Week 7

Question 1

The goal of acute is to ____ uncertainty

The goal of chronic is to ___ uncertainty

Answer 1

Decrease

Manage

Question 2

Uncertainty influences the ability to ___ and ____ to chronic illness

Answer 2

cope and adaptation

Question 3

Sources of uncertainty

Answer 3

Medical (r/t condition)
Personal (ie. social roles, work)
Social (ie. relationships)

Question 4

Four Constructs/Forms of Uncertainty

Answer 4

Inconsistency - inadequate info about condition
Complexity of condition and treatment
Unpredictably of trajectory
Ambiguity of disease

Question 5

What are the two best interventions/essential to manage uncertainty

Answer 5

Maximize perception of confidence and control

Question 6

Three types of interventions for uncertainty

Answer 6

Cognitive - educative
Emotive
Behavioural - ADLs

Question 7

What are some of the emotive strategies for uncertainty

Answer 7

Normalization - reconstruct life to incorporate to the unpred. of disease
Cognitive schema - making up scenarios
Cognitive reframing - examining expectations and making them realistic

Question 8

Sexuality def

Answer 8

What makes one human

touch, connectedness, self-image***

Question 9

Sexual behaviours

Answer 9

Specific actions that allow to obtain sexual release

Question 10

Sexual functioning

Answer 10

Physiological components

Question 11

Side effects of CAD and diabetes

Answer 11

Erectile dysfunction

Diabetes - vaginal dryness, dyspareunia

Question 12

Effects of cancer on sexuality

Answer 12

• surgery on GI affects innervation of sexual organs
• removal of upper uterus (short vag)
• testicular cancer
• breast cancer

Question 13

Interventions for sexuality

Answer 13

Implement sexual assessments into daily practice to reduce embarrassment and allow pt to discuss any difficulties

Question 14

PLISSIT Model for Sexual Assessments

Answer 14

Permission (assess)
- let them know sexual issue are part of nursing practice
- ask about sexuality
Limited info (educate)
- how treatments will affect sexual functioning ie. ED
Specific Suggestions (advise)
- needs knowledge of how conditions affect sexual functioning
Intensive Therapy (referral)

Question 15

What is powerlessness (3)

Answer 15

the inability to affect an outcome
when
individual controlled by environment
can be real or perceived

Question 16

Frameworks for powerlessness

Answer 16

Shifting perspectives in chronic illness
Self-determination theory
Cognitive Adaptation Theory

Question 17

Self-determination theory

Answer 17

Proposes there’s 3 basic psychological needs to obtain optimal well-being
Competence -ability to adapt
Relatedness - integrate into social networks
Autonomy

Question 18

Cognitive Adaptation Theory

Answer 18

a person’s attempt to maintain control is heightened when challenged with an unpredictable condition

Question 19

What are the two main issues r/t with powerlessness in chronic illnesses

Answer 19

Lack of self confidence and disrupted identity

Question 20

What are the perspectives on self-care and self-management according to Orem

And examples

Answer 20

Self care as adherence to medical treatments
- screening, prevention interventions
Self care as in the belief in the ability to self-manage
- self efficacy, attitudes, coping and most influential is PREVIOUS lifestyle behaviours

Self care as functional abilities and independence
- ADLS, IDLS

Self care as self-determined behaviours that meet the individuals needs
- promote independence ie. let them feed themselves

Question 21

Modelling and Remodelling Framework involves three type of self-care

Answer 21

Self-care knowledge
- personal knowledge r/t to their needs and availability of resources
Self-care resources
- internal; genetics, mental and physical functioning
- external; social networks, environment, living arrangements, involves knowledge on resources
Self-care action
- activities taken by person to influence health status.. involves knowledge and use of self-care resources

Question 22

The three best practice guidelines for self-management

Answer 22

1) Manage symptoms
2) Engaging in healthy behaviours; following medical regime
3) Keep in regular contact with HCP