Week 7 Flashcards
The goal of acute is to ____ uncertainty
The goal of chronic is to ___ uncertainty
Decrease
Manage
Uncertainty influences the ability to ___ and ____ to chronic illness
cope and adaptation
Sources of uncertainty
Medical (r/t condition)
Personal (ie. social roles, work)
Social (ie. relationships)
Four Constructs/Forms of Uncertainty
Inconsistency - inadequate info about condition
Complexity of condition and treatment
Unpredictably of trajectory
Ambiguity of disease
What are the two best interventions/essential to manage uncertainty
Maximize perception of confidence and control
Three types of interventions for uncertainty
Cognitive - educative
Emotive
Behavioural - ADLs
What are some of the emotive strategies for uncertainty
Normalization - reconstruct life to incorporate to the unpred. of disease
Cognitive schema - making up scenarios
Cognitive reframing - examining expectations and making them realistic
Sexuality def
What makes one human
touch, connectedness, self-image***
Sexual behaviours
Specific actions that allow to obtain sexual release
Sexual functioning
Physiological components
Side effects of CAD and diabetes
Erectile dysfunction
Diabetes - vaginal dryness, dyspareunia
Effects of cancer on sexuality
- surgery on GI affects innervation of sexual organs
- removal of upper uterus (short vag)
- testicular cancer
- breast cancer
Interventions for sexuality
Implement sexual assessments into daily practice to reduce embarrassment and allow pt to discuss any difficulties
PLISSIT Model for Sexual Assessments
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)
What is powerlessness (3)
the inability to affect an outcome
when
individual controlled by environment
can be real or perceived
Frameworks for powerlessness
Shifting perspectives in chronic illness
Self-determination theory
Cognitive Adaptation Theory
Self-determination theory
Proposes there’s 3 basic psychological needs to obtain optimal well-being
Competence -ability to adapt
Relatedness - integrate into social networks
Autonomy
Cognitive Adaptation Theory
a person’s attempt to maintain control is heightened when challenged with an unpredictable condition
What are the two main issues r/t with powerlessness in chronic illnesses
Lack of self confidence and disrupted identity
What are the perspectives on self-care and self-management according to Orem
And examples
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
Modelling and Remodelling Framework involves three type of self-care
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
The three best practice guidelines for self-management
1) Manage symptoms
2) Engaging in healthy behaviours; following medical regime
3) Keep in regular contact with HCP
