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Unit 1 > integrative care > Flashcards

integrative care Flashcards

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1
Q

What are the two components of postural control?

A

postural orientation and postural stability

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2
Q

What is postural orientation?

A

ability to maintain an appropriate relationship between different body segments and between the body and the environment for a task

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3
Q

What is postural stability?

A

the ability to control the center of mass in relationship to the base of support

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4
Q

What is the center of mass?

A

the point at the center of the total body mass

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5
Q

What is the center of gravity?

A

the vertical projection of the center of mass

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6
Q

What is the base of support

A

the area enclosed by the body in contact with the surface

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7
Q

what happens as the COM shifts upward?

A

object becomes more top heavy, tendency to be overthrown increases

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8
Q

how will the center of mass shift with a left unilateral AK amputee

A

COM will shift up and right

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9
Q

what is center of pressure?

A

distribution of total forces applied to the support surface; at static equilibrium COP directly under COM

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10
Q

what is static balance

A

the ability to maintain COG within the supporting base while standing or sitting

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11
Q

what is dynamic balance

A

maintaining an upright position while COG and BOS are moving and COG is outside BOS (ex walking)

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12
Q

what is functional balance

A

the ability to preform daily movement tasks requiring balance and involves static and dynamic balance

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13
Q

what are stability limits

A

refer to the boundaries within which the body can maintain stability without changing base of support

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14
Q

what creates stability limits

A

interactions between position and velocity of COM

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15
Q

what systems are involved in balance

A

vestibular, visual, tactile, proprioception

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16
Q

how can you test anticipatory postural control in the clinic

A

ask them to make typical movements like sit to stand, push up on toes. etc.

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17
Q

how can you test reactive postural control in the clinic

A

have patient lean into hands, remove them and watch how they recover

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18
Q

Where is the balance control center in the brain

A

cerebellum

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19
Q

what is absolute effect?

A

mean difference; reported with units

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20
Q

What is a within group change?

A

comparing pre to post in the same group

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21
Q

What is between group change?

A

comparing the mean change for group 1 and group 2

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22
Q

what is standardized effect

A

compares magnitude of change across different outcome measures - NO UNITS (also expressed at g)

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23
Q

statistical approach vs effect size approach

A

statistical approach reported p values and is useful in research; effect size reports mean changes and confidence intervals; important in applying research

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24
Q

What components are used to calculate a confidence interval

A

standard deviation; sample size; how confident you want to be; mean effect

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25
What is behaviorism?
theory of learning that focuses on observable behaviors
26
What are tools used in behaviorism?
simplified tasks, repetition, stimulus and response, reward and punishment
27
what is the role of the teacher in behaviorism?
manipulated environment, reinforces, rewards/punishes
28
what are external motivations of behaviorism
avoid negative consequences, seek rewards
29
what is classical conditioning?
associative learning - pair a natural stimulus with another to get the desired response, results in a conditioned response to single artificial stimulus
30
what is operant conditioning?
use reinforcement and punishment to maintain or change a behavior
31
what is cognitive learning?
theory of learning that focuses on information processing and incorporating new info into existing frame works
32
what is the role of the teacher in cognitive learning
present facts and assist with assimilation of material
33
what is the role of the learner in cognitive learning
actively constructing knowledge, motivation is largely intrinsic
34
what is experiential learning
learning theory that is an extension of cognitive learning; focuses on context and experience and problem solving
35
what is the role of the teacher in experiential learning
present structured opportunities, act as guides
36
what is social-cultural learning
theory of learning that focuses on knowledge being constructed from cognitive process and social experience; community based learning and peer interaction are huge in this.
37
what is the role of the teacher in social-cultural learning
structures group interactions and guides discussion
38
what is the role fo the student in social-cultural learning
to observe, associate, model and construct meanings from the community of practice
39
what filters are presented by Plack and Driscoll to influence learning
perceptions, gender, generational experiences, social role, culture, past experiences, level of expertise, learning styles
40
factors that influence learning presented by Watson & McKinstry
age, educational status, volume of information, health status, mode and contest of information, gender, emotional status, perceived importance
41
what is pedagogy
the study of teaching, typically applied to children
42
what is andragogy
art and science of helping adults learn
43
what do adults bring to a learning experience
a need to know, independent self concept, experience, life centered learning, motivation for current life situations.
44
how does a navigator learn
with a spelled out list of steps, planned ahead
45
how does a problem solver learn
think through scenarios
46
how does an engager learn
by giving meaning to the task and being submerged in it
47
what are the learning domains
cognitive, psychomotor, affective
48
what is encompassed in the the physiologic stress response
sympathetic NS, parasympathetic NS, epi &norepinephrine, cortisol
49
what are protective responses of stress
increased arousal increased energy, increased alertness, enhanced performance
50
what are ineffective responses of stress
rumination, worry, wandering thoughts, self doubt, negative loop
51
what are the stages of general adaptation syndrome
1. alarm(+) - stressors identified, response initiated 2. resistance (+/-) - compensatory strategies continue, continues until stressor is overcome or resources depleted 3. exhaustion (-) - tissue damage, death
52
consequences of chronic stress
cortisol dysfunction, inflammatory process, objective changes, disease
53
cognitive and behavioral changes with chronic stress
depression, fatigue, burnout, health, life balance, memory impairment, learning, impaired task performance
54
examples of active coping
mindfulness, awareness/reflection, positive affect/optimism, purpose/vision, social support, self esteem
55
examples of stress avoidance behaviors
distraction, disturbed sleep, poor dietary choices, excessive smoking/drinking, unhealthy levels of physical activity
56
mindfulness is...
the awareness that emerges through paying attention on purpose, in the present moment, non-judgmentally to the unfolding of experience
57
why do PT's document?
for insurance, to track progress, for the use of other PT's/medical professionals, for future planning/research, etc
58
who is the audience of PT documentation
3rd party payers, PT's, medical team, managers, administrators, researchers, patients and families
59
is documentation required for a phone call?
yes, documentation is required for every visit/encounter
60
is documentation required for cancellation?
yes, documentation should include indication of no shows and cancellations
61
is documentation digital or hand written?
both, electronic entries are made with appropriate security and confidentiality measures and hand written entries are made in ink, include original signatures, date and time
62
how should a documentation error be corrected
with a strike through and initialing and dating or through similar measures in digital form
63
how is a patient identified on a chart
full name, identification number, DOB
64
how is a physical therapist identified on a chart
date, full legal name, appropriate designations (SPT/PT/PTA)
65
what is a SOAP note
form of documentation including 4 parts; subjective, objective, assessment; plan
66
other than SOAP what framework can be used for documentation
patient management model
67
what is a health care delivery system
an interplay between access, cost, and quality of healthcare
68
what does financing for a health care system look like
the flow of dollars form individuals and employers to health insurance plans
69
what is an accountable care organization (ACO)
groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to their Medicare patients
70
what are the % for US health spending
private health insurance - 34% Medicare - 20% Medicade - 17% out of pocket - 10%
71
what kind of insurance model is medicare?
social insurance model meaning it requires a contribution in order to receive a benefit
72
list the parts of medicare
parts A, B, C, and D
73
when did medicare parts A & B originate
1965
74
who is eligible for medicare part A
65 yrs and eligible for SS; persons under 65 who are totally and permanently disabled after 2 years pd receiving disability benefits; people with chronic renal disease requiring dialysis or transplant; people not eligible for SS can enroll at a cost
75
how is medicare part A financed?
SS system & payroll tax (1.45% of wages & salaries from employer and employee each)
76
what hospitalization services are covered under medicare Part A
hospitalization - first 60 days covered after deductible; daily cost starting at day 61, cost increases post day 90 - Admission require!!!
77
what SNF services are covered under medicare part A
first 20 days covered; requires min 3 days hospital admission; daily cost 21-100days; beyond 100 medicare pays nothing
78
what home health and hospice care is covered under medicare Part A
100 home care visits of "skilled care" per benefit period; 6 months or less of hospice care with doctor certified terminal illness, patient only has $5 co-pay per Rx for pan management meds
79
who is eligible for medicare part B
anyone eligible for Part A and who opts to pat a monthly premium
80
what does medicare part B cover
80% "approved amount" outpatient services deemed medically necessary after deductible, some preventative care at no cost
81
what is a medigap
supplemental private insurance to pay for deductibles or gaps in coverage - financed by employer or beneficiaries themselves
82
What is Medicare Part C
medicare advantage plans; medicare contracts with private insurance companies to provide coverage for hospitalization, physician services, and some RX
83
what is medicare part D
prescription drug coverage; premiums and deductibles apply
84
what type of insurance model is medicade
public assistance model; federally funded but administered by state
85
requirements for medicade
low income families with children, elderly disabled and blind who receive assistance under supplemental security income, children under 6, adults whose family income is below 150% of federal poverty line; children <19 who's family income is at or below federal poverty line
86
What is a medicare waiver?
gives states more control in program beneficiaries and scope of services and required enrollment in managed care plans and healthcare exchanges under ACA
87
what is SCHIP
state children's health insurance program; companion to Medicaid
88
who is covered under SCHIP
uninsured children in families with income at or below the 200% federal poverty line but above medicaid eligibility

Unit 1 (3 decks)

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