Final exam Flashcards
(265 cards)
1
Q
Literacy
A
“Ability to understand and use reading, writing, speaking and other forms of communication as ways to participate in society and achieve one’s goals and potentials.”
2
Q
Health literacy
A
“The degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health care decisions.”
3
Q
who on average has lower health literacy skills
A
seniors, immigrants and unemployed
4
Q
what percent of people find it difficult to judge when to go to the doctor
A
54%
5
Q
Links to health literacy
A
- access (to info on health)
- Comprehend (ability to understand)
- Evaluate (interpret info)
Communicate (make informed decision about health issues)
6
Q
Can someone be literate and not have health literacy
A
yes
7
Q
WHO facets of health literacy
A
community health literacy, health literacy development, health literacy of an individual, health literacy responsiveness
8
Q
How can low health literacy effect Health
A
poorer overall health
misuse of medication
misunderstanding of health information
preventable use of ER
wait longer to seek medical attention - crisis state
9
Q
Signs of low health literacy
A
Patient may not follow instructions of recommendations for self care
* High frequency of visits or missing scheduled appointments
* Unable to self-manage condition even after being provided instruction over several visits * May not look at pamphlets or information provided, or may say no when they are offered * When given forms, may decline- “I left my reading glasses at home”
* May bring a family member to visits and defer to them to answer questions
* Noticeable language barrier
* Observing non-verbal signs of lack of understanding (nod and agree)
10
Q
people with low income are more likely to
A
attempt suicide, have diabetes, Hep C, teen birth, infant die, immunize less
11
Q
Health disparities that play a large role
A
overall health, income, education, employment
12
Q
what is a big goal of nurses when it comes to the enviornemnt we set
A
we have to have a supportive and respectful environment
13
Q
Patient education hierarchy
A
top:
Self determination
problem solving
treatment: genera and specific
understand disease and pathology
safety
14
Q
what is the patient education hierarchy
A
Tool to help prioritize patient’s knowledge needs.
* Moving up the pyramid means more mastery and self determination = more control over health care.
* Safety needs met first
* RN’s approach/interactions directly influence how a patient will move through the stages
15
Q
client is expert of
A
self
16
Q
Provider is expert on
A
health
17
Q
Health promotion and education: Roel of RN
A
-minimize health disparities
-work toward conditions that promote equity and social justice
-support people in gaining control over their health care experience
-provide health info
-teach in a way that meets the need of the individual
18
Q
StandardII:KnowledgeBasedPractice:
A
The registered nurse practices using the evidence informed knowledge, skills and judgement from diverse sources of knowledge and ways of knowing
19
Q
Documentation of education should include
A
- Document formal and informal teaching
- Description of methods/materials used
- Involvement of patient/family
- Outstanding issues requiring follow-up
- Evaluation of objectives/Pt and Family Comprehension
20
Q
The following should be recorded by the RN in the client’s health record:
A
A clear and concise statement of the client’s status (physical, psychological and spiritual);
– All relevant assessment data (including client and family comments as appropriate);
– All ongoing monitoring and communications;
– The care provided to the client including interventions (treatments, advocacy, counseling, consultation, client and family teaching); and,
– Evaluation of the care provided, including the client’s response and any impact for discharge planning. “
21
Q
3 factors that influence learners assessment
A
- learning needs
- readiness to learn
- learning styles
22
Q
methods to teach patients with low health literacy
A
-have a friend sit in
-simple clear language.
-open ended questions
-teach back
-summarize 1-3 key points
-write down main things
-offer educational materials
23
Q
nurse barriers to teaching
A
System barriers (lack of time, space, privacy)
* Low importance placed on client education
* Unfamiliar with HOW to teach
* unfamiliar with instructional
design of materials
* unskilled communication practices
24
Q
Patient barriers to learning
A
System barriers
* Lack of knowledge about body
* Communication issues (language, level of information provided)
* Pain,fear,grief
* Poor health literacy
* No motivation to learn
25
Low end of education spectrum
telling a patient about their medication. Prep for how to teach this learned in school and practiced so many times it will become rout. Is quick and follow up is often complete by other staff, which makes charting essential
26
Middle of education spectrum
discharge care plan teaching. Reviewing this with the patient, potentially over a few sessions to ensure understanding
27
End of the education spectrum
clinical nurse educator, public health nurse, their job is teaching
28
what is the education process
Assessment
Planning
Implement
Evaluate
29
Assessment
Determine learning needs, readiness to learn
30
Planning
Teaching plan based on mutually developed goals
31
Implement
Peform the act of teaching
32
Evaluate
Determine behaviour changes in knowledge, attitude, skills
33
Essentail elements of clinical communication
-Communication problems in medical practices are important and common.
-Patients feel anxiety and dissatisfaction related to uncertainty and lack of information, explanation, and feedback.
-Professionals often misperceive the amount and type of information the patient wants to receive.
-Psychological distress is less when patients perceive they have received adequate information.
34
PATIENT AND FAMILY CENTERED CARE
Acknowledge people as experts on their own lives
* Encourage open and honest conversations
* Support pts to understand their options and make decisions about their care
* Look for ways to improve care based in the needs of each pt
35
Communication skills
misunderstandings can be devastating-fatal
* recognize uniqueness of the learner
* structure information so each person can receive, understand, remember and apply it
36
what is VARK used for
learning styles
37
what does VARK stand for
-visual
-Aural
-written
-Kinesthetic
(logical, social, solitary)
38
should nurses only take 1 approach when teaching
no use multiple
39
What can a nurse do to cater to their clients needs
-give them options
-provide oppurtunity for feedback
-assess by direct observation
-cevome familiar with learning models
40
UDL (universal design for learning)
a framework to improve and optimize teaching and learning for all people based on scientific insights into how humans learn"
41
recognizing culture influences health care increases:
-accessibility to healthcare and overall health literacy
-informed decision making
42
Cultural awareness
-first step to enhance health literacy and reduce inequities
-developing sensitivity/awareness to differences
-not assigning judgement to cultural differnence
43
cultural reflection
Provider realizes importance of culture when providing information
44
cultural aware ness in action
Practitioner creates language appropriate written materials
45
CULTURAL COMPETENCY
focus is on skill of PRACTITIONER not client
*integrating and transforming your own health knowledge based on knowledge found in other cultures
*reduce long standing inequities
* improvesaccess,qualityof
service, outcomes
* risk-do'sanddon'tscanleadto assumptions based on traits or attributes
46
why do we educate on health promotion
Help people maintain and improve their health
Reduce disease risk
Manage chronic illness
47
Primary prevention
“Activities aimed at reducing factors that are known to lead to health problems; prevent the occurrence of disease or injury”
48
Examples of primary prevention
Safe sex education
Annual check-up
Immunization
49
Secondary prevention
“Activities that seek to detect a disease early in its progression, before signs and symptoms occur, to made a diagnosis and begin treatment; Early detection of and intervention in the potential development or occurrence of a health problem”
50
Examples of secondary prevention
HIV screening for injection drug users
Mammogram, PAP test
Accurate blood glucose testing: diabetes
51
tertiary prevention
The effects of disease become obvious; goals are to interrupt the disease course, to lessen its effects and to prevent further deterioration/recurrence.”
52
Examples of tertiary prevention
Therapy group for mentally ill adults
Physical therapy program for person with spinal cord injury
Walking programs post heart attack
53
Methods to assess the learner
Informal conversation
Structured interview
Observations- ongoing assessment during caregiving
Documentation
Survey tools/questionnaires (not always available or practical)
54
what you need to know prior to teaching
1. WHO is your learner?
Developmental stage
Culture
Meaning of the illness (heart to heart)
2. What do they know already?
3. What do they need to know?
4. How do they like to learn?
5. What are the BARRIERS that prevent their learning?
6. What is their MOTIVATION?
7. What is MOST important?
8. Who will participate? (may include family)
9. How does the learner like to learn? ask questions!!
10. Understand team goals- involve others
Prioritize needs (pt. education hierarchy)
11. Choose the right setting
What resources do I have?
How much time do I have?
Inform patient ahead of time
Minimize distractions
55
RN responsibility with needs
assess when, what they need or want to know and how to adapt content for each learner.
56
Patients responsibility with learner needs
determine what they want to know and adapt the learning based on premise of adult learning
No matter how important the information is perceived to be by the nurse, it will not be retained by the client if they are not ready to learn.
Time wasted if you set the objectives before connecting with your learner
57
what is a very important component of learner needs
Timing is vital- anything affecting physical or emotional comfort will affect a learner’s willingness and ability to learn.
58
Adherence
“The extent to which a person’s behaviour (taking meds, following recommendations, making lifestyle changes) corresponds with agreed recommendations from a health care provider.”
59
Motivation
“Internal state that arouses, directs and sustains behaviour and a willingness to embrace learning.”
Personal attributes
Environment
Relationships
60
Prioritizing learner needs
mandatory: Survival safety
Desirable: not life dependant but related to well being
Possible: nice to know but not essential not connected to daily activity
61
learner readiness
The time when the learner demonstrates interest in learning the information necessary to maintain optimal health"
62
PEEK model
a model that can help determine the patients readiness
63
P stands for
Physical readiness
(health status, complexity of task, gender, environmental effects) is the patient at the place in their health journey they have the capability to learn. Do they have the capability
64
The first E stands for
emotional readiness
Anxiety
Motivation for learning
Available support systems
Risk taking behaviour
Frame of mind
Developmental Stage
65
The second E in Peek stands for
Past experiences
Cultural influences
Coping and control mechanisms
Cultural background/context
Locus of control
Orientation
66
K in peek stands for
Level of individual’s current knowledge
Cognitive ability
Learning disabilities
Learning style
67
Health belief model ideas
1. Individual perception (how susceptibleam I, how bad do I think this is)
2. Modifying factors (demographics, age. culture, gender, socio-psychological, structural variable, knowledge of disease, prior contact)
3. Likelihood of actions (perceived benefits of preventative actions minus perception)
68
approach for pre contemplation stage
increase awareness of need for change personalize info about risk and benefits
69
stages of change
pre contemplation, contemplation, preparation, action, maintenance, relapse
70
approach for contemplation stage
motivate encourage making specific plans
71
approach for Preparation
assist with developing and implementing concrete action plans help set gradual goals
72
approach for action
assist with feedback problem solving social support and reinforcement
73
approach for maintenance
assist with coping reminders finding alternatives avoiding slips
74
approach for termination
end well recount the success plan for maintenance over long period of time
75
accommodate the learners needs not the
providers needs
76
Model should be:
logical
consistent with everyday observations
similar to those used in previous successful programs
supported by past research in the same area or for related ideas.
77
8 basic elements of a teaching plan
1. The purpose
2. The statement of the overall goal
3. List of objectives
4. Outline of content to be covered
5. Instructional method chosen
6. Time allotted for each objective
7. Instructions resources chosen
8. Methods used to evaluate learning
78
where to start with patient teaching
Develop a teaching/learning plan with the patient that contains goals and objectives.
79
it is the RN's responsibility to determine:
WHAT needs to be taught
◦ WHEN to teach
◦ HOW to teach
◦ WHO the focus of teaching should be (consider developmental stage)
80
what is the point of goals and objectives
they provide direction as to how to arrive at a specific destination
81
what are objective
they are the steps toward meeting your goal. They are short term and very specific. They are measurable
82
Goal
outcomes to be achieved at the end of teaching and learning process. Broad, global, long term target. Reaching a goal means meeting several objectives.
83
Things to consider with goals and objectives
Need to have internal consistency (Bastable, 2017, pp. 366)
* Need to be clear, concise, realistic and learner centered
* Set realistic goals as unrealistic goals can discourage the pt and sets them up for failure
* Mutual involvement of RN and pt * Learner readiness, motivation
84
WRiting behavioural objectives
-performance objectives
-statements that describe what the learner will be able to do once they successfully complete a unit of instruction
-do not describe what the RN will do describe what the patient will do
-must be specific, measurable, and clearly stated
85
ABCD model
audience, behaviour, condition, degree
86
Audience
who is your client? literacy, health literacy, context, determinants of health
what is their developmental stage?
87
behavioural
what the learner is expected to be able to do to demonstrate the skill has been learned
observable/visible: written down nonvisible - identify or recall something
precise action words (verbs) as labels that are open to few interpretations
88
Condition
situation under which the behaviour will be observed or performance expected to occur
89
Degree
how well?
to what extent?
within what time frame?
90
what is helpful about behavioural objectives
they provide guidance on selecting instructional material, teaching methods, using technology, assessment methods.
They help patents understand what they are expected to learn and understand how they will be assessed
91
step 1 of writing clear leaning objectives
Learning objectives begin with a consistent phrase: “The learner will” “The student will” “By the end of this session”
92
Step 2 of writing learning objectives
Connect step one using an action verb which communicates the performance by the learner. Use verbs which describe an action that can be observed and that are measurable within the teaching time.
93
Step 3 of writing learning objectives
Conclude with the specifics of what the learner will be doing when demonstrating achievement or mastery of the objectives. Stress what the participant will walk away from the activity with
94
Performance words should be
specific
95
taxonomy
Way to categorize things according to how they are related to one another.
96
blooms taxonomy
top:
create
evaluate
analyze
apply
understand
remember
97
taxonomy 3 learning domain
Cognitive, affective, psychomotor
98
Cognitive domain
"HEAD": Thinking
*learning information based on intellect and
thinking
*traditional focus of most teaching
*prerequisite for affective and psychomotor skills
99
Cognitive action verbs
compose, examine, estimate, illustrate, summarize, recall
100
cognitive hierarchy
top:
Evaluation
synthesis
analysis
application
comprhension
knowledge
101
Affective domain
The “heart”- feelings
*"learning is values driven & subjective
*internalizing information involves degree to which feelings/attitudes are incorporated into one's personality or value system
*explore & clarify learner feelings, emotions, & attitudes
102
Affective action verbs
Discriminate Integrate Complete Participate Observe
103
Affective hiarchery
Top:
characterization, organization, valuing, responding, receiving
104
Psychomotor domain
doing it with your hands and neuromuscular coordination, asking questions. Practice and repetition is key
105
Psychomotor action verbs
formulation, replace, demonstrate, organize, practice, prepare, describe
106
Psychomotor heierarchy
top:
origination
adaption
complex overt response
mechanism
guided response
set
perception
107
it is important not to mix
multiple levels of learning
108
Assessment
a process to gather summarize, interpret and use data to decide a direction for action
109
Evaluation
a process to gather, summarize, interpret and use data to determine the extent to which an action was successful
110
What are the 5 components of evaluation
audience, purpose, questions, scope *Who is involved, how big will this get), resources
111
4 types of evaluation
-process, content, outcome, impact
112
4 reasons for teaching plan
-ensures a logical approach
-Keeps instruction on target
-communicates in writing an action plan for the learner, teacher, and other providers
-Serves as a legal document that indicates a plan is in place and tracks progress toward implementation
113
7 essentail elements of a teaching plan
purpose, statement of overall goal, list of objectives, outline of content to be covered, time allotted for teaching of each objective, instructional methods and materials, method to eventuate learning
114
Influences of developmental stages
readiness, rate/capacity, barriers, knowledge of developmental tasks, correct level
115
The 4Mat cycle
if, why, how, what
116
The 4 Mat cycle: if
Adaption:
How will learners adapt this info and apply it In their lives?
Skipping this will limit ability to use into more broadly
117
The 4Mat cycle why
the meaning:
why should your learner care about this? what do they already know and where are they now?
118
4Mat cycle what
concepts what content is vital for them to know
119
The 4 Mat cycle how
skills:
How will the learner apply these ideas, how will they practice or experiment
120
PITS model
This is informal (beds 1:1)
Pathophysiology
indications
treatment
specifics
121
Pathology
what is happening in my body
Any physical/chemical changes in the body that have or could occur as the result of the disease process
*What is normal?
*What is abnormal?
*Helps client to understand “why” of treatment if they better understand the pathophysiology
*Connect dots between pathophysiology and symptom
122
Indications
"signs and symptoms resulting from injury or disease"
What the patient is experiencing
*what is observed, found on assessment
*Signs or symptoms that may occur because of the disease
*What does this mean for me??
*Talk about treatment of the disease process- generic management *Connect chemical changes (pathophysiology) to physical symptoms *Helps client better understand health status
*Assist with making decisions regarding treatment plans/options
*Beginning understanding of providers view- rationale for what is being recommended and why
123
Treatment
*May differ based on HC team member
*OT: how to use walker, RN: Raise legs, MD: Meds
*Provide treatment information specific to the disease
*Break down complex steps/instructions (ie insulin, weight monitoring, etc.)
*May incorporate educational tools here- addressing disease - NOT patient specific treatment
*Review the previous steps - repetition assists retention and understanding
*Connects new thinking/knowledge with previous knowledge
124
Specifics
Information becomes CLIENT centered Instructions customized to client's context Used in a 1:1 setting
125
Gagne Nine events of instruction
1. Gain attention of the students
2. Inform students of the objectives
3. Stimulate recall of prior learning
4. Present the content
5. Provide learning guidance
6. Elicit performance (practice)
7. Provide feedback
8. Assess performance
9. Enhance retention and transfer to the job
126
Gagnes model of instructional design
exploring, bridging, practicing, enhancing
127
Exploring
Gaining the learner’s attention: foster interest/engagement. *Why should your learner care about this?
*What do learners need to know before presenting new material? *What do they already know? Where are they at now?
*Inform the learner of the purpose of the interaction (objectives)
128
Bridging
Linking past learning/current knowledge with new information
*What do they need to know?
*Key concepts/essential information/big ideas *Linking content to objectives
*Address 3 domains of learning: knowledge, psychomotor skills, attitude
129
Practicing
-Hands on application of learning
-hwo will your learner apply these new ideas
-how will they practice
-provide feedback
130
Enhancing
-how will new info be integrated into their own context
-how can learner adapt new ideas
-giving and receiving feedback
-assessing degree of learning (knowledge/skills/attitude)
-Suggesting alternate ways for the learner to try out the new learning
131
examples of teaching methods
-Lecture
*Return demonstrations
*Gaming
*Role playing *Simulation *Self-instruction
132
general principles of teaching
-give positive reinforcement
-attitude
-organised and given direction
-ask questions (factual, clarify, analyze, interpret)
-teach back and tell back
-know the audience
-repeat/pacing
-summarize important points
133
5 considerations when choosing teaching methods
1. learner assessment and what are my objectives
2. what resources do I have
3. how much time do I have
4. How comfortable am I with the method
5. Settting
134
Evaluating teaching methods for effectiveness
-does the method help me reach my objectives
-is the learning accessible and acceptable to the patient/group
-does the method match the time/resources/learners present
-Are my active participants strategies inclusive of learner needs
135
General principles choosing instructional materials
Be familiar with the method/material before using it
Materials should COMPLEMENT, REINFORCE, ENHANCE nursing knowledge- not be a substitute
Choice of content should match the content and skills you want the participant to learn
Cost
Instructional aids must fit the physical conditions of the learning environment
◦ Space
◦ Number of people ◦ Lighting
◦ Sound
Match the sensory abilities of the participants Accurate/ Up to date/ Unbiased
136
Choosing of the Instructional Materials
1. Characteristics of the learner
2. Characteristics of the medium
3. Characteristics of the task
137
passive learning
Passive learning at the post-secondary level involves receiving information without actively engaging with it through critical thinking or application. This often includes activities like listening to lectures, watching presentations, or reading assigned materials without active participation or synthesis
138
active learning
active learning is commonly defined as activities that students do to construct knowledge and understanding. The activities vary but require students to do higher order thinking. Although not always explicitly noted, metacognition—students’ thinking about their own learning—is an important element, providing the link between activity and learning
139
Blooms taxonomy
top:
analysis
application
comprhension
knowledge
140
who started the developmental psychology study of human behaviour
Charles Darwin
141
Sigmund Freud
While some of his theories have been debunked, his psychodynamic theories laid the basis for much of the work done on defense mechanisms
142
what experiment did Pavlov do?
experiments with animals and conditioning them to respond to the ringing of a bell
143
Social learning theory is developed by
Bandura
144
Social development theory
improving the well-being of every individual in society so they can reach their full potential.
145
Cognitive learning theory is made by who
Piaget
146
cognitive learning theory
Cognitive Learning Theory asks us to think about thinking and how thinking can be influenced by internal factors (like how focused we are, or how distracted we've become) and external factors (like whether the things we are learning are valued by our community or whether we receive praise from others when we learn).
147
who is humanistic theory made by
malows heiarchy of needs
148
what is the humanist theory
focuses on how healthy people develop and emphasizes an individual's inherent drive towards self-actualization and creativity.
149
4 different stages of mental developmental
sensorimotor, pre operational, concrete operational and formal operational
150
The sensorimotor stage
(0-2)
The infant knows the world through their movements and sensations.
-Children learn about the world through basic actions such as sucking, grasping, looking, and listening. Put things in their mouth to see if they are edible. 5 senses are developed
-Infants learn that things continue to exist even though they cannot be seen (object permanence). Peek a boo
-They are separate beings from the people and objects around them.
-They realize that their actions can cause things to happen in the world around them
151
The pre operational stage
Age 2-7 years
Children begin to think symbolically and learn to use words and pictures to represent objects.
-Egocentric and struggle to see things from the perspective of others.
-While they are getting better with language and thinking, they still tend to think about things in very concrete terms. Lack logical reasoning- A leads to B leads to C
152
The concrete operational stage
age 7-11
-Begin to thinking logically about concrete events
-begin using indicative logic, or reasoning from specific information to a general principle
--thinking becomes more logical and organized but still very concrete
153
The formal operational stage
-12 and up
-At this stage the adolescents or young adult begins to think abstractly and reason about hypothetical problems
-Abstract thoughts emerge
-teens begin to think more bout moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning
-begin to use deductible logic or reasoning from a vernal principle too specific information
154
Ericsons 8 stages of psychosocial development
-Basic mistrust vs trust
-shame and doubt vs autonomy
-guilt vs initiative
-inferiority vs industry
-identity vs role confusion
-intimacy vs isolation
-generaticity vs stagnation
-ego integrity vs despair
155
Infancy stage
trust vs mistrust
-virtue is hope
-learn that basic needs are met by caregiver but if not met develop a deep mistrust
156
Early childhood stage
autonomy vs shame
-virtue is will
-develop a sense of independence in many tasks
157
Play age
-initiave vs guilt
-virtue is purpose
-take initiate on some activities may develop guilt when unsuccessful
158
School age
industry vs inferiority
-virtue is comptence
-developing self confidence in abilities when competent or sense of inferiority
159
Adolescence
identity vs confusion
-virtue is fidelity
-Experimenting with and develop identity and roles
160
Early adulthood
Conflict is intimacy vs Isolation
-virtue is love
-establish intimacy and relationships with others
161
Middle age
generatively vs stagnation
-virtue is care
-contribute to society and be a part of family
162
Old age
Integrity vs despair
-Virtue is wisdom
-assess and make sense of life and meaning od contributions and fall into despair when they think life or contributions and worthless
163
Role of family in education
The nurse educator and family should be allies
* Most important variables influencing outcomes.
* Encourage participation in all aspects of the educational plan – can be great assets to nurses
* Primary resource to answer questions about children’s disability, their odd habits, and their favorite toys: all affect their ability to learn
* Important to choose the most appropriate caregiver to receive information.
164
Pedagogy
is the art and science of helping children to learn.
-Infancy and Toddlerhood
* Early Childhood
* Middle and Late Childhood * Adolescence
165
Early childhood development
-Fine and gross motor skills more refined /coordinated
-precasual , concrete, litaeral thinking
-limited sense of time
-fears bodily injury
-cannot generalize
-seperation anxiety
-motivated by curiosity
-active imagination and prone to fears
-play is work
166
Piaget pre operational stage
years 3-5
-egocenteric understanding
Thinking is literal and concrete; magical thinking- all
powerful
* Precausal thinking: (“gets dark at night because we go to sleep”)
* Example: animistic thinking (lifelike qualities to inanimate objects)
* limited sense of time
* Transductive reasoning (extrapolates from one situation
to another)
167
Eriksons initiative vs Guilt
age 3-5
-Inquisitive learner
-taking on tasks for the sake of being involved and on the move
-active imagination can lead to fear
-learninh to express feeling through play
-impulsive action, frustration and anger
-begining to understand what is right and wrong
-interacts with playmates not side by side play
-seperation anxiety play is work, fears loss of body integrity
168
Communication strategies
-Allow time for them to complete thoughts
-approach toddlers carefully
-prepare toddlers before things occur
-it often takes longer for the younger child to find the right words particularly in response to a question
-use toddler preferred words for object or action
-keep questions and comments concrete
-they enjoy stories, dolls and books
169
Short term teaching strategies (age 3-5)
hands on, images, physical, language
-max 15 mins
-learning with peers less threatening
-praise and approval
-provide awards
170
Long term learning (Age 3-5)
enlist help of parents, parents can role model, reinforce positive health behaviour
171
things to keep in mind about teaching children (3-5)
Initiates activities with others
* Acts out role of other people (real,
imaginary)
* Likes exploring new things
* Short attention span
* Learns through observing and imitating
* Able to make simple classifications- can relate objects
* Curious about facts (“Do fish sleep?”)
* More realistic sense of causality
172
Nursing approach during teaching (3-5)
-Build trust, calm warm approach
-allow for manipulation of objects
-use representation and positive reinforcement
-encourage simple drawings and stores
-ficus on play therapy express anxiety, try out negative feelings, address fear
-stimulate the senses
-simple/breif explanation of procedures
-questions to elicit feelings
173
Health promotion education for 3-5 years olds
-healthy snacks, reduce sugary beverages, car sears, bike helmets, poison control, swimming safety, parent first aid/CPR
-Physcial activity
174
middle to late childhood age
6-11
175
Piagets concrete operational stage
6-11
-causial thinking can draw conclusion and intellectually can understand cause and effect
-developing logic increased concentration
-Syloogistic thinking (consider 2 premises and draw conclusions)
-Understand conversation
-classify objects and systems
-communicate more sophisticated thoughts
-thinkign remains literal, but beginning to understand abstracts
176
Ericksons Industry vs inferiority
6-11
Gaining a sense of responsibility and reliability
-increased susceptibility to social forces outside the family unit
-gaining awareness of uniqueness of special talents
-self concept developing fears failure and being left out of groups
-fears illness and disability
177
Middle/late childhood development summary
-develop critical thinking skills and problem solving strategies that enable them to adapt change
-internalize moral standards develop and evolving moral capacity
-language development shows increasing representation and facility in conversing with others
-a large number of students are identifies as EEL
-Link between self esteem and competence grows stronger
-form and test social relationship
178
What to keep in mind when planning teaching
more realistic objectives, understand cause and effect, deductive and inductive reasoning, wants concrete info, able to compare objects and events, understands seriousness and consequences of actions, immediate orientation
179
Short term teaching (middle to late childhood 6-11)
Concrete: step by step instruction: assess for understanding
* 30 minute sessions
* Encourage active participation: Relate to child’s
experience
* Use logical explanations/analogies- diagrams, models
* Relate care to the experiences of other children: compare
* Provide group activities
* Be honest & allay fears
* disucssion, clarification, validation, reinforcement
180
teaching strategies for long term learning (6-11)
Develop self care skills, assist them in learning to develop health promotion behaviours/habits, reinforce positive health behaviours
181
Health promotion education (6-11)
Body image, nutrition, sexuality, puberty, influence of peers, self esteem, self worth, injury prevention, helmet, bike safety, sport safety, ATVs, swimming, forearm safety, sleep and rest, relationships, bullying, online safety, physical activity
182
Adolescence age
12-19
183
Adolescents development
transition from childhood to adult hood; big changes
-Adapt to rapid body mental changes
-preoccupation with appearance and sexual urges
-perspective of self and the world influences health:ones of the most at risk populations
-leading cause of death: accidents, homicides, and suicide
184
Piagets formal operational stage
(12-19) major premise is ability to think of possinlilty not just reality
-capable of abstract thought
-deductive reasoning is improving
-imaginary audience: believe everyone is watching them and that other people are concerned with the same issue they are highly in behaviour choices
-identify health promotion behaviours but may reject them
-personal fable: it won't happen to me
-aware of risk still need guidance
185
Imaginary audience
(everyone is watching/focused on me, my looks
and my behavior and is judging me)
186
personal fable
(that won’t happen to me, I’m invincible)
187
Eriksons identity vs role confusion
12-19 3 Stages: Early, Middle, Late
* Comparing their self image to an “ideal” image
* Adjust to body changes
* Increased responsibility for behaviours
* Struggle to develop own identity- fit in, yet be unique
* Separation from parents
* High need for acceptance/support from peers
* Focused on personal space, privacy, confidentiality
* Hospitalization: loss of independence, embarrassment, change in body function, separation from peers
188
identity confusion
no exploration or commitments made to pick an identity
189
identity foreclosure
occurs when an individual commits to an identity without exploring options. (often related to parental expectations)
190
Identity moratorium
actively exploring options nut no commitment is made
191
Identity achievement
options are being explored purpose is discovered and relatively permanent identity commitments have been made
192
Code Switching
Teenagers often use code switching to try on different personas with different groups, but this is different from code switching for survival.
-often code switching happens with people who do not live in a country that speaks the same language as them
193
Communication strategies for adolescent
-most difficult challenge is establishing a trusting therapeutic relationship
-set aside time for discussion with no interruptions
-ask questions to assess their perspectives
-be direct with what you mean
-be aware of your tone and body language
194
Nursing approach during adolescents teaching
-establish trust
-abstract hypothetical thinking
-can build on past learning and future oriented
-reason by logic scientific principles
-identify control focus
-use peers for support and influence
-focus on details
-make info meaningful to life
195
Short term learning strategies for adolescents
1:1 instruction: confidentiality
-peer groups discussion
-benefits from others who have successfully dealt with same experience
-learning with peers
-allow participants in decisions
-avoid confrontation
-expect negative response
196
Long term adolescent teaching
accept personal fable and imaginary audience as valid acknowledge feelings as valid, allow for testing of personal convictions
197
mental health influence on adolescence
-Mental disorders most prevalent medical condition causing disability in this population
-most begin prior to age 25
-tenf to be chronic with substantial negative short and long term outcomes
-poor academic and occupational success, substantial personal, interpersonal and family difficulties
-Increased risk for physical illnesses shorter life expectancy economic burden
-10-20% of Canadian children and youth develop mental disorders
198
Body image with adolescents
Increased worry, diet, exercise, height weight, body build
-have over time become taller and heavier
-increased eating disorders
199
Common topics that should be addressed with teens
(health promotion)
-mental health
-body image
-health
-substance use and sexual health
-gender identity
200
What ages are considered young adults
20-40
201
Main point is adulthood development
establishing long term intimate relationship
-choosing a lifestyle and adjusting to it
-deciding on accusation and career
-managing home and family
202
Andragogy
the art and science of helping adults learn
203
Knowles framework of adult learning assumptions
-self concept: dependent to indecent
-accumulation of experiences
-readiness to learn based on developmental task
-most motivated when a need arises
-personal fulfillness is a motivator
203
Adult Learning Principles
relate learning to immediate needs, self directed, teacher is facilitator learner desires active role
-primary motivator for learning is immediate problem solving
204
Piagets formal operations
(20-40)
Cognitive capacity fully developed
-abstarct thought reasoning is both inductive and deductive
-experiences enhance cognitive, perceptions, generalizations
-increased critical thinking and problem solving
-learning motivated by solving immediate problem/daily tasks
205
Eriksons intamacy vs isolation
(20-40)
-Focusing on relationships and commitment to others in their personal, occupational, and social lives
-major events happy but psychologically draining/stressful higher education, career, marriage, parenthood
206
Marriage rates as of 2023
at an ultimate low
-rate of same sex marriage has tripled
-average age for 1st marriage rising
-women 29, men 31
207
how has family structure changed over the years
Traditional family no longer the norm
* Proportion of common-law and lone-parent families
is increasing
* Lone-parent families account for 1/4 Canadian families with children
208
common reasons for divorce or seperation
-run out of steam or falling out of love
-communication breakdown
-unreasonale behaviour
-infidelity
-midlife crisis
-financial issues
-physical, psychological or emotional abuse
209
a persons work situation has direct impact on
financial opputinities, peers, leisure time, living arrangements, decisions about self and family
210
healthy work identity
establish relationship with mentor
-seperate financial hopes and needs from creative or intellectual hopes and needs
-help to avoid emotional distress if career ambitions not met
211
Sincethe1970’sthenumberofCanadianfamiliesthathave two incomes has
grown from 36% to 69% in 2015
211
things to keep in mind with young adulthood teaching
-foster a therapeutic relationship
-crucial for developing healthy behaviours
-choices made during this period hard to change later
-use anticipatory guidance assessing life stage/lifestyle can give cues for education
-connect past learning with current learning
-make sure info is relevant
-ensure meaningful active participation
-find info that expands knowledge bade
212
teaching strategies with young adulthood
-use problem centred focus
-draw on meaningful experiences
-focus on immediacy of application
-allow for self direction and setting own pace
-organise material
-enocurage role playing
213
Health promotion for adolescents
health screening
-diet and nutrition
-cholestrol and heart health
-mindful and mental health
-physical fitness
-use of alchohol
-use of tobacco
-peer pressure
214
How old are middle adulthood
41-64
215
Summary of middle adulthood
career and family is established
-lifestyle changes children leaving, again parents, planning treatment
-physcial changes menopause for people with uterus decrease muscle mass potential for body weight increase
216
Piagets formal operational stage
41-64
abstract thought reasoning is both inductive and deductive
ability to learn remains steady throughout this stage
217
Eriksons generativity vs Self absorption and stagnation
reflecting on accomplishments and determining if life changes are needed. feeling productive making a contribution others struggling with isolation, unproductive
-facing issues with grown children, changes in health, and care for parents
218
Generativity
Satisfactionofcaringforand nurturing next generations, or expressed through creativity and contributions to society
219
stagnation
to be bored self indulgent and unable to contribute to society welfare
220
midlife crisis
-reevaluation of belief values dissatisfaction
-manifest in minor ways or significant marital change job change, depression substance abuse
-self reflection, setting realistic goals, revising career refocuigng personal relationship
-active lifestyle prevents anxiety relating to concerns about aging
221
Empty nest syndrome
Reductioninstressesrelatingto money, children, and career achievement can allow a happier marriage
* Realizationthatnothingincommon apart from the children, leading to emotional divorce
* Maritalsatisfactionr
222
sandwich generation
caregivers for birth children, grandchildren and aging parents
-increased mental, emotional stress especially for women
-complicated schedules
-possible reduces income related to work hours
-less likely to engage health promotion
-more likely to choose unhealthy foods/smoke
223
physical changes for middle adulthood
-concerns about health increases
-more mindful about threats to health
-more medical testing and measures for diet and exercise lower
-visible signs of aging
224
teaching strategies for middle adulthood
Connect to current life concerns and problems
* Assess associated risk factors: Health Promotion
* Assess potential sources of stress
* Maintain independence and re-establish normal life patterns
* Info on chronic diseases-maintenance
* Assess positive and negative past learning experiences
225
health promotion
Height, weight, BMI, waist-hip ratio Nutrition, exercise
Influenza immunization
Alcohol, tobacco, drug use
Heart health: blood pressure, cholesterol test
Cancer screening: breast or testicular self- exam, pap smear, mammogram, colorectal screening
Diabetes risk and screening Family violence
226
women health promotion
menopause 10-55 years
-change in sexual respinse
-risk for loss of bone mass
-higher risk of heart disease
-incresed cancer risk
-diabetes
* Increased cancer risk: reduced estrogen
* diabetes
Nutrition/Exercise Mammogram screening Regular physical exams
Mental Health: Sandwich Generation (coping, stress management, increasing health promotion behaviours
227
health promotion physical activity
2023 only 45% of Canadians are meeting the weekly target of 150 minutes
-report reveals nearly half of Canadians of not get 30 mins
-only 1;5 150 minutes of moderate to vigorous exercise in 10 minutes
228
health promotion chronic disease
main cause of death in middle age adults caused by drinking alcohol, smoking cigarettes overeating not getting exercise. Diabetes, hypertension, heart disease and stroke
229
what is considered late adult
65+
230
gerogogy
the teaching of older persons, accommodating the normal physical, cognitive, and psychosocial changes
* Must adapt teaching strategies to account for these changes
* Focus on healthy development & positive lifestyle changes- not on impairments
231
ageism
prejudice against the older adult
232
how to combat ageism
To combat ageism, it is necessary to raise public awareness about its existence and to dispel common stereotypes and misperceptions about aging.
233
western view on elderly
Western countries devalue our elderly and its common to send them to facilities to be cared for
234
asain view on elderly
many asian and mediterranean countries have elderly still heavily involved in family life, living in the house and caring for grandchildren
235
First Nation view on elderly
valued
236
trends in canada senior demographic
preparation of seniors is expected to increase rapidly until 2031 when all baby boomers will have reached 65
-seniors could represent between 23%-25% totally population in 2036
-between 2015 and 2021 the number of seniors is projected to exceed the number of children aged 14 for the first time ever
237
Fluid intelligence
capacity to perceive relationships, to reason, and to perform abstract thinking, which declines with aging
238
crystallized intelligence
the intelligence absorbed over a lifetime, which increases with experience
239
Erikson Ego integrity vs despair
(65+)
Coping with reality of aging mortality reconciliation past failures within current reality and developing a sense of growth and purpose for the years remaining
-adjust to changes in lifestyle and social status (retirement, illness, death, of spouse friends and relatives, moving away of children grandchildren and friends, relocation of an unfamiliar environment
240
physiological development
-adjust to physical changes
-adapt to lifestyle diminishing energy and ability
-maintain vital signs within recommended target range
241
psychosocial
manage retirement in satisfying manner
-participate in social leisure activities
-socail network and support person
-view life as worthwhile
242
Activities of daily living
health practices in nutrition, exercise, recreation, sleep patterns
-ability to care for self or secure appropriate help
-satisfactory living arrangements and income to meet changing needs
243
cognitive changes in late adulthood
-decreased ability to process info
-greater tendency to be distracted
-reduced working memory
-decreased ability to perceive relationships
-short term memory loss
-decline in executive functioning
-confise a previous symbol with a new work or symbol
-be aware of any effect of meds
244
impact of cognitive changes with late adults
Assess existing knowledge before teaching adjust pace of instruction and link new info to familiar and past experiences
-provide additional time
-focus on need to know info
-repeat essential info
-communicate desired action rather than what to avoid
-limit to need to know basis
-proceed from simple and familiar to complex
245
visual changes effect on teaching
-decreased visual acuity (remind to wear eye glasses)
-sensitivety to glare (provide magnifying glass or reader)
-Decreased depth perception (14-16 font)
-Less light reached retina (stay away from windows)
-pupil adapts less readily to light and darkness (face client directly
Poor night vision (do teaching during the day)
Difficulty in discriminating colours at the blue end of the spectrum (avoid using blue, green, violet ink)
246
Auditory changes effect on teaching
decreased hearing acuity (use lower pitch voice)
Unable to filter out ambient noise (face client when speaking)
Unable to hear middle frequency sounds (eliminate background noise)
Auditory reaction time increases (allow client additional time to process verbal instructions provide paper and pencil have client restate what they heard)
247
Physical change strategies for teaching
musculoskeletal problems, decreased kidney function, decreased cardiac efficacy
(short sessions, access to bathroom, stretch breaks)
Declined CNS functioning decreased metabolic rates
(more time for giving/recieving info more time for prating a new psychomotor skill, loss of energy does not mean loss of interest)
248
Role of family in client education in late adulthood
-very important for teaching plan
-assess who their supporter is and include them
-assess how they feel about their support role and new info
-share info with caregiver to support self care and ensure consistency
-family members may need more info than the client themsleves
-what does family expect going forward
249
How can you prevent stereotypes
-did I talk to the family and ignore the patient
-did I tell the older person not to worry if they had a question that we were handling it
-did I eliminate some of the info I would have told a younger person
-did I attribute a decline in cognitive functioning to agin without considering the other potential factors like medication, infection or sensory impairment
250
common health promotion topics for late adulthood
chronic disease, experience of change and loss, nutrition and exercise, falls prevention, elder abuse and neglect
251
end of life defined by Sask health
anyone who has received a diagnosis that is not treatable or curable and won’t go away, or adults who are suffering from grievous and irremediable medical condition
252
end of life care includes what
physical, emotional, social, and spiritual support for patients and their families. Goal is to control pain and other symptoms to help patients achieve a quality life
253
Professional communication includes
requires skills, knowledge, motivation, self awareness, practice, reflection and critical thinking.
254
sympathy
subjective nontherapetuic communication technique of over identofying with clients feelings
"im so sorry this is happening to you"
255
Empathy
the ability to imagine how or what someone else might be feeling "Wow I can only imagine how bad that must feel"
256
Bereavement
refers to outward expressions of grief. Mourning and funeral rites are expressions of loss that reflect personal and cultural beliefs about the meaning of death
257
Grief
the psychological, physical and emotional experience of loss.“The loss may be actual or perceived and is the absence of something that is valued”. Grief is very personalized and does not follow a predictable, linear pathway.
258
Anticipatory grief
occurs when a death is expected and survivors have time to prepare before the death
259
how to talk to somone experiencing Grif
-do not talk just listen
-ask how they are feeling
-do not minimize loss or give advice it is better to just say im sorry I font know what TO SAY I AM HERE"
-get experienced help
260
what to say to a child experiencing greif
-be a role model children learn by watching how adults surround them deal with loss
-answer questions as honestly as you can
-let them know its okay to be sad
261
5 stages of loss
denial, anger, bargaining, depression, acceptance
262
3 ways people die
physiological death: vital organs no longer function, digestive and rep shut down the person-sleeps more
Social death: begins much earlier others begin to withdraw from someone who is terminally ill or has been diagnosed with terminal illness.
Psychic death: the dying persons begin to accept death and withdraw from others and regress into themselves. This is sometimes called losing the will to live
263
Things to educate regarding end of life
-MAID
-what do they do when someone dies
-what symptoms may occur
-What CPR is what a power of attorney is
-how to choose level of care to receive
