SIM Flashcards
Define:
Culture
Cultural Sensitivity
Cultural Compentency
Culture:
- beliefs and behaviours that define the values of communities and social groups
Cultural Sensitivity:
- awareness of cultural differences and how these affect values, learning and behaviours
Cultural Competency:
- Ability to interact with people of different cultures due to awareness of own culture, attitude toward differences, knowledge of different cultural practices, and cross-cultural skills
Discuss the LEARN model for cultural competent care
L: Listen with sympathy regarding patient problem
E: Explain situation and elicit culturally relevant information
A: Acknowledge differences in culture
R: Recommend options and alternatives
N: Negotiate treatment plan
What are some barriers to providing healthcare to recent immigrants
Lack of education leading to poor diet and physical inactivity
Barriers to accessing care:
- language
- cost
- transportation
- community awareness
- cultural barriers
- unfamiliarity with preventative medicine
- foreign health conditions
- healthcare unable to provide culturally competent care
Define shared decision making and list the process of proper decision making
Interactive process between physicians and patients in all phases of the decision making process
- physician identify >=2 options
- physician list options pros and cons for each
- explore patient expectations, ideas, concerns
- check understanding and allow for questions
- discuss their preferred level of involvement
List barriers to shared decision making
- time
- patient characteristics
- presumed patient preference
- lack of familiarity
Discuss the stages of change model
Pre-contemplation: patient does not view behaviour as problem and have no intention on changing
- >6 months from change
Contemplation: patient is ambivalent about change, weighing pros and cons
- <6 months from change
Preparation: patient resolved to make serious attempt at change and are committed but have yet to begin
- <1 month
Action: patient involved in change within last 30 days
- change <6 months
Maintenance: behaviour change for greater than 6 months
What are some barriers to behaviour change
Psychological barriers: - admission of problem - initial attempt at change - long term change Physical barriers: - geography - cost
What is the CAGE questionnaire
C: Have you tried to cut down on your smoking
A: are you annoyed when people ask you about your smoking
G: Feel guilty about your smoking
E: eye-opener, do you ever need to smoke immediately when waking up
List the common pharmacotherapeutic agents used to help with smoking cessation
Nicotine Replacement
- alleviate nicotine withdrawal
- used for 8-12 weeks
- dose depends on dependence
Bupropion (Zyban)
- NDRI so increases dopamine and norepinephrine levels leading to blockage of the nicotinic receptor
- begin 1 week before quit date and on for 8-12 weeks
- 150mg Q12H
- Adverse effects: Seizure, insomnia, GI upset
- Contraindicated with alcohol or benzo withdrawal, or use of MAOI
Varenicline (Champix)
- nicotinic receptor partial agonist so have moderate increase in dopamine in the mesolimbic cortex
- taken for 12 weeks
- 1mg Q12H
- adverse effects: nausea and vomiting, bad taste, constipation, sleep disturbance
Define the following Limitation Restriction Impairment Disability Hazard
Limitation:
- patient can do task but not at usual force, pace or duration
Restriction:
- patient should not due task
Impairment
- organ based concept cannot due task due to abnormal psychologic, physiologic or anatomic function
Disability
- lack of ability to perform specific task due to physical or psychiatric limitation
Define hazard and list types of hazards
Hazard: condition or practice that can lead to harm or damage
- ergonomic
- chemical
- biologic
- physical
- psychological
Discuss hazard surveillance
- Recognition
- Evaluation
- Control
Recognition - identify hazard Evaluation - provide risk assessment of likelihood someone will get harmed and how serious injury would be Control - elimination or substitution - engineering controls - warnings and alarms - training and administrative controls - personal protective equipment
Discuss the two methods of obtaining a history of exposure
- WHACS
- IPREPARE
WHACS
- What does patient do for living
- how does patient perform job and duties required
- are patients worried about exposure
- Coworkers exposure similar symptoms
- Satisfaction with job and influence of that on risk
I PREPARE
- Investigate all exposures: considered when not responding to typical therapy
- Present work: detailed history of what they do
- Residence
- Environment
- Past work
- Activities
- Resources and referals
- Educate
Discuss what type of information is required to be released to employer and insurance
Employer
- limitations, aids, and protective devices required
- do not need to know diagnosis, investigations or treatment plan
Insurance:
- diagnosis, restrictions on function or anatomy, treatment plan
- requires consent from patient
Discuss the main functions of public health
SHIPPE
- Surveillance: collect, interpret and communicate health data on disease trends
- Health promotion: build healthy environments and promote healthy behaviour
- Injury and disease prevention: implement interventions at population level (water safety, needle exchange, bicycle safety)
- Population health assessment: monitor and address social determinants of health
- Protecting health: reduce health hazards
- Emergency preparedness
