Final Exam - Weeks 6 -12 Flashcards

Question

Patterns of Abusive Behaviour

Answer 1

Physical: slapping, choking, punching, threats Sexual: threats, force used for sexual acts Verbal: making degrading comments Emotional: humiliation, inducing fear, threats to children, pets Economic: stealing/controlling money/possessions Spiritual: using beliefs to manipulate / control Stalking: persistent, unwanted following or watching, use of electronic devices to monitor

Answer 2

Forty years of research Initially understood as violence that only happened to women Referred to as battering, woman abuse, coercive control, intimate partner violence, intimate terrorism

Answer 3

Situational couple violence most common / arguments escalate to violence Coercive control abusive partner controls and coerces pattern of behaviour Violent Resistance victim of coercive control fights back

Answer 4

Highest risk cases (DVDRC) Most serious injuries (Stats Can) More likely to be reported to police (Stats Can) Women almost exclusively victims of sexual assault in relationships (Stats Can) More likely to fear for their lives (Stats Can)

Answer 5

229 cases resulted in 328 deaths since 2002 Perpetrators: - women (3%) - men (97%) Victims: - 29 children (11%) - 212 women (80%) - 23 men (9%) 45% of cases are homicide - suicides

Answer 6

One third (33.6%) had experienced DV in their lifetime Female, transgender, and Aboriginal respondents, those with disabilities, or a sexual orientation other than heterosexual had higher rates Rates consistent with other large Canadian surveys

Answer 7

Federal funding continues for the provincial health insurance plans, provided the five criteria are met. Health care must be: Publicly administered Comprehensive Universal Portable Accessible

Answer 8

Benefits Ensures that Canadians have access to to health care regardless of their ability to pay or where they live Defines health care as a right Upholds values of social justice and equity Drawbacks: Covers only essential medical and hospital services – what are they?? Health promotion, disease and injury prevention, health protection, home health care not emphasized (i.e., cost may not be covered by shared prov/federal cost sharing)

Answer 9

promotes healthy lifestyles as a pathway to disease and injury prevention provides continuing care of chronic conditions and recognizes the importance of the broad determinants of health. Involves a broad range of health-care providers (CIHI, 2006)

Answer 10

service at the entry of the healthcare system “responsible for coordinating the care of patients and integrating their care with the rest of the health system by enabling access to other healthcare providers and services”

Answer 11

1. Accessibility Healthcare universally available regardless of geography 2. Public participation Clients are actively encouraged to participate in decision-making for their own health and needs 3. Health promotion Includes the spectrum from health enhancement to disease prevention 4. Appropriate technology Appropriate modes of care are available 5. Intersectional cooperation Need collaboration between national and local health goals, public policies, and planning of services

Answer 12

Move towards a more integrated system to provide full spectrum of healthcare services at a community/neighbourhood level- upstream approach Community Health Centers Family Health Teams (FHTs)

Answer 13

Public Health: services depend largely on provincial (or municipal) governance and delivery structures Funding and infrastructure being eroded Home Health: MHLTC funds homecare (HCCSS) Medical, nursing, social & therapeutic treatment/assistance and ADL support Fastest growing nursing care sector in Canada

Answer 14

Main Government of Canada agency responsible for public health in Canada Led by Chief Public Health Officer – Dr. Theresa Tam Mission is to protect the health of Canadians Goal is to strengthen Canada’s capacity to protect and improve the health of Canadians and to help reduce pressures on the health-care system

Answer 15

No legislative mechanism to fund = a wide variation in services across Canada All provinces offer basic home care services however: - Variation in access to and variety of homecare services - Individuals may have to copay or pay entirely for services they need - There is significant inequity in funding of home care across Canada

Answer 16

A principle or protocol to guide decisions and achieve rational outcomes A definite course or method of action selected from among alternatives and in light of given conditions to guide and determine present and future decisions (Merriam-Webster, 2013)

Answer 17

Building healthy public policy involves advocacy for any health, income, environmental or social policy that: fosters greater equity creates a setting for health increases options/resources for health (Stamler & Yiu, 2012) policy development can be regarded as an act of social justice

Answer 18

describe the problem access readiness for policy development develop goals, objectives, policy options identify decision markers & influencers Build support for a policy write/revise policy implement the policy evaluate/monitor the policy

Answer 19

CHNs work in a variety of settings where resources are finite Policy: guides the work of CHNS and occurs within a political context Politics: “is the use of relationship and power” to encourage stakeholders to influence policy and the allocation of scarce resources Power is “ the ability to act so as to achieve a goal”

Answer 20

When there is bad policies and politics Despite our universal health care system there are still barriers to access for many i.e. immigrants, refugees , Indigenous peoples This has resulted from poor social policies and programs, unfair economic conditions and bad politics

Answer 21

CHNs should be prepared to perform in the policy and political arenas Need knowledge, skills and behaviors that support social justice Advocating and influencing policy is critical for health care leadership Nurses have traditionally not been politically active

Answer 22

What? A process by an individual/group aimed at influencing public-policy and resource allocation within economic, political and social systems and institutions An act of social justice The vehicle for the profession to have a voice and effect change Why? Builds capacity A moral imperative that changes the social conditions that contribute to poor health

Answer 23

Seat at the table Link with government agencies (via RNAO) Engage politicians OR become one Development external informal and formal links with industry, politics and media Be proactive Stay the course Be realistic strategies and focused Have strengths-based relationships Collaboration and partnerships

Answer 24

Disaster - Sudden, unpredictable Multiple causes Natural (e.g., nature) Social and economic crisis Man-made (e.g., human error, school shootings) Biological hazards Infectious disease Other? Considered random killers Affect all in the community! Can result in an emergency situation

Answer 25

1881 – The Victoria Steamship disaster (182 lives lost) 1898 – City Hall collapse (23 lives lost) 1937 – The Great London Flood (5 lives lost) 1973 – Oxford Park area – Gas explosion (27 injured, 10 houses exploded and burned, 40 houses damaged, 3,000 homes evacuated) 1980 – Hyde Park train derailment (explosion propane tank car, 300 people evacuated) 1984 – White Oaks area – Tornado (30 people injured, 600+ homes and businesses damaged) 1990 – Tornado, Komoka ($20 million damage) 1995 – Hyde Park train derailment (diesel spill, 25,000 gallons of liquid propane remained intact) December, 2010 – Blizzard (100 + cm snow)

Answer 26

Largest most concentrated population in Canada with 7 million in GTA alone High concentration of rail lines, major highways and airports Largest nuclear jurisdiction in North America (20 large nuclear reactors) 50% of Canada’s chemical industry Yearly floods and forest fires More than 100 severe summer storms Average of 14 tornadoes every year Extensive aging infrastructure High tech dependence

Answer 27

May 21,2022. Derecho storm hits Southern Ontario and Quebec A derecho is described as a widespread, long-lived, straight-line wind storm that is associated with a fast-moving group of severe thunderstorms. On May 21, 2022, a derecho storm hit Southern Ontario and Quebec. One of the most impactful thunderstorms in Canadian history, it had winds up to 190 km/h along with several tornadoes that caused widespread, extensive damage along a path that extended for 1,000 kilometres. Tragically, at least 11 persons lost their lives in this storm

Answer 28

gradual sudden

Answer 29

describes and quantifies the level of exposure to objects, substances etc

Answer 30

regulations, policies

Answer 31

distribution and presentation of risk assessment and risk management information to public

Answer 32

How is preparing for emergencies and disasters a health promoting practice? Planning: Activities that are taken to build capacity and identify resources that may be used Legislation Public education Chain of command Role description Mitigation: Activities that reduce or eliminate a hazard Immunization programs 72 hour kits Accessible counselling Infrastructure renewal Assessment: Understand: Impact Priorities Causes Current safety status for those going in Response: Action Triage Treatment Leverage of resources Recovery Repair: Infrastructure Physical impacts Systems Mental health impacts

Answer 33

Prevention entails avoiding a potential disaster. An example here is a position statement by the Canadian Paediatric Society that outlines key steps that can prevent gun violence in schools, Mitigation involves reducing the impact of a disaster. Introducing vaccinations against certain infectious diseases can mitigate their impact.

Answer 34

Preparedness involves maximizing the efficiency of the emergency response through planning and preparation. Preparedness – to be ready to respond to a disaster and manage its consequences through measures taken prior to an event, for example emergency response plans, mutual assistance agreements, resource inventories and training, public awareness activities, equipment and exercise programs.

Answer 35

With the emergency response, the immediate effects of the emergency are addressed. With COVID, Canada and Ontario’s response involved mobilizing providers, coordinating services, acquiring supplies, ensuring tertiary centres are equipped, tracking cases, ensuring compliance with self-isolation measures. Response – to act during or immediately before or after a disaster to manage its consequences through, for example, emergency public communication, search and rescue, emergency medical assistance and evacuation to minimize suffering and losses associated with disasters

Answer 36

Lastly, with recovery, communities return to an acceptable and normal condition This is the longest phase that includes restoration of health, services, and infrastructure. Recovery – to repair or restore conditions to an acceptable level through measures taken after a disaster, for example return of evacuees, trauma counseling, reconstruction, economic impact studies and financial assistance. There is a strong relationship between long-term sustainable recovery and prevention and mitigation of future disasters. Recovery programs provide a valuable opportunity to develop and implement measures to strengthen resilience, including by building back better. Recovery efforts should be conducted with a view towards disaster risk reduction

Answer 37

Guiding Principles - No one who experiences a disaster is untouched by it - Panic is rare - Most people pull together and function during and after a disaster - Mental health concerns exist in most aspects of preparedness, response and recovery - Disaster stress and grief reactions are “normal responses to an abnormal situation” Survivors respond to active, genuine interest and concern. Disaster mental health assistance is often more practical than psychological in nature (offering a phone, distributing coffee, listening, encouraging, reassuring, comforting). Disaster relief assistance may be confusing to disaster survivors. They may experience frustration, anger, and feelings of helplessness related to disaster assistance programs and may reject disaster assistance of all types.

Answer 38

Disasters have an impact on entire communities Psychological impact on people can be great and long term but there are things we can do pre-event to mitigate Role: Provide services Awareness of legislation Emergencies Act Emergency Preparedness Act Knowledge of role of the ICN and CNA

Answer 39

Morbidity and mortality increase brought on by emergency/disaster Public safety Populations at risk in an emergency/disaster situation Vulnerable groups Children Elderly Those living in poverty People living with mental and physical health challenges/disabilities Other?

Answer 40

All health professions Government - local, regional, national, international - e.g., Volunteer agencies – e.g., Red Cross

Answer 41

To whom is a duty owed? How do we enforce limitations on individual rights? Curfew; quarantine; evacuation? What duty of communication/warning is owed the public? What is the duty of the media in disseminating messages about risk?

Answer 42

Culture is learned, shared, and changes. It encompasses all aspects of our lives: what we have learned to value, represents our assumptions about how to perceive, think, and behave in acceptable, appropriate, and meaningful ways Culture is embedded in everyday life Culture is shared and relational Culture is largely implicit Culture is fluid and dynamic Culture intersects with other social constructs ( race , gender, ethnicity, class, language and disability)

Answer 43

Refers to variety and differences of attributes among, between, and within groups Includes characteristics and constructs such as race, gender, language, sexual orientation, and visible and invisible disabilities As CHNs we must use an anti-oppression, anti-racism framework for practice

Answer 44

Race refers to any group of people who share the same physical characteristics An artificial way to categorize people Racial profiling occurs when generalizations are made about certain groups

Answer 45

“The systematic practice of denying people access to rights, representation, or resources based on racial differences” Includes more than solely the action of individuals A system of discrimination involving social institutions

Answer 46

1834 - slavery abolition act 1876 - indian act 1885 - Chinese immigration tax 1910 - immigration act section 1911 - order in council Oklahoma black farmers 1923 - Chinese immigration act WW2 (1939-1945) - Japanese Canadian internment 1996 - Last residential school

Answer 47

health personnel imposing their beliefs practices and values on other cultures, because they believe that theirs are superior.

Answer 48

integrates the knowledge, attitude, and skill in order for a nurse to plan effective and appropriate interventions

Answer 49

requires us to shift our gaze onto the culture of health care, and how practices, policies and research approaches can themselves perpetuate marginalizing conditions and inequities

Answer 50

Studies on cancer screening behaviour among women in Canada reveal that South Asian immigrant women are less likely to have a mammogram or a pap-smear

Answer 51

Cultural humility – life-long process and a personal commitment to understand one’s biases through education and self-reflection

Answer 52

Land purchased by government and Indigenous peoples relegated to living on reserves Settlers brought disease i.e. Smallpox, TB and measles Settlers depleted buffalo and beaver that had sustained communities Resulted in malnutrition, starvation and death Policies of assimilation resulted in loss of language and culture

Answer 53

Process of education/religion and cultural degradation Parents legally required to send children to residential schools Failure to do so meant incarceration Physical and emotional abuse in the schools Generation and intergenerational trauma resulted and continue i.e. high rates of suicide, addictions violence and abuse; incarceration

Answer 54

High rates of TB- 70 times that of general population Trauma and injuries i.e. burns, firearms accidents Diabetes secondary to obesity and food insecurity Cancer rates increasing Indigenous women overrepresented in poverty, abuse, missing and murdered women and girls

Answer 55

First of its kind in Canada In British Columbia Transfer from Federal government in 2013 As of 2019 specific regional initiatives in Quebec, Saskatchewan, Ontario, & in Northern Manitoba to improve regional capacity for health governance - Paving way toward self-determination - Building on lessons of First Nations Health Authority in British Columbia

Answer 56

Societal stigma and discrimination - Harassment/ bullying at school or in the workplace - Higher rates of physical or sexual abuse - Stress - Increase in mental health issues (depression, SI, anxiety) - Higher substance abuse and homelessness

Answer 57

Address assumptions, beliefs and values Use inclusive language and material Challenge discriminatory attitudes

Answer 58

The fair distribution of society’s benefits, responsibilities and their consequences. Social justice looks at the position of social groups in relation to others and attempts to understand the root causes of disparities and how to eliminate them.

Answer 59

Power Influence stemming from the professional position we hold and that we have an impact on a person physically, mentally, emotionally Need ethical use of power Persons viewed as unique, Includes entire context each person’s life (SDOH) Everyday life decisions Attend to how every day actions are carried out Ethical dilemmas arise when there are equally compelling reasons for or against an action

Answer 60

All societies experience broad systemic oppression and inequities (i.e., racism, sexism, ageism, classism, etc.) We all contribute to this inequitable distribution even if unintentional Thus, we are all responsible to contribute to the achievement of social, economic and political parity

Answer 61

Recognizes: that basic resources and prerequisite conditions are necessary to achieve health that social justice is the foundational moral justification for public health the need to address systemic disadvantage that severely limits the well-being of vulnerable/oppressed/marginalized groups

Answer 62

Barriers impact Equitable access and distribution of health services SDOH Some barriers include Age Sexual orientation Mental health challenges SES Poverty and homelessness are increasing in Canada Homelessness is a barrier which limits access to health services

Answer 63

Lobby for and work toward income security, housing, nutrition, education, and environment as essential in improving the health of vulnerable population Promote radical policy and social change Research The power of one: Recognize that small change is important in working towards social justice

Answer 64

Global health is an area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide. - Focuses on issues that directly affect health but that can transcend boundaries - Requires global cooperation to develop and implement solutions - Addresses both prevention in populations and clinical care of individuals - Major goal is for health equity among nations and for all people - Is interdisciplinary and multidisciplinary

Answer 65

increasing inequalities within and between countries new patterns of consumption & communication commercialization global environmental change urbanization

Answer 66

Life expectancy – the average life span Healthy life expectancy – not just life span but years of healthy and unhealthy life Mortality – number of deaths in a given population Disability – a person’s abilities or limitations relative to a group standard including physical, mental, and cognitive

Answer 67

Low income - neonatal conditions, lower respiratory infections, ischaemic heart disease High-Income: ischaemic heart disease, Alzheimers, stroke

Answer 68

ethics, politics, social factors

Answer 69

doing good, of benefit

Answer 70

do NO harm

Answer 71

Culture Religion Language Values, beliefs, and social norms

Answer 72

Illnesses caused by a “specific infectious agent, or its toxic products that arise through transmission of that agent, to a host (either directly or indirectly)”

Answer 73

Epidemiologic Triangle - host, environment, agent Agent Host - Resistance: The ability of the host to withstand infection Immunity: A resistance to an infectious agent - Herd immunity: The resistance of a group of people to invasion and spread of an infectious agent - Infectiousness: A measure of the potential ability of an infected host to transmit the infection to other hosts Environment

Answer 74

Low income is linked to increased rates of sexually transmitted infections (STIs). Low literacy levels are a barrier to receiving effective care for STIs.

Answer 75

Shift from biomedical based perspective of health care toward self-care in the socio-environmental/political (i.e., SDOH) context It is anticipated that there will in an increase in nurse practitioners as primary care givers

Answer 76

Nursing practice is expected to be increasingly community based It is predicted that in the future, 2/3 of nurses will work in community care We will most likely see increased advocacy and system navigator roles

Answer 77

CHNs must address health inequities Must develop health equity strategies to create environments of empowerment Health equity approaches are rooted in social justice Must address root causes of inequities: ask “Yes, but why?” regarding inequities

Answer 78

increased numbers of what you would expect

Answer 79

its always present – it exists in that environment (ex malaria)

Answer 80

a state of two or more concurrent disease states that are the result of interactions between biological, social, environ- mental, economic, and structural factors that amplify the risk of disease or worsen the disease process

Answer 81

Paternalism is the interference with the liberty or autonomy of another person, with the intent of promoting good or preventing harm to that person. Examples of paternalism in everyday life are laws which require seat belts, wearing helmets while riding a motorcycle, and banning certain drugs.

Answer 82

Previously called evidence-based nursing Is the conscious, explicit, and judicious use of current best evidence in making care decisions (Stamler & Yiu, 2012) Sources of evidence include: Research evidence Health care resources Patient preferences and actions Clinical state and circumstances

Answer 83

In statistics, a meta-analysis refers to methods focused on contrasting and combining results from different studies, in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies. IS a source of pre-processed evidence

Answer 84

practice community program development policy development/legislation

Answer 85

Susceptibility and risk - Vulnerability determining host response Causation - Definite, statistical cause/effect relationship between stimulus/response not due to chance Mortality = Death rate Morbidity = Rate of illness – disease and health challenges over time in a particular population - Prevalence – specific status of disease at one point in time - Incidence – identification of new cases in a population during a specified period– see map in next slide

Final Exam - Weeks 6 -12 Flashcards

(110 cards)