Random Flashcards
Piaget formal operations stage
11-17yr, cooperative, beginning to see others point of view. Think they are invincible. Bring in role models: peer group works best, not a parent
Abstract reasoning, logical, can see possibilities beyond reality
Recommended lesson plan times for lower elementary school
15min preschoolers
30min 1-3 grade
45min 4-5grade
60min middle schoolers
Piaget concrete operational phase
7-11 yr
What they see is reality to them. Not abstract. Very visual. “Grandma died bc I was bad”
Egocentric/literal interpretation
Lower elementary students
Preschool thru 2’s grade.
Love stories, pictures, poems, songs. Very visual and go by rule governed thought.
Middle school and high school students
Eriksons stage - Identity vs role confusion: 12-18 years old. “See themselves as immune to consequences, and self as special unique and exceptional. Peer teaching is most effective. “Everybody’s doing it” need to combat this with normative education.
Middle and high schoolers
Teach short and long term but focus on short term that can happen immediately do they will identify more.
Smoking= talk about $$, smell more. (Short term). Not about lunch cancer (long term)
Animistic thinking
Naming toothbrush or puppets. Assigning human attributes to inanimate objects.
Middle and high schoolers
Better able to problem solve but don’t always do so, peer pressure.
**practice role playing and decision making with refusal skills in a safe environment so they can recall what they’ve practiced. —practice!! Give them the instincts to say no.
As nurse, don’t butt in as a facilitator; let them learn from each other. Informal situation so they can be comfortable.
Concrete stage teaching examples
Lower elementary students.
visual “jar of tar” to show how much from smoking one pack a day
Using black light to show how well they washed hands.
Hairy meets Horace the health hound and Merle the shy turtle (animistic thinking
Dental diary/worksheet or snack attack pledge
Upper elementary school students
3-5th grade. Can still be egocentric but with role play can get better at seeing other viewpoints, still not perfectly though. Use role play to practice stating their own feelings, basic refusal skills.
Upper elementary school students
Erikson stage industry vs inferiority
Try to come up with activities they can do, make, perform. Construct models, experiments, present plays or songs, draw ads for health or organize campaigns. Writing own songs/performing it so it’s meaningful.
Upper elementary students
Have them give you the issue they want to talk about, keep them more interested! at this age, they can begin to understand cause and effect and to problem solve.
–pull in values, have them choose what’s important to them
Upper elementary
Use exercises that help kids realize effort media has on our perceptions of so many things.
- this age is highly affected by movies, TV and magazines
- at his age, always include concept of peer pressure
Purpose of health promotion
Health maintenance and wellness
Prevention of illness
Restoration of health
Coping with impaired functioning
Benefits of teaching/health promotion
Quality control- when you teach you increase quality of. Care. When you increase quality of care you increase quality of life.
Cost control- teaching will prevent illnesses that may mean expensive care. Prevents readmission. Helps them recognize problems early and seek prompt care. Prevents long hospital stays by increasing self care that can be done at home.
Never events
Teaching prevents never events!!
Ex. Hospital acquired infections, falls or trauma, bed sores, or wrong side amputation
Encourage patient to speak up for their health to also help prevent never events
Ineffective behavioral change strategies
Fear (you’re gunna fiend you don’t xyz…) coercion/confrontation, paternalism (giving advice or telling client what is best)
Effective behavioral change strategies
- Stage of change based interventions. 2. Motivational interviewing ( helping client resolve ambivalence about change). 3. Cognitive behavioral therapy
3 learning domains
1 cognitive (understanding). 2. Affective (attitudes) 3. Psychomotor (motor skills)
Cognitive domain
The thinking domain/understanding.
Ability to make sense of and use information. (Learn and apply then comprehends) *like us students.
Acquiring knowledge, able to analyzed synthesize and evaluate based on knowledge obtained
Affective domain
The “feeling” domain. Includes feelings values and beliefs associated with info received:
- willing to listen/discuss feelings. Moves clients to attach worth to information, shown by choosing a particular action from a month alternatives
Ex. Lifeboat - which 10 get in lifeboat?
Psychomotor domain
The skull domain. Includes physical and motor skills. Uses cues from environment.
Performance of skill moves from imitation to creation of a new way to perform skill. Must have physical, mental and emotional readiness. Still have to know cognitive but also involves skill. Similar to lab
Learning to give meds, or start IV, or catheterize someone..
Cognitive verbs
“Client will list side effects” client will describe symptoms.
Categorize explain, identify, label, name, prepare, write, define. Differentiate
Planning objectives
Specific statements used to evaluate learning. avoid vague terms. Client centered. More short term than goals. Include only one behavior per objective
Planning goals
More long term and broader than objectives. Set in terms of “the client will”
Problem identification
1 deficient knowledge
- Altered or deficient health maintenance - difficulty adapting behavior or managing healthy behaviors. Not seeing Dr regularly
- Health seeking behavior. Client needs to alter health habits, may need to modify or avoid environmental factors
Older adults and teaching
Intelligence same, just need more time to process and respond. Simple instructions, teach only what is necessary and keep seasons 30 min or less. Teach one thing at a time and get something in writing. Teach when alert and rested
Principles of teaching and learning
Deal with any anxiety before teaching!!!!! Patient can’t learn if anxious.
Teach in order of maslows hierarchy
Establish therapeutic relationship first. Start simple then more complex. Repetition. Match with learning style. Active participation. Relate teaching to prior life experiences (specially for older adults)
Teaching young and middle adults
Try to keep sessions under 1 hour. Learning must be practical and relevant. Learner must see the need. Give time to practice skills in private. Often motivated by social task mastery so relate to those (work play or relationships)
Appropriate teaching methods for cognitive learning
Discussion lecture question and answer session
Role play/ discovery
Independent project or field experience
Teaching methods for affective learnig
Role play (allows expression of values and feelings). discussion groups, (support groups for women who are victims of domestic violence) discussion one on one.
Teaching for psychomotor learning
Demonstration like lab, practice, return demonstration , independent project or games
Precontemplation
sees no need for a change. Not ready to make a change for 6 months. May not realize the need.
Tasks: goal is to get them ready/motivate and encourage them to think about making a change.
- Awareness of need to change. 2. increase concern about current behavior. 3. envision change as a possibility.
Emotional Arousal: “Your wife has COPD and is getting sicker from the second hand smoke.”
Help client identify benefits to changing. (save money by not having to buy cigs!)
Contemplation
Sees the need for some change and has some desire. Ready to make a change in the next 6 months.
Tasks: 1. Analyze pros and cons of current behavior. 2. Weigh costs and benefits. 3. Struggle with ambivalence.
Interventions: self assessment and environmental evaluation, pros over cons (how quitting fits with values and life goals), help consider barriers and ways they can over come them!
social liberation: realization that behavior change is acceptable in larger society
Preparation
Intending to make a change in immediate future: within next 30 days! Plans to make a change soon, may even make small attempts at change. “Am I going to be successful?”
Tasks: increase commitment to change and design a plan for change.
Interventions: identify connection between stimulus and behaviors, contracting with self to stop, help client recall past successes, provide info on effective ways to make change. Helping relationships in community, and help client stop negative thoughts!
Action
Has made a behavior change within the past 6 months. VISIBLE commitment to change.
Tasks: Implement strategies for change, revise or change plan, sustain commitment in the face of difficulties.
Interventions: help monitor change (journal), rehearse approaches to problems, reinforcement management (change environment, no smoke break with friends,) Continue to point out benefits and be supportive and point to resources. *Help them with how to sub newer healthier behaviors for old bad behaviors!
Maintenance
Change lasted 6 months.
Tasks: sustain change, avoid relapse, integrate new behavior into life.
Intervention: applaud continuation, help client relabel, continue supportive relationship.
Messages should begin to focus on skills needed o create and maintain action plan for change. Pt aware of situation that could cause relapse!
SPICES
Overall assessment tool for elder adults.
S- sleep disorders. P- problems with eating and feeding. I- incontinence - (nocturia/toileting regimen) C- confusion - (from pain or meds) E-evidence of falls, (gait, assistive devices, walking with furniture, S - skin breakdown (ulcers or thin skin or bruises)
Factors influencing aging
heredity, environment, lifestyle, nutrition, medical history, psych factors, support system, socioeconomic resources, education bc it impacts income
Aging in the US
> 65 = older adult
Women tend to live longer!
Top two causes of death, 1. cardiovascular disease. 2, cancer. Prevention of death: health promotion and management of chronic disease
Never too old for a change!
Frail adult
Having any of the combo of the following two things *Vulnerable and may need help or outside interventions!!
-over 75 falling frequently, losing weight or poor nutrition mild memory loss no close family in community depressed bc of losses hospitalized 3x's in 2mo taking >5 meds regularly and getting confused needs health teaching
Goals of elder assessment
Maintain health, minimize hospitalizations, establish diagnosis’s that are often overlooked, and decrease over prescription of meds.
