Exam 2 Supplemental material questions Flashcards
(33 cards)
palliative vs hospice care
Palliative care is focused on improving quality of life for people with serious illness ⇒ for any age and wants to manage symptoms effectively involving multiple types of doctors and other care providers that work together so care reflects the sick persons goals and values
- Hospice is a specific type of palliative care in the last months to weeks of life
what does palliative care include
- home, assisted living, nursing home, hospital, palliative care clinics
- Advanced care planning, hospice, and bereavement support
- Time for family, communication about what to expect, management of physical and mental symptoms (pain, depression, anxiety, fatigue, shortness of breath, constipation, nausea, loss of appetite, difficulty sleeping), etc
who can get palliative care?
anyone with a serious illness
child life specialist
help children understand hospitalization, illness, and procedures
responsibilities of a child life specialist
distract during invasive procedures, friend, be fun, be positive, emotional issues, collaborate, play with them, get special entertainment, art projects, pet therapy, music therapy, socialize, celebrate life, work with family, etc
- preparation, teaching doll, medical equipment, etc.
who is likely to provide care to a family member
women are usually the caregiver
what support is available for caregivers?
finding relaxation, time with friends, take time for themself, support groups, resources in the community, speak with your physician, caregiver support programs (reimbursement), home modifications, options and waiver programs for a home health aid (60+ and income), call local offices or state department for aging, accept help, etc.
how does advanced planning help the one receiving care as well as the caregiver?
have medical desire conversations early because we don’t know what will happen ⇒ advance directive/living will, durable power of attorney for healthcare, POLST, etc.
- This avoids unnecessary intervention and trauma, it also makes it easier for the caregiver to not have to worry about things in the middle of the crisis
is dare effective and why?
No it fails to substantially reduce drug use among peoples peers ⇒ likely because teens were good at catching and dismissing clear exaggerations about the detrimental health effects of relatively harmless drugs like marijuana which discredits overall efforts
what is relevant about DARE now that recreational marijuana is being approved
With marijuana legalization, we will likely need to shift to education and rehabilitation programs
- Best way to discourage drug use is to dispute the idea that drug use makes someone an independent risk taker
- Kids should know that studies exist and make up their own mind
- Scaremongering doesn’t really work
- Honesty is likely the best policy
what is true of statements about drugs to teens?
We need to use credible statements that tell it how it is and not exaggerate or teens will pick up on it and dismiss anything related to the education
- Some anti drug messages lead to even more drugs ⇒ foster curiosity
- Some of the approaches normalize drug use
what health behavior is the focus of research in the Dubner and Levitt article? How did they frame things successfully?
poor hand hygiene by doctors and other hospital staff ⇒ perception deficit and arrogance
- agar plated everyone’s hands and showed the amount of bacteria on them ⇒ this was placed as the screensaver for all of the computers which fixed the hand washing problem
what does habits trump medicine mean?
good choices involving food and lifestyle are more effective preventatively than treatments done by medicine ⇒ food and exercise is more effective than drugs are
what forms of social support are there for health issues?
- Support groups meeting face to face
- Diabetes screening centers to public transportation sites
- Caregivers and healthcare professionals
- Online support groups
how did Frakt induce the placebo effect?
He told the nurse to tell him he was giving him Demerol in his IV when he had a kidney
stone because he knew he would believe it if the nurse said it => placebo ≠ treatment absence
what were Frakts observations about placebo?
He felt his pain subside even though the nurse didn’t actually give him dermol
What does a placebo-controlled study tell us about a given treatment and about the placebo effect according to Frakt?
Whether the second effect (placebo effect) operates only through belief or if the active part of the treatment does more
- 2 placebos relieve more pain than 1
- Placebo pills with name brands are more effective
- Patients taking cholesterol medications survive longer than those with placebos skilling doses
- Measurements of increased endorphins aka our bodies natural pain relievers are associated with placebos
is the placebo effect real according to Burton?
Yes, when there was no medicine we only had placebo effect treatments and those appeared
to work somewhat effectively
what are physiological mechanisms uncovered about placebo according to Burton?
Belief in positive thinking and personal self control push us to scientific validity
- The placebo effect reduces pain by triggering endogenous opiate like hormones
aka endorphins ⇒ opioid receptors were engaged
- Dopamine receptors responsiveness is associated with placebo too
what was found in the placebo controlled dental surgery Burton looked at?
Those who were told they were getting a powerful analgesic that was actually saline had the same response as those who were actually given morphine
what are the placebo and nocibo responses in the Harvard Magazine?
P: sham patients of the acupuncture and pills that were having a placebo effect said they
felt amazing ⇒ acupuncture patients said they felt even better than the anti pain pill ones
N: The other patients said that they felt sluggish from the pills and had swelling and redness from the needles ⇒ each of the procedures were fakes
was the sham acupuncture more affective than the pills?
Yes, more “invasive” procedures such as needles are more effective because they feel more realistic
what were the IBS study results for patient-provider interactions according to Harvard Magazine?
Methods of placebo administration are as important as the administration itself
- Patients who experienced the greatest relief were those who received the most care
- This showed a dose dependent response
what happened in the IBS study follow up with openly labeled placebos according to Harvard Magazine?
Even patients who know they are taking a placebo still report feeling better
- 2x the amount of relief as no treatment groups
- Rituals and drugs have the same effect on the brain
