Planning Flashcards
1
Q
what does the dh care planning identify
A
- the action and intervention to rectify problems and achieve desired outcome
2
Q
what are the 4 stages of care planning
A
- setting priorities
- developing outcomes (defines goals)
- dental hygiene care plan (who, what, when and frequency of planned activities)
- documentation
3
Q
what is the planning phase overall
A
- identify actions and interventions, rectify problems in our dh diagnosis to achieve outcomes
4
Q
what do the stages address
A
- clinical (50%), performed on pt, need pt approval
2. behavioural (3 theories of health behaviour) (50%); Pte actively involved in care plan, crucial to achieving goals
5
Q
what is the basis of dental hygiene care planning
A
- epidemiological approach
6
Q
what is epidemiology
A
- effects of disease on population over a period of time
- systemic observation
- review numbers individual cases
7
Q
how does epidemiology relate to dh planning
A
- apple epidemiology research to individual clients
- identify stage, risk factors, and interventions to achieve outcome
8
Q
what is epidemiological data
A
- requires anticipation of future disease
- scientific knowledge of natural history of disease
- allow us to predict with some natural history of disease
- pre-pathogenisis (incubation or prodromal stage) vs pathogenesis period (s&s are visible)
- allows individualized care
9
Q
what is the epidemiological model
A
- host (client)
- environment
- agent
- abbreviated to HAE
10
Q
what are the levels of prevention
A
- we need to use the right level of prevention according to where the disease is at in the pre-path or path period
11
Q
what is primary prevention
A
- prevent initial contact of HAE (host agent environment)
- no interaction of host, agent and environment = no disease
12
Q
what are the 2 types of primary prevention for disease
A
- health promotion: increases awareness
- specific protection
13
Q
what is health promotion
A
- general wellness
- increase awareness
- OH group presentations, tv advertisements
- goal: therapeutic seeding (plant an idea or seed in the clients head)
- increase readiness to learn (lets the pt think about an idea then ask)
- then health promotion ends and health medications begins
14
Q
what is specific protection
A
- affect at least one aspect of host, agent, environment
- mouthguard
- fluoride rinse programs
- space maintainer
- type of tx
15
Q
what is secondary prevention
A
- ex. incipient caries - tx with fluoride, improve diet and proper OHI may prevent decal
- diagnose at early stage
- most of DH care efforts in perio disease in this stage
- early detection
- maintenance
- scale, root plane
16
Q
what is tertiary prevention
A
- late in pathogenic stage, HAE has interacted, goal is to min path effects on disease
- rehabilitation - implants (restore)
- disability limitations
- perio surgery
- delay/prevent consequences
- restorations
- root resection
- root canal therapy
17
Q
what are host factors
A
- inherent - genetics, disease, age
- acquired - lack of nutrition, poor OH, values
18
Q
what are agent risks
A
- bacteria in perio disease
- toothbrush in abrasion
- high carb diet in caries
19
Q
what are environmental considerations
A
- biological, socioeconomics, physical
- biological: drug effect ie xerostomia
- physical: environment ie resources
20
Q
how can we use the epidemiological approach in care planning
A
- the DH care planning is based on problems that are changeable by us stated in the dh diagnosis. using the natural history of disease, we find if pt is in the pre-path or path phase, HAE had contact already or not
21
Q
what is the specific plaque hypothesis
A
- before: increase plaque… increase disease (non specific plaque hypothesis)
- now: specific microorganisms, role in oral cavity and the immune response of the host determines the course of disease (specific plaque hypothesis)
- ex. environmental factors like smoking, systemic factors like diabetes. both will affect host response
22
Q
what do dh address
A
- tissue response rather than simply evaluate calculus, plaque removal and root smoothness
- dh need to keep all current concepts in mind
23
Q
what does the epidemiological approach allow us to do
A
- define characteristics of disease: clinical s&s. assess contributing risk factors. bleeding = gingival, bone loss = perio
- disease contributing factors: pathophysiological (clinical), deposits, bacteria (type). psychosociobehavioural (behaviour)
24
Q
what are behavioural considerations
A
- understanding the social psychological basis for health behaviour helps to direct the education and increases the chance for lasting change
- 3 theories on health behaviour and education, which we need to take into consideration and apply
25
what are the 3 models for behaviour and education
1. health belief model
2. multiattribute utility theory
3. human needs conceptual model
26
what is the health belief model
- comes from the stimulus response theory and the cognitive theory
- individuals take preventive action if:
1. they feel they are susceptible to a disease
2. they believe the disease has serious consequences
3. they can have and impact on reducing the severity or susceptibility
4. the benefits outweigh the barriers ie time, cost
- more education, more preventive behaviour
27
what are the 2 different locus of controls
- internal: easy motivation, less time, successful in change agent
- external: client feels powerless to do anything about a situation, thinks the condition is due to bad luck and genetics. overwhelmed and inadequate, less motivation, needs close monitoring, more time - more frequent visits
28
what is self efficacy
- so that they have control over their disease
- skillful with new techniques
- make it easy, start with easiest part of skill
- do not overwhelm
- keep locus internal
- short term goals toward ultimate long term goal -- ex. start flossing concentration on anteriors and 2x/wk
29
what is the multiattribute utility theory
- identify barriers preventing change
- identify issues that are important to pt, their values
- based on value expectancy theory: what they value re health issues; the health related behaviour is the result of the value that the pt places on the outcome of an action and the expectation that the action will indeed lead to a desired outcome
- predicts behaviour by the pt's evaluation of the consequences with yes or no action - do I floss
- does not judge a value or a belief
- more willing to do the action if they value the outcome an they think that they can have an impact on the outcome
30
what is the human needs conceptual model
- based on Maslow's hierarchy of needs
- lower order needs satisfied before higher
- 11 human needs related to dh
31
what are the 11 human needs
```
1 - safety
2 - wholesome body image
3 - freedom from pain/stress
4 - skin & mucous membrane integrity of head and neck
5 - biologically sound dentition
6 - nutrition
7 - conceptualization & problem-solving
8 - appreciation & respect
9 - self determination & responsibility
10 - value system
11 - territoriality
```
32
what does applying the human needs to the care plan determine
- determine if deficit in any needs
- diagnosis regarding the deficit
- written in reference to human needs
- increase risk to caries due to high carb diet
Vs
- human need deficit in nutrition related to high carb diet
- human need deficit in wholesome body image related to self-image of discolored dentition
33
what does using the multiple theories help us do with the care plan
- incorporate various methodologies as required
- determine locus of control, internal, external
- determine Client’s values or perceptions
- help eliminate negative barriers
- determine reason for past failures in health behavior change
34
what is the role of information in dh care
- accurate knowledge
- consumer decision making
- satisfy a need versus optimal alternative
- tt will do!
- heuristics (known as guidelines) (no research for best tx)
- guidelines
- simple solution is the best solution
- when in doubt choose cheapest or more expensive or less time consuming…
- knowledgeable, up to date and professional
- professional and Credible
- know what u are talking about
- know the products
- relate to experience
- relate to research
- know statistics and current research!!!
- brand x reduces bact by 80% and not brand x works well when we can….want data to back up statements.
- these all affect health behaviors and have impact on locus of control, attributions/perceptions and human needs
