safety
88
Increased poverty causes:
Decreased productivity
Limited funds designated to healthcare costs
Increased risk for physical and mental health issues
89
Education creates opportunities for improved health
```
Greater income and resources
Social and psychological benefits
Health behaviors
Poor health reduces education
Impacted by social policies and individual characteristic
```
90
Lower incomes have less resources such as:
Supermarkets, green space (sidewalks, parks), fewer healthcare providers/facilities, higher crime, fewer high-quality schools, less jobs, increased environmental toxins, less political influence (decreased ability to advocate for needs)
91
Access to Food and Nutrition Related Diseases
A high rate of chronic illness is related to poor diet, physical inactivity, smoking, and alcohol use
Many of the most fatal chronic diseases have nutrition components (heart disease, cancer, diabetes)
Income and limited resources make food access difficult
Food choices are impacted by many personal and community factors
OTs must empower people to change diet habits with education and implementation of planning, preparation and iadl activities that support health (Implement into intervention)
92
What is the 4th leading cause of death?
Physical inactivity
93
Physical activity lowers the risk of:
- Early death, heart disease, stroke, type two diabetes, high blood pressure, metabolic syndrome, colon and breast cancers, obesity, falls and depression.
- May improve cognition and lower the risk of hip fractures in older adult, improve bone density, sleep quality, and lower cancer risk
94
Factors associated with Physical activity behaviors
Individual
Built Environment
Social Environment
95
OTs can: (physical activity and health)
Promote routines that support physical activity, increase the availability of opportunities for physical activity through advocacy and develop programs that address the needs of vulnerable populations to have access to opportunities for physical activity participation.
96
Tobacco Use
Most preventable cause of death in the US
Smoking has declined but smokeless tobacco rising
Can cause many big problems (even second hand smoke)
Many challenges occur to reducing smoking habits
OTs role:
Smoking cessatiion programs
97
Eustress vs. Distress
Eustress: Can promote positive change, adaptation and accommodation
Distress: Actual or perceived threat to the body’s ability to maintain homeostasis
98
Acute Stress
```
Nervous system
Musculoskeletal system
Respiratory system
Cardiovascular system
Endocrine system
Gastrointestinal system
```
99
Chronic Stress:
```
Gastrointestinal-ulcers
Respiratory-strep
Skin-exzema
Musculoskeletal-joint pain
Metabolic- hyperthyroidism diabetes
Neurologic-migraines
Cardiovascular-coronary artery disease
Pain reported as well as suffering • Cognitive
```
100
What helps body stay alert for fight or flight response?
Cortisol
101
Encounter-Perceive-Interpret Stressor
Stress management approach begins with self-regulation (mindfulness and spirituality help to cope with stress
102
Self regulation
The impact of neurotransmitters on cognitive function and recall has been established and supports use of self-regulation to decrease anxiety and promote working memory and overall executive function
103
Biological effects of exercise
Strengthens cardiovascular system, via increasing O2 intake, fuels metabolism • Metabolic activities • Altering hormonal and immunological function • Improving blood lipid profiles • Neurologic functions • Musculoskeletal
104
Psychological effects of exercise
Helps to alleviate aversive states • Physically fit are less challenged from a cardiovascular standpoint during periods stress • Role in decreasing depression • Role in increasing cognitive performance
105
Physical Activity Recommendations for disease prevention
30-60 minutes per day, include weight bearing, stretching and range of motion, by bending and stretching in ADL and IADL tasks.
106
Physical Acivity Recommendations for basic health:
Play or large muscle repetitive activity 20+minutes, 3x/day, 2-4 limitation specific stretches after exercise, 1 rep. 30-40 seconds, lift to challenge level
107
Physical Activity Guidlines
Incorporate 4 main forms of exercise: cardiovascular, strengthening, stretching, balance & agility
Apply FITT Principle: Frequency, Intensity, Type, Time
108
Psychological Options for Managing Stress:
Mirthful Laughter and Music
This research demonstrated a direct correlation with reduction in systolic blood pressure following the use of musical experiences, counseling, and Music Assisted Relaxation and Imagery.
109
Wellness Recovery Action Plan (WRAP)
technique used to support self-management and coherence, reduce depression and anxiety and improved participants' self-perceived recovery over time.
110
5 key principles
Hope, Personal responsibility, Education, Self-advocacy, Support
111
Hope
People who experience mental health difficulties get well, stay well and go on to meet their life dreams and goals.
112
Personal responsibility
It's up to you, with the assistance of others, to take action and do what needs to be done to keep yourself well.
113
Education
Learning all you can about what you are experiencing so you can make good decisions about all aspects of your life.
114
Self advocacy
Effectively reaching out to others so that you can get what it is that you need, want and deserve to support your wellness and
115
Support
While working toward your wellness is up to you, receiving support from others, and giving support to others, will help you feel better and enhance the quality of your life.
116
Sedentary Populations
Physical activity reduces the risks of developing many debilitating conditions but most adults are becoming inactive as a result of changing lifestyles
Risk factors
Women more likely than men
People 65 years and older
CDC recommends that there are more opportunities provided within the community to allow individuals to be active
117
Caregivers
- Typically not prepared and do not have support
- Poor health is the biggest reason for having to remove someone from the home
- Costs is a burden (less likely to have health insurance/financial means)
- Increased stress, anxiety, and disabilities (Females have more issues in this area; Drugs and alcohol may also become a problem)
- Increased risk for physical disabilities, Decreased care for themself and long term stress
- We can provided services and opportunities for individuals to take time for themselves and decrease the burden of caregivers, dealing with transitions or managing care of a loved one, find resources for financial support, refer caregiver to care for self, and advocated to give them what they need
