Exam 1 Flashcards
(79 cards)
1
Q
Major changes of healthcare in 21st century
A
- Development of patient/client care
- Increased use of technology
- Increased personal responsibility
2
Q
Eight principles of PHN
A
- The client or unit of care is the population
- Primary obligation is to achieve the greatest good for the greatest number of people or people as a whole
- Public health nurses collaborate with the client as an equal partner
- Primary prevention is the priority in selecting appropriate activities
- Public health nursing focuses on strategies that create healthy environmental, social, and economic conditions in which populations make thrive
- A public health nurse is obligated to actively identify and reach out to all who don’t benefit from a specific activity or service
- Optimal use of available resources and creation of new evidence- based strategies is necessary to assure the best overall improvement in the health of populations
- Collaboration with other professions, populations, organizations, and stakeholder groups is the most effect way to promote and protect the health of people
3
Q
Challenged if PHN in 21st century
A
- Engaging in EBP
- Helping eliminate health disparities in underserved populations
- Demonstrating cultural competence
- Panning for community change
- Contributing to a safe and healthy environment
- Responding to emergencies, disasters, and terrorism
- Responding to the global environment
4
Q
Purpose of comparing HC systems and philosophies
A
- Gives understanding on how these systems work and ensure health and wellness of populations
- helps set standards and initiatives for organizations like WHO, world bank, organizations for economic cooperation and development
5
Q
US HC System
A
- federal, state, local governments
- federal regulation: food, drugs, devices, occupational health, environment
- federal allocates tax funds to state govts
- state: public health regularities
- local: implement public health activities within communities
6
Q
Canada health system
A
- national health program: single-payer system with universal coverage
- everyone had Medicare, fundings comes from personal, sales and corporate taxes
- some federal transfer payments
7
Q
France healthcare system
A
- general health management and hospital and HC management
- hierarchy like FDA (govt presents a law to parliament each year as a way to use public policy to finance a social security fund)
- HC includes private, public and non for profit sectors that make sure the long wait lists aren’t as big an issue
8
Q
Germany HC system
A
- universal
- private practice physicians provide ambulatory care
- centralized nonprofit provide majority of inpatient care
- sickness funds financed by public and private sectors
- standard insurance comes from employer and employee contributions along with govt subsidies
- option to pay a tax and opt out of standard plan and get private insurance instead
9
Q
Netherlands HC
A
- dual enrollment: all primary and acute care is financed from private, mandatory insurance
- Social insurance is a long term care for elderly, dying, long term mentally ill is covered by taxes
10
Q
United Kingdom’s HC
A
- part of NHS
- provides HC for UK
- provides HC for all permanent residents of UK
- people can choose own physician
- NHS decentralized with access to cafe and prevention provided by the strategic health authorities
- meds paid through a flat rate or annual capped charges
- physicians contracted by NHS for salaries
- hospitals owned and run by NHS
- NHS revenues form taxes, employer-employee contributions and user fees and co payments
11
Q
Characteristics of marginalized and oppressed
A
- different genders and ethnicities
- less education
- low socioeconomic status
- certain geographical errors
12
Q
HC Implications for marginalized and oppressed
A
- higher rates of morbidity and mortality
- difficulty assessing care
- negative outcomes when receiving care
13
Q
Areas of care that are overseen for marginalized and oppressed
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- infant mortality
- cancer screening
- CVD
- diabetes
- HIV/aids
- immunizations
14
Q
Governmental agencies
A
Assess info regarding level of health in their jurisdiction, assure infrastructure (personnel and resources), legislate to support and implement health policy, recruiting skilled personnel, run report and gather data (even research)
15
Q
Non governmental agencies
A
Use their resources to address and provide info/resources/care for a specific or a variety of health conditions. Have an important and impactful role in developing society, improving communities, and promoting citizen participation
16
Q
WHO
A
- World Health Organization
- goal: attain highest level of health for all people
- public health services
- allow access to current info about disease and disability and establishing standards of care on the basis of evidence found in health research
17
Q
CDC
A
- center for Disease Control
- avoiding epidemics, recognizing trends, interventions
18
Q
USDHHS
A
- US department of health and human services
- protects health of all Americans and provides essential human services
19
Q
International council of Nurses
A
- federation of over 130 national nurses associations
- represents 16 M nurses worldwide
- formed 1899
- goals are to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, the presence worldwide of a respected nursing profession and competent and satisfied nursing workforce
- active in international classification of nursing practice, advanced nursing practice, entrepreneurship, hiv/aids, tb, malaria, women’s health, primary HC, family health and safe water
20
Q
Clinical model of health
A
Elimination of disease or symptoms
21
Q
Role performance model of health
A
Health that involves a match between people and social roles
22
Q
Adaptive model
A
Health that involves adaptation to environment
23
Q
Eudaemonistic model
A
Health that is the actualization or realization of human potential (functioning physical, emotional and socially)
24
Q
Which health model does the world collectively strive for
A
Eudaemonistic
25
Globally burden of disease definition
Risks to health and health outcomes in different demographic populations and social settings
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What are some things that impact the GBD
Climate, public policy, age of population, socioeconomic conditions and risk factors
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Examples of GBDs
Non communicable disease
| Impact of disease burden
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Risk factors affecting GBD
- childhood and maternal malnutrition
- other nutritional-related risk factors and inactivity
- addictive substances
- sexual and reproductive health
- environmental risks
29
What are key determinants of health
Physical environment
Social environment
Health behaviors and coping skills
Individual health
Access to health services
Overall health policies and interventions
30
What are some worldwide barriers to health
Political factors:
Economic factors
Socioeconomic factors
**poor= less health
31
Purpose do sustainable development goals
To address inequalities between nations, but also within nations
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Who created the sustainable developmental goals
World leaders (United Nations)
33
Nurses impact on sustainable development goals
- nurses understand link btw wider conditions on individual and population health
- staying informed and continually educating ourselves on how to implement the SDGs
- becoming a leader
- reasoning your voice
34
Primary level of prevention
Maximizing health and wellness through strategies that are set in place before the illness or injury is present
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Secondary level of prevention
Maximizing health and wellness through strategies set in place at the earliest and active chronic stages of injury and illness
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Tertiary prevention
Maximizing health and wellness through strategies that are set in place at the palliation and end stage of disease and illness trajectories
37
Behavioral models
Motivational interviewing: client centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence
Behavioral change models: models that assist clients, groups, and communities to redirect activities toward health and wellness
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Learning model
A behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose
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Health belief model
Baggier change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventative action, and the challenges that may be faced in taking action toward the goal of health promotion
40
Trans theoretical model
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Phases:
Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse
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41
Theory of reasoned action
Behavior model that emphasizes that individual performance of a given behavior is primarily determined by a persons intention to perform that behavior
42
Social learning model
A behavior change model that considers environmental influences, personal factors and behavior as a means component of change
43
Theories of social support
Family members, friends, neighbors, and adjacent communities influencing change by offering instrumental assistance, informational support, emotional support, and or appraising support
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Relapse prevention model
Negative emotional state
Lack of or limited coping skills
Decreased motivation
Stress
High risk experiences
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Ecological model
Belief that all processes occurring within individual people and their environment should be viewed as interdependent
46
Health literacy definition
The degree to which someone can obtain, process and understand basic health info to make appropriate health decisions
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What is the role of nursing education in health literacy
Helps increase and individuals level of health literacy and helps them make proper health decisions about their cars
48
Populations at risk of lack of health literacy
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65+
Limited edu or income
Non native English speakers
Racial and ethnic minority groups
Event airs and immigrants
Adults with any type of disability, difficulty or illness
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Implications of low health literacy
Impacts everyday functioning
Probably won’t use internet for health related issues
50
Three levels of health literacy
Functional
Interactive
Critical
51
Nurses and health literacy
- understand the three levels of health literacy
- change resource type to help pt understand it best
- make sure info is easy to access
52
Epidemiology definition
Study of distribution and determinants of states of health and illness in human populations; used both as a research methodology to study states of health and illness, and as a body of knowledge that results from study of a specific state of health or illness
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Epidemiological triad
Model based on belief that health status is determined by the interaction of characteristics of the host, agent and environment
54
Wheel of causation
De emphasizing the agent as the sole cause of disease, whereas it emphasizes the interplay of physical, biological and social environment, with or without identifiable agent, remains major determinant of health status in all epidemiological models
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Web of causation
Epidemiological model that strongly emphasizes the concept of multiple causation while de emphasizing the role of agents in explaining illness
56
Natural history model
Integrates the pathogenesis of an illness with primary, secondary and tertiary prevention measures
57
What is a risk factor
Characteristics or events that have been shown to increase the probability that a specific disease of illness will develop
58
NP vs EP assessment
NP: individual client database established, data interpreted
EP: data gathered form reliable sources, nature/extent/scope of problem identified, problem described by person/place/time
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NP vs EP diagnosis
Np: HC needs and assets identified, goals and objectives for cafe established
EP: tentative hypothesis formulated, data analyzed to test hypothesis
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NP VS EP PLANNING
Np: processes for achieving goals selected
Ep: plans made for control and prevention of condition or event
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Np vs ep implementation
Np: actions initiated to achieve goals
Ep: actions initiated to implement plan
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Np vs el evaluation
Np: extent of goal achievement is determined
Ep: actions are evaluated and report is prepared, further research is conducted if necessary
63
Rate definition
Primary measurement used to describe the occurrence of a state of health in a specific group of people in a given period of time
64
Crude rate definition
Measurement of occurrence of health problem or condition being investigated in entire population
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Prevalence rate
Measures number of people in given population who have and existing condition at a given point in time
66
Incidence rate
Measure the probability that people without a certain condition will develop that conditions over a period of time
67
Incidence density ratio
Use of person-time denominator in calculation of rates; person day reflects one person at risk for a day and a person year represents one person at risk for a year
68
Proportion
A type of ratio that includes the quantity in numerator as part of denominator
69
Specific rate
Detailed rates that are calculated using the number of people in smaller subgroups of population in denominator
70
Relative risk ratio
Ratio of incidence rate in the exposed group and the incidence rate in non exposed group
71
Attributable risk
Difference btw incidence rates in exposed and unexposed group of people
72
Adjusted rate
Statistical procedure that removes the effects of differences in compositions of a population, such as age, when comparing one or another
73
Epidemiological study cycle
1 descriptive study
2 model building/hypothesis formulation
3 analytical/hypothesis testing studies
4 analysis of results
Continuous cycle
74
Descriptive research
Classifies, describes, compares, measures data
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Analytical research
Focuses on cause and effect
| Why is it that way and how it came to be
76
Types of descriptive studies
Case studies, surgery research, cross sectional studies
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Cohort studies
Type of analytical study Longitudinal studies
Monitor subjects over time to find associations between risk factors and health outcomes
Established relative risk
78
Case control study
Work backward from effect to suspected cause
Subjects selected based on presence or absence of controlled disease
Groups compared to determine presence of specific exposures or risk factors
79
Experimental studies
Can be used in preventative trials focusing on primary prevention
