Concepts Flashcards

Question

True or false: mutuality is a relationship that is mutually beneficial, it involves knowing and deeply understanding another person's goals, values, beliefs

Answer 1

TRUE Mutual respect is inspired by responsibility to the other. “When we respect something [someone], we heed its call, accord it its due, [and] acknowledge its claim to our attention” (Dillon, 1992). Mutual respect is the means to mitigate power differentials. This does not mean that the nurse and the patient have equal power. It means that the nurse and the patient have different power. Within the relational ethic framework mutual respect provides a means of interacting with others that are not equal, through recognition that “our differences complement rather than exclude one another” (Benhabib, 1987, 87). Mutual respect develops from an intersubjective experience arising from a non-oppositional perception of difference. This is achieved by acknowledging the phenomenological experience of the selves in the relationship.

Answer 2

B. the ability of a nurse to act in a moral or ethical way, which benefits outcomes From CNA (ethical (or moral) agent. Someone who has the capacity to direct their actions to some ethical end, for example, good outcomes for patients (Storch, Rodney, & Starzomski, 2013). Exercising that capacity would be ethical (or moral) agency.)

Answer 3

FALSE People with advanced illnesses don’t experience hunger or thirst as healthy people do. People who stop eating die of their illness, not starvation.

Answer 4

False: Palliative care can benefit patients and their families from the time of diagnosis of any illness that may shorten life.

Answer 5

False- Allowing children to talk about death and dying can help them develop healthy attitudes that can benefit them as adults. Like adults, children also need time to say goodbye to people who are important to them.

Answer 6

Palliative care ensures the best quality of life for those who have been diagnosed with an advanced illness. Hope becomes less about cure and more about living life as fully as possible.

Answer 7

FALSE: Keeping people comfortable often requires increased doses of pain medication. This is a result of tolerance to medication as the body adjusts, not addiction.

Answer 8

Appropriate doses of morphine keep patients comfortable but do not hasten death.

Answer 9

FALSE: Palliative care does not hasten death. It provides comfort and the best quality of life from diagnosis of an advanced illness until end of life.

Answer 10

b. violent death

Answer 11

\*\*\*\*\*\*\*D\*\*\*\*\* more info: → pt’s and families usually recognise that physicians cannot accurately give an answer but mostly they want an educated guess and willingness to discuss end of life topics. → when pt’s ask “how long have I got” clarify what they are asking, are they asking how long until the next exam/dx test? How long until they can leave hospital? → also you need to determine the reasoning behind the question: pt may have things to complete before death (paperwork, family visits etc) or they have a trip planned, family may be wondering if they should come visit now or if they can come later. Many different tools exist for prognosticating disease course:  most important factor is the patient's level of function, usually referred to as his/her performance status. Measuring the rate of decline of performance status will demonstrate a momentum that can be used to estimate further decline. In other words, in palliative care, conditions that deteriorate week by week usually continue to do so, day by day etc.  Measuring performance: → palliative performance scale: useful in documenting performance status & therefore monitoring decline in performance to gain an estimate of prognostication. Also useful tool for communication of illness. → Karnofsky performance scale: similar to palliative. Measures performance in oncolog.  Pt’s rate on scale of 100 - 10 based on status in 4 areas (activity & evidence of disease, self-care, intake, and LOC) Predicting performance: 2 tools are identified in this paper for prognostication. Bothe are designed for oncology but can be used for other diseases.  However: many progressive, life-threatening non-cancer diseases have more unpredictable courses and prognosticating is more difficult → palliative prognostic score 30-day survival probability is less than 30% with a score greater than 11, and more than 70% with a score of 0 to 5.5.  → Palliative prognostic index Scoring greater than 6 on the palliative prognostic index predicts a survival of less than 3 weeks (sensitivity 80%, specificity 85%).

Answer 12

→ The 2 components of prognosticating are formulating an accurate prediction and communicating it to the patient and family. Together, these components are a mix of art and science.

Answer 13

→ Underestimation: (pt live longer than expected) family members believe they have been robbed of “usable” time.  → Overestimating: (pt dies earlier than expected) might delay referral to palliative care services or delay aggressive analgesia use. might also increase the use of potentially toxic and difficult treatments, which will have little effect on the patient's time and might result in lower quality of life. Family may delay visiting, proper documents may not be in place when death occurs.

Answer 14

False- it's transactional..... Shared Mind includes talk of interactional and transactional interactions (it's a continuum) which are described as: At one end of the continuum, an interactional approach promotes knowing the patient as a person, tailoring information, constructing preferences, achieving consensus, and promoting relational autonomy. At the other end, a transactional approach focuses on knowledge about the patient, information-as-commodity, negotiation, consent, and individual autonomy

Answer 15

ways in which new ideas and perspectives can emerge through the sharing of thoughts, feelings, perceptions, meanings, and intentions among 2 or more people.

Answer 16

Relational ethics

Answer 17

\*\*\*\*\*\*\*\*E\*\*\*\*\*\*\* The other tips on BBN: Preparation -Identify who needs to be present -Find a setting that is private, where interruptions will be minimized; ensure chairs are available so everyone can be seated. -Ensure those being given the information know beforehand that they are going to receive significant news by alerting them to the seriousness of what they will be told. -Ensure there is time available for explanation, questions and emotional reactions so that the patient does not feel rushed. -Familiarise yourself with the relevant information — if you do not have the opportunity to do this because the situation is unplanned then listen, find the information and take it back within an agreed time frame. -Think beforehand how you will deliver the news and also the words and phrases that you are comfortable to use -Use open questions to find out what the patient knows and is expecting to hear; determine preferences for what and how much the patient wants to know -Do not make assumptions about what the patient or relatives know or what they want to know; seek their clarification. \*\*Giving the information\*\* -Provide the information accurately and clearly, getting a balance between being honest while at the same time being encouraging, supportive and hopeful. -Do not use jargon or medical terms without a thorough explanation. If patients do not understand they may feel confused or stupid and reluctant to ask questions. -Use words and phrases that have a clear meaning to prevent misunderstanding or multiple interpretations. -Do not use euphemisms such as ‘growth’ instead of ‘cancer’, ‘they didn’t make it’ instead of ‘they have died’, and ‘they are better’ when they have improved a little but there is no significant change. -Break the information into chunks, giving one piece of information and then moving on once you are sure the recipient has understood. -Continually assess preferences for additional information; confirm this with the patient and follow the patient’s lead. -Repeat key information; be aware that those receiving the news may not take in further information once the bad news has been given. -Respond to reactions and answer questions -Expect an emotional reaction. -Allow time and opportunity for expressing emotions — as Gauthier (2008) suggested, ‘listen more and talk less’. -Acknowledge the emotions being expressed and name them to give them legitimacy — for example, ‘I can see you are sad/angry/ overwhelmed by this news’. -Provide frequent opportunities for questions. \*\*Plan the next step\*\* -Agree a plan about what will happen next so patients and relatives have a sense of control and know what to expect. -Offer hope and encouragement about the options that are available. -Inform the patient and relatives that you will be available to discuss and listen to concerns in the future (if you will continue to be involved in their care) and/or provide information about support services that are available and the contact details of those involved in the next stage of their care. -Provide written information where this is available and appropriate. \*\*\*Debrief: develop and use support systems\*\* -Managers should be aware that breaking bad news is time consuming and demanding and can have an impact on workload and the emotional wellbeing of staff. -Formal and informal opportunities to reflect and provide support should be made available. -Senior staff should take responsibility for ensuring sources of support are developed and used. Individual practitioners should pay attention to looking after themselves and find effective ways of coping with the stressful consequences that can follow involvement in breaking bad news.

Answer 18

a) not eligible because must be 18 years of age or older b) not eligible because mental illness does not qualify for MAiD yet c) not eligible because must be mentally competent to give consent d)THE RIGHT ANSWER- competent, old enough, etc.

Answer 19

True, it answers: -Who do you want to make your health care decisions for you? -what health care treatment(s) do you agree to, or refuse to, if a health care provider recommends them? -would you accept or refuse life support and life-prolonging medical interventions for certain conditions? -what are your preferences should you need residential care and not be able to be cared for at home? (my voice)

Answer 20

\*\*\*\*\*\*\*\*\*D\*\*\*\*\*\*\*\*\*\*\*\* our Advance Care Plan can also include: A Representation Agreement where you write your instructions and name someone to make your health and personal care decisions if you become incapable. An Advance Directive with your instructions for health care that are given to your health care provider, which they must follow directly when it speaks to the care you need at the time if you become incapable. An Enduring Power of Attorney where you appoint someone to make decisions about your financial affairs, business and property.

Answer 21

where you appoint someone to make decisions about your financial affairs, business and property.

Answer 22

An Advance Directive is instructions for health care that are given to your health care provider, which they must follow directly when it speaks to the care you need at the time if you become incapable.

Answer 23

A Representation Agreement is when you write your instructions and name someone to make your health and personal care decisions if you become incapable.

Answer 24

\*\*\*\*\*FALSE\*\*\*\*\*\* A nurse who has a conscious objection (goes against values or religion, but is not based on biases, prejudices or ease) can give manager notice well in advance to make other arrangements. The nurse is still responsible for making sure that there is no interruption to continuity of care, quality, etc.

Answer 25

\*\*\*\*D\*\*\*\* They still have to ensure continuity of care

Answer 26

Grief is commonly defined as a state of deep mental anguish commensurate with many difficult emotions such as sorrow, heartache, anguish, pain, distress, misery, and woe; it can be effectively understood as a process encompassing a much broader range of experiences -Human grief is a natural, inevitable neuropsychobiological response to any kind of significant loss. -Grief is a universal phenomenon, whereas mourning assumes many different cultural expressions. Extra from teacher's answer: “The grief response is generally associated with degrees of suffering, at times intense or even unbearable, and of widely variable duration. Grief is a systemic event, whether the system is an individual or a larger group of individuals thrown out of equilibrium through changes brought on by loss” (p. 33).

Answer 27

Mourning is the outward, shared expression of the experience of grief. -Normal practices of mourning vary across cultures -Mourners bring their own respective life history and context to the grief experience, Teacher's answer: “Mourning is the shared expression of a grief experience, important in gaining a new equilibrium following any manner of deficit, including decreased function or role, loss of assumed health, and diminished dreams of the future. Mourning + Grief = Grief Process

Answer 28

Grief= response to loss or anticipation of loss Mourning= expression of the grief Grief is a universal phenomenon, whereas mourning assumes many different cultural expressions (grief is the feeling of loss, whereas mourning is the outward expression of these feelings).

Answer 29

-aid in provision -be empathetic -explore reasoning -ensure access to info -provide same, competent, ethical care without judgement or abandonment

Answer 30

-It is an emotional burden -decrease in personal health -injury -depression and anxiety -fatigue -financial problems -employment loses -vulnerable to social isolation and psychological stress

Answer 31

Provide support, advocate for better respite services, show them that you care about them, and try to support preemptively before they become too burdened.

Answer 32

This term is controversial. This person guides the dying journeyer and their family through the process- provides a continuum of support.

Answer 33

emotions can be explosive at times. They include: sorrow, heartache, anguish, pain, distress, misery, and woe, depersonalization, sadness, anger, guilt and self-reproach, panic, anxiety, fear, loneliness, listlessness and apathy, yearning, relief, shock-denial-numbness-disbelief; disorganization-confusion-searching yearning; -There may be a sense of timelessness. If someone has died, there is often a sense of presence, or of seeing or hearing the deceased. There may be sleep and appetite disturbances, social withdrawal, sighing, searching and crying, restless overactivity, reminiscing and laughing, treasuring objects that belonged to the deceased, or avoiding such reminders.

Answer 34

Empathy (awareness of self and other), attentiveness (staying mindful – emotionally, spiritually and cognitively) and respect (culture sensitivity) (p. 34)

Answer 35

-Grief will begin with any manner of loss, including decreased function or role, loss of assumed health, or diminished dream of the future. -The grief process may begin at the time of diagnosis—or even before that point. -Every change in status will alter the grief trajectory to some degree It is important to understand bc. each stage poses a challenge to human systems at each level—through personal, interpersonal, family, and caregiver systems. The nurse should be there to support through the entire journey. -At each loss and change there is a potential for growth or to decline, so the nurse must also understand the process is multifaceted and complex, involving somatic, psychological, social, cultural, spiritual, and historical components, and do their best to support the patient and family holistically, and reassess frequently as changes occur. The impact of disease or loss on total functioning of a patient or family system must be considered. How is self-concept affected? Identity, expectations, and sense of the future all may need adjustment. What is—or was—the role of the patient in the family system? This may require change. A loss of roles, accustomed activities, capabilities, and personal dignity may occur.

Answer 36

physical sensations (psychosomatic) might include muscular weakness, fatigue, tightness in the chest and throat, dry mouth, nausea, and sensitivity to noise. There may be sleep and appetite disturbances, social withdrawal, sighing, searching, and crying, restless overactivity, reminiscing, and laughing, treasuring objects that belonged to the deceased, or avoiding such reminders” (p.34).

Answer 37

paternalism

Answer 38

Nurses are moral agents in providing care. This means that they have a responsibility to conduct themselves ethically in what they do and how they interact with persons receiving care. This includes self-reflection and dialogue.

Answer 39

Exercising the capacity to direct actions to some ethical end (e.g. good outcomes of patients) would be ethical (or moral) agency.

Answer 40

-Palliative care: -available in all primary care settings and at all stages of illness — not just near the end of life — and continues after death (support of family/ friends) -seeks to improve quality of life and relieve suffering for patients diagnosed with chronic, life-limiting conditions -does not diminish hope --\> supports patient and fam to gain better control -is highly individualized -holistic (spiritual, psychological, social, physical, family, etc.)

Answer 41

The palliative approach to care: --it puts patients and their families at the centre of all decisions and considerations of care. -promotes autonomy, and applies other principles of P.C. (dignity, hope, quality of life, etc.) -holistic (spiritual, mental, physical, social, psychological and practical aspects) --from time person is diagnosed with chronic, life-limiting illness until after a patient has died through ongoing support to the bereaved family and friends.

Answer 42

starts in the final stage of dying, then continues until death and into family bereavement and care of the body. It is provided across all settings across the continuum of care to relieve suffering and improve the quality of living until death

Answer 43

Hospice care is a “term that may be used to describe both a place of care (i.e. institution) and a philosophy of care, which may be applied in a wide range of care settings”. (the philosophy version is often used interchangeably with palliative care because the approach/ philosophy is the same or similar)

Answer 44

-ensure have informed consent to provide tx -respect pt's right to withdraw from tx at anytime -relieve pain and suffering -appropriate and effective symptom management -promote care that allows person to live and die with dignity -nurses foster comfort, alleviate suffering, advocate for adequate relief of discomfort and pain, and assist people in meeting their goals of culturally and spiritually appropriate care. -uses a palliative approach to care -support family during and following death

Answer 45

spiritual, philosophical, emotional and psychological suffering concerned with: -fears of death/ knowledge we will die -a lost sense of control to predict future -with isolation -meaning of life -This often follows a life-threatening crisis/ diagnosis -can be related to religion, but not necessarily (other higher powers, nature, others, etc.)

Answer 46

Compassion fatigue is a preoccupation with absorbing trauma and emotional stresses of others, and can be caused by the prolonged exposure from listening/ seeing traumatic things/ suffering (cumulative effect). Burnout is about being ‘worn out’ and can affect any profession. The impacts of burnout emerge gradually over time and are easily identified to direct links and stressors within the working and personal life. NURSING SCHOOL!!!!!!!!!!!

Answer 47

Is a sociological theory describing multiple threats of discrimination when an individual's identities overlap with a number of minority classes — such as race, gender, age, ethnicity, health and other characteristics. For example, a woman of color may face sexism in the workplace, which is compounded by pervasive racism.

Answer 48

When a dominant‐defined social environment is challenged and/or stressed by individuals who do not conform to this normal social standard, the dominant person or group responds by identifying and differentiating (othering) these non‐conforming individuals, who are then relegated to the status of “the other”. In creating difference through othering, potentially the dominant person or group is empowered while the non‐conforming “others” are consigned to a substandard status

Answer 49

a process that strives to connect through difference”. In these terms, Inclusionary othering uses the recognition of difference for alliance building, rather than as a mechanism for reinforcing marginalization and exclusion. I really like this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500989/

Answer 50

The TRC is a component of the Indian Residential Schools Settlement Agreement. -the mandate is to inform all Canadians about what happened in Indian Residential Schools (IRS) -this involves First Nations, Inuit and Métis former Indian Residential School students, their families, communities, the Churches, former school employees, Government and other Canadians.

Answer 51

To guide and inspire Aboriginal peoples and Canadians in a process of reconciliation and renewed relationships that are based on mutual understanding and respect. -Health authorities, education institutions, etc. have also made individual promises to support this goal. A lot of times the strategic initiatives are categorized under goals for "cultural safety"

Answer 52

a) To better describe coping with loss b) To predict good vs. poor adaptation to loss c) To better understand individual differences in in how people comes to terms with bereavement

Answer 53

Coping: is a process. Coping defines whether the consequences of bereavement are adaptive or mal-adaptive

Answer 54

Definition:” Grief work is understood to refer to the cognitive process of confronting the reality of a loss through death, of going over events that occurred before and at the time of death, and of focusing on memories and working toward detachment from (or relocating) the deceased (Stroebe, 1992, in Stroebe and Schutt, 2010, p. 275)

Answer 55

a) Non-confrontation is not specifically linked to mal-adaptation b) Grieving is not passive but is an active process c) Respite from grieving is important to consider (“Dosage of grief”) d) It may be beneficial to consider the benefits of denial e) Grief work only focuses on the loss - consideration of additional stressors following loss (financial, change in role, arrangements…etc.)

Answer 56

“Carrying” the deceased sibling forward into their lives, not replacing them (p.822).

Answer 57

Three factors to consider: the amount of communication, cohesiveness and support the family gets through the grieving process. Surviving siblings may become: distraught watching their parent(s) grieve, want to protect them, become frustrated in watching their parents grieve. \*Parental support is essential in supporting surviving siblings and creating an adaptive response to the loss Adaptive: parents model their grief and continuing bonds, open communication and expression of emotions. Ability to talk about the loss as years go by and children reach different developmental ages and understanding of the loss. There can also be opportunities for growth seen in adolescents who make meaning of the loss and mature and gain higher moral values and attitudes (p.828)

Answer 58

Open communication and the ability to express emotions is key to adaptive responses.

Answer 59

Negative: 1. Psychosomatic disorders 2. Behavior problems 3. Guilt, anxiety and depression (adolescents) Positive: 1. Increased capacity to handle adversity A sensitive outlook on life – meaning of life Increased compassion, sensitivity, empathy Growth in maturity Higher moral values and attitudes Increased adaptability and flexibility (if the sibling was sick for a period of time – taking on new responsibilities within the household (p. 828, 829)

Answer 60

To provide or allow spiritual exploration and support during grief. (p.35)

Answer 61

AKA frozen grief (p.35). Examples – drug addiction, dementia, mental illness, brain injury. a loss that occurs without closure or understanding. This kind of loss leaves a person searching for answers, and thus complicates and delays the process of grieving, and often results in unresolved grief.

Answer 62

1. Denial 2. anger 3) Bargaining 4. Depression 5. Acceptance (stages overlap and can coexist but it is progressive) (p. 35) I think our instructor wanted us to realize that the models were a bit more rigid and structured before

Answer 63

Hope – defined as: ““the feeling that all of this must have some meaning, and will pay off eventually if they can only endure it for a little while longer.” NB: “Interestingly, the patients that Kübler-Ross interviewed showed the greatest confidence in those physicians who allowed them to express and maintain their hope, in whatever form” (p.35).

Answer 64

Not he stages could be revisited once triggered by an event such as a birthday or anniversary of the death (p.35)

Answer 65

1. Shock and disbelief 2. Searching and yearning 3. Disorganization and disrepair 4. Rebuilding and healing (p.35)

Answer 66

1. Accepting reality of the loss 2. Experiencing the pain of grief 3. Adjusting to an environment where the deceased is missing 4. Withdrawing emotional energy and investing it into another relationship NB: “four undertakings need not follow a specific order; they can be concurrent, cyclical, or overlapping, and the grieving person will work on them with effort until regaining balance.” (p. 36)

Answer 67

Each person’s grief experience is unique and there are no predictable or orderly stages (p. 36). NB: “The mourner is the teacher and not the recipient of another’s expertise. Mourner and supporter go on a journey of discovery” (p.36)

Answer 68

“caregivers to the bereaved should “companion,” rather than treat those in grief. In his words, ‘Companioning’ is about honoring the spirit, being curious, learning from others, walking alongside, being still, listening with the heart, bearing witness to the struggles of others and being present to their pain, respecting disorder and confusion rather than imposing order and logic. Companioning is about going to the wilderness of the soul with another human being; it is not about thinking you are responsible for finding the way out.” (p. 36) “Rather than viewing grief as a disease state from which to seek recovery, he sees the pain of loss as an inherent part of life resulting from the ability to give and receive love.” (p.36)

Answer 69

1.to inwardly experience and outwardly express the reality of loss through mourning; 2. to tolerate the pain of grief while caring for oneself; 3. to convert the relationship with the lost person from presence to memory (relocation of the relationship in the heart of love versus decathexis or withdrawal); and 4. to develop a new self-identity based on life without the person who died, taking on new roles, and exploring positive aspects of oneself in the change. Added to the process are 5.to relate the experience of loss to a context of meaning, telling a story about the loss until it becomes “the story” that makes some sense of it all, teaches some lesson, or provides some doorway to continuance; and 6. to develop an understanding, enduring support system that will provide a strengthening brace while healing takes place in the months and years ahead. These are fellow human beings who will companion the mourner and encourage self-compassion whenever a normal resurgence of intense grief occurs

Answer 70

It is based on a constructivist approach: we co-construct our reality; each experience having the potential to influence and shake our assumptions. Grief counselling is led by the bereaved, “Grieving is active, affirming or reconstructing a personal world of meaning that has been challenged or ruptured by loss. It is a period of decision making, practically and existentially, not a time of passive waiting through a series of emotional transitions or stages.” “Emotions during grief are functional and useful guides.” “The reconstruction of a grieving person’s identity is a social process.” “Grieving individuals adapt to loss by restoring coherence to the narratives of their lives, making sense of their own great continuing story, putting the pieces of the shattered puzzle back together.”

Answer 71

“What is required or expected of the grieving person’s culture in this situation?” (p.38).

Answer 72

Wolfelt and Neimeyer – because they are led by the bereaved.

Answer 73

More intense feelings of grief may be normal in this case (p. 38)

Answer 74

Loss-orientation is the grief work and restoration-orientation is the focus on other stressors that are the result of bereavement.

Answer 75

The four phases in each model are similar but build on each other by taking into consideration other factors and / or elaborating.

Answer 76

Moving on from grief (emotional detachment) was central to adaptation, “severing ties with the deceased.” New (old) idea of grief process - Continuing Bonds – the life is gone but the relationship lives on. NB: History of the Grief Process – Prior to WWI: lifelong process (continuing bonds) A shift occurred after WWI number of deaths shifted the grief process towards detachment, “self-constraint rather than self- expression” (Pavckman et al., 2006, p.818).

Answer 77

Sibling relationships are life long, siblings influence the development of personal identity through exchanges in which they define each other, they have enduring contact compared to other relationships within and outside of a family. (p.820)

Answer 78

Ongoing Attachment = Continuing Bonds (p. 822) a) regretting—desiring to have a better relationship; wishing to continue a shared relationship b) endeavoring to understand—searching for reasons for the sibling’s death; wanting to know circumstances of the death; c) catching up—asking what heaven is like; how are things? bringing the siblings up to date; d) reaffirming—loving and missing the sibling; e) influencing—seeking guidance from the sibling; and f) reuniting—anticipating reunion in heaven.

Answer 79

Through a search for new meaning of the loss -Ongoing attachment to the deceased -no longer physically there but felt by the sibling as a presence -“Continuation” – the sibling lives in memories of who she or he was.

Answer 80

a)”I hurt inside” – psychophysiological response to loss – may be represented by fights, behavior outbursts, nightmares b)”I don’t understand” – making sense of the loss is dependent on the child’s cognitive development stage(operational ways of thinking – more abstract and conceptual ways of thinking) children nee to re-process the death as they develop c) “I don’t belong” – loss of normalcy within the family may make the child feel that they do not belong. d) “I’m not enough” – feelings of inadequacy can take over if the parents are pre-occupied with the sibling that died or is terminally ill. Children may respond by trying to be "perfect" or act on to prove the parent (s) still them

Answer 81

“1. Individual characteristics include physical characteristics as well as the following: gender and age, health status, coping style, temperament, self-concept, and experience with loss and death. 2. Situational characteristics include circumstances surrounding the death such as cause of death, duration of illness, place of death, time elapsed since death, involvement in events surrounding the illness and death, such as visiting in the hospital or participating in the funeral. 3. Environmental variables constitute the third category of factors that influence siblings’ bereavement responses. These include shared life space, centrality, family environment, parent–child communication, parental grief, family functioning, continuing bonds expressions of parents, and ability of parents to foster continuing bonds expressions in the surviving children” (p.831)

Answer 82

NOOOOOOOOOOOO.... This is unacceptable and abusive. This does not help individuals "weight stigma is not a beneficial public health tool for reducing obesity or improving health. Rather, stigmatization of obese individuals poses serious risks to their psychological and physical health, generates health disparities, and interferes with implementation of effective obesity prevention efforts."

Answer 83

NO!!!! stigmatization of obese individuals poses serious risks to their psychological and physical health, generates health disparities, and interferes with implementation of effective obesity prevention efforts.

Answer 84

Disease stigma is when you blame the people with the disease for their circumstance. For example-- people with diabetes are fat, lazy and eat sugar all day, or people with HIV got what they deserved for sleeping around. The government recognized that stigma VERY NEGATIVELY effected health outcomes, and said it was the duty of public health to reverse stigma HOWEVER obesity is another example of this, and it has really not been addressed, which needs to change.

Answer 85

Being overweight is multifactoral!! Blaming an individual ignores science, as well as social, environmental, economic, etc. factors. Also, in research studies comparing non-overweight and overweight individuals, sometimes OW people were metabolically health, whereas the NOW people were not, so don't generalize. Many factors are beyond an individuals control. Some E.g.: -\> genetic and biological factors regulating body weight, -\> people are required to work more at desk jobs, so expenditure of energy has gone down (environment) -\> healthy foods are often expensive, this encourages the purchase of junk foods --\> higher density of restaurants, stores --\>greater access to transportation/ poor walkability --\>heavy marketing of junk foods exposes children to these ideas at a young age -\>extreme challenge of weight loss (it's not easy... even by taking every measure)

Concepts Flashcards

Remember Concepts (112 cards)