HLTH344 Chapter Notes - Chapter 1: Social Anthropology, Deductive Reasoning, Health Promotion

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blushzebra658

25 Sep 2016

School

University of Waterloo

Department

Health Studies

Course

HLTH344

Professor

Ellen Mac Eachen

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Document Summary

Looks at sociology of health in developed countries focusing on concepts of health and illness, inequalities in health etc. Social anthropology- study of people in the context of culture and society. History of medicine- contributed to understanding of medicine and medical knowledge, understanding the role of health and illness in social history, and to policy studies in health arena. The methods of social research have become an accepted part of health research in areas such as public health, primary care, health promotion and nursing. Health research includes two strands of work: first are critical studies of health from various social science perspectives which addresses questions like what illness and health are and how they are managed. Second are studies for health, from within the disciplines of public health, health promotion or health services research, in which the contributions of social science are defined in terms of the health agenda.

Related Questions

Q37 Research indicates more than 90 % of the deaths occur in older adult 65 and older due to lack of appropriate immunizations on which annual vaccination should the nurse first instruct the patient?

A Pneumonia

B Varicella

C TDAP

D influenza

Q38 which strategies of care would be least likely to enhance the physical function of older adult choose? Choose 2 answers

A weight control

B hearing and vision screening

C smoking cessation

D illness management

E forcing them to attend all activities

Q39 what are common risk factors that contribute to functional decline in the older adult population?

A physical inactivity

B tobacco use

C low sodium dietary intake

D having small families

Q40 what principle is least related to promoting health and preventing certain disabilities in older adults?

A continue activities of daily life (ADLs)

B Maintain as active a lifestyle as possible and desired

C Monitor illnesses through annual health screening ( AHS)

D keep up on assistive and information technology and other tools

Q41 Which focusing on the psychosocial needs of older adults, authorVirginia satir recommends that Healthcare providers get back to the basic communication. whatare the five basic principles satir describes?

A invite

B follow through

C respect personal space

D maximize understanding

E Arrange environment

F maximize attention levels

G trust

H maximize communication

Q42 how do electronic health records facilitate better care coordination? Choose 2 answers

A saving time typing rather than writing

B increasing the accuracy of diagnosis and health outcomes

C preventing an increase in the number of medical errors

D improving communication among health providers

Q43 Rick a 91 year old male, hasa history of chronic otitis media and is experiencing mild hearing loss in hisright ear,what type of assistive technology would Rick use to improve communicative function?

A icon communication board

B behind the ear ( BTE) hearing aid

C Augmentive and alternative communication ( AAC)

D completely in the canal ( CIC) hearing aid

Q 44 An elderly patient has suffered a stroke and is currently in the process of transitioning out of the hospital and into an assisted living facility. The patient's primary diffulty after the stroke is dealing with dysarthria, whichhas limited the patient's ability to speak. whatcommunication technology would appropriately promote an optimal transition of care for the patient?

A an over the ear (OTE) hearing aid

B an augmentation and alternative communication ( AAC) device

C an assistive listening device ( ALD)

D an analog technology to amplify sound

Q45 what must the nurse inform the patient and family or caregivers about assistive devices? Choose 2 answers

A may lessen the importance of ongoing communication with healthcare providers.

B they may result in complete recovery from chronic illness

C they may limit complications of an illness or disability.

D they may enable independent performance and reduce risk of injury.

Q46 An 81 year old Patient has multiple chronic conditions including uncontrolled hypertension and peripheral artery disease and agrees to try assertive devices for monitoring blood pressure and improving circulation provided by a home health agency. Choose 2 answers

A allowing the patient enough time and opportunity for repetition

B only presenting the most relevant content to the patient.

C refraining from suggesting mnemonic devices to Aid the patients use of Technology

D having an outside educator provide several hours of detailed device instructions

Q47 A goal of the National Health Initiative healthy people 2010 is to increase the quality and extend the years of healthy life. What are two ways that this initiative can achieve its goal? Choose 2 answers

A by pressuring older adults who are lonely to move to nursing homes at younger ages

B By encouraging people to have more children so that the children can help their parents as they grow older

C by helping people overcome views of denial and foreboding as old age approaches

D by trying to spread the view that aging is natural and need not include illness and disease

Q48 match each government program with its description. Answer options may be used more than once or not at all

A provide health insurance for low-income families

B bases basic benefits on a workers average indexed monthly earnings in covered employment

C offers a payment system for long-term care ( LTC) foreligible older Americans and persons with disabilities

D is the health insurance program for those 65 or other people with disabilities

Q49 a senior is being cared for by her daughter. The daughter works a full-time job and is only able to care for her mother before she goes to work. On her lunch break, andafter she gets off work. thesenior expresses to a nurse that she gets lonely during the day and sometimes cannot perform tasks by herself.which community resource should the nurse recommend looking into?

A a local Health Clinic

B Day Care Services for Seniors

C a medication assistance program

D Meals on Wheels.

Q50 the Independence at home demonstration was created by the Affordable Care Act. Which statement is true regarding Primary Care teams participating in this initiative?

A the teams are led by a licensed administrator

B the teams must serve at least 500 Medicare beneficiaries.

C the teams be led by a physician.

D the teams can be lead by a nurse practitioner.

Q51 which important facts about Medicare should nurses know? Choose 2 answers

A Medicare requires income assessment in order to qualify for coverage

B Medicare cover assisted living services for Americans in extreme poverty.

C Medicare recipients range from those simply needing Wellness services to those who are profoundly Frail.

D Medicare covers certain disabled Americans who have not reached age eligibility.

Q52 what is a common preventable error that can occur during the transition of care for older adults?

A unhelpful Hospital staff B inaccurate medication reconciliation.

C disorganized dosing schedule

D lost nursing equipment.

Q53 how is communication further facilitated? Choose 2 answers

A through communication to between and among the patients family caregivers and health care providers

B through active engagement of patients and family caregivers with a focus on meeting the patients goals

C through reliance on use of text messages that are less disruptive to the patient and family.

D through Healthcare Providers conversing with the patient and allowing the patient speak with the family.

Q54 what are appropriate evaluation measures related to successful transitions of care? Choose 2 answers

A emotional and social domains of quality of life.

B all clinical indicators related to Chronic conditions.

C functional status

D exclusion of nursing sensitive measures.

Q55 a critical competency in geriatric nursing is the ability to assess family knowledge of the skills necessary in the care of older adults. What Broad caregiver competencies are included in this assessment?

A knowing the science behind the scenes of geriatrics

B allowing the active participation of the patient in all aspects of care.

C balancing the patient autonomy with safety

D knowing how to safely start an IV.

Q56 what Communications techniques promote safe transition of care in patients with aphasia?

A respond in the affirmative when a question is asked

B speak softer so as to never have a harsh tone

C give the patient time to speak

D use non-verbal gestures to communicate.

Q57 what roles of the nurse protect the patient from harm in a care transition?

A symptom manager,educator, collaborator, carecoordinator.

B medication manager screener educator listener

C liasson with Hospital decision maker collaborator coordinator

D decision maker Symptom Manager care coordinator.

Q58 which statements are true regarding health-related quality of life? Choose 2 answers

A cannot be measured in persons with chronic illness

B is measured by and object Observer, basedon the number of times an individual emits both verbal signs of happiness and well-being

C is measured by individuals perceived healthy days per month.

D can be measured by an instrument developed by the center of Disease Control (CDC)

Q59 several options are available as a care approaches to chronic illness care. Which method best describes palliative care?

A care that is only delivered by family or other personal caregivers

B end-of-life care that suspends active treatment

C a combination of active treatment and comfort measures

D a continued focus on here rather than comfort and quality of life.

Q60 A nurse caring for people at the end of their lives knows that Dysnea is relatively common and interferes with patients'comfort and rest. What is the evidence based intervention for shortness of breath?

A liquid morphine at starting dose of 10 mg every 4 hours and titrating dose upward until dyspnea is relieved.

B administer O2 at least 5 liters per minute

C 5 mg of liquid morphine every 4 hours,along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness.

D elevate the head of the bed no more than 20 degrees.

Q61 what do dying persons typically experience grief over?

A loss of bodily function and independence that occurs as illness becomes more prevalent

B loss ability to give and receive love

C loss of basic beliefs,values and faith.

D the feeling that nobody cares that the person is dying.

Q62 which of the following is often the biggest barrier to overcome in crucial conversations to death and dying?

A mistrust of healthcare providers

B lack of energy

C societal attitudes about death

D cost of care

Q63 The End of life Nursing Education consortium (ELNEC) is a resource targeted to nurse providing end of life care that supports evidence based care of dying patients and their families,as well as self care that lessens stress and anxiety and sustains nurse in providing excellent end of life care. Which of the following are self care principles? Choose 2 answers

A maintaining professional boundaries and relationships with patients and families, by tightly controlling feelings and empathy

B. Making good use of the expertise and support of the interprofessional care team

C. Diminishing attention on maintaining an active personal life since end-of-life care is a callings of sorts

D. Developing expertise in symptom management, which not only helps patients and their families, but increases satisfaction and lessens anxiety among professional caregivers

Q64. In addition to a living will, advanced directives may also include a durable power of attorney that encompasses health care related decision making. Which two of the following are accurate so statements regarding the legal instrument known as the durable power of attorney?

A. The alternative decision maker must be a close relative of a dying persons in order to understand his or her wishes.

B. It allows for an alternative decision maker in the event that the dying persons is incapacitated and no longer able to make health care decision

C. The living will remains a useful tool in providing direction to the alternate decision maker.

D. A durable power of attorney for health care decision also enables the alternative decision maker to also handle finances and other legal matters.

PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION:

1 - Please share your experience on selecting a managed care plan. Please discuss the advantages and disadvantages of your MCO plan.

Up until about ten years ago my company offered an HMO MCO plan option managed by Kaiser Permanente. This plan was less expensive in my paycheck deduction and offered $10 co-pays for every office visit and 100% hospitalization. In 1992 as a single young man in my twenties I found this option very attractive. I ended up getting married early that year, had a flu episode and a bout of food poisoning. My wife ended up with a hospitalization as well. What looked good on paper ended up being a very restricted healthcare experience. My office visits were restricted to only one clinic where the health care professional point of contact were physicians assistants under the supervision of an MD which we never saw. All of the prescriptions were for generic medicines and when my wife was hospitalized she was not allowed branded medicines either. We also thought she was discharged too early. The advantages of this type of plan are costs and simplicity. If we had not been sick that year we probably would have signed back up for it. The disadvantages were that our level of care was reduced to a less skilled health care professional and the attending physician who cared for my wife in the hospital discharged my wife early due to a time limit the HMO had placed on the length of stay for her illness code. That was the first and last year I chose an MCO plan for my health coverage.

2 - Many argue that there is no consistent, direct correlation between the cost of care and its quality in a managed care program. Do you agree or disagree?

In my personal experience managed care plans attempt to lower the primary care contact to non MD health care professionals such as Nurse Practioners and Physicians Assistants. While these clinicians are well trained and certainly have their appropriate place in medicine, they do not have the extensive medical training that MDs and DOs spend a minimum of 8 years mastering. These clinicians cost less than MDs and are very attractive way to reduce staffing costs. As a patient however I prefer the highest skilled level clinician caring for me and my family and am willing to pay more for this higher level of care. In my opinion Kaiser Permanente may have saved money but I was not happy with the level of care and medicines provided. They may have saved money that year but they lost me as a customer. Epstein et al, (2014) compared Accountable Care Organization (ACO) patients with non ACO patients and while they found that there were many differences in spending, age, and severity of illness, there was no difference in quality metrics despite non ACO members costing more overall. It would seem that in this example costs can be lowered without affecting quality outcomes. However ACO participants had access to significantly more participating clinicians and hospitals. What is missing from this study is a patient survey comparing the satisfaction of ACO and non-ACO patients.

3 - Do you think patients' choice of provider and access to care will be limited under ACOs?

In my personal experience and through observations of managed care offices and hospitals as a pharmaceutical representative, ACOs not only restrict the choice of provider and access to hospitals they utilize lesser trained medical professionals in Primary Care, Specialty and Hospitals in addition to restricting access to branded medications. This observation is in agreement with Epstein et al, (2014) in which ACO members cost less but had less access and choice of participating access points and clinicians.

4 - In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?

ACOs can be very useful in curbing costs. For those with limited health care budgets or those patients who receive public assistance an ACO model whether public or private. However Lewis et al, (2014) found that even though there was an almost even split between ACOs contracting for private and public contracts in the U.S.A., public contracts were less profitable than private ones due to public patients costing more to manage per capita than private ones. Quality was not examined. It would seem that an ACO would be ideal when faced with limited resources but ACOs may be reluctant to engage in contracts that are less profitable.

Item 1 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version (written in 2002) The technological tools available today for creating computer-based learning materials are incredibly more powerful than those introduced just a few years ago. We can make our own movies with camcorders in our homes; we can publish our own books. Soon teachers and students will be able to use computer-video technology to produce their own learning materials. All it takes is time, know-how, and some funds. References: Frick, T. (1991). Restructuring education through technology. Bloomington, IN: Phi Delta Kappa Educational Foundation. Computers are so powerful that K-12 educators and students are now able to produce their own multimedia and Web-based learning materials. They just need to take the time required to learn to use the authoring tools and related technologies such as digital cameras and camcorders. References: Frick, T. (1991). Restructuring education through technology. Bloomington, IN: Phi Delta Kappa Educational Foundation. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 2 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version The philosophical position known as constructivism views knowledge as a human construction. The various perspectives within constructivism are based on the premise that knowledge is not part of an objective, external reality that is separate from the individual. Instead, human knowledge, whether the bodies of content in public disciplines (such as mathematics or sociology) or knowledge of the individual learner, is a human construction. References: Gredler, M. E. (2001). Learning and instruction: Theory into practice (4th Ed.). Upper Saddle, NJ: Prentice-Hall. The philosophical position known as constructivism views knowledge as a human construction. The various perspectives within constructivism are based on the premise that knowledge is not part of an objective, external reality that is separate from the individual. Instead, human knowledge is a human construction. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 3 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version Educational researchers, policymakers, and practitioners agree that educational research is often divorced from the problems and issues of everyday practice--a split that creates a need for new research approaches that speak directly to problems of practice (National Research Council [NRC], 2002) and that lead to the development of "usable knowledge" (Lagemann, 2002). Design-based research (Brown, 1992; Collins, 1992) is an emerging paradigm for the study of learning in context through the systematic design and study of instructional strategies and tools. We argue that design-based research can help create and extend knowledge about developing, enacting, and sustaining innovative learning environments. References: DBRC (Design-Based Research Collective). (2003). Design-based research: An emerging paradigm for educational inquiry. Educational Researcher, 32(1), 5-8. A decade later, researchers interested in studying learning in naturalistic settings (inspired by Brown's approach) began a concerted effort to define the standards and argue the legitimacy of this type of research through design. For example, the Design-Based Research Collective defined design-based research (DBR) as "an emerging paradigm for the study of learning in context, through the systematic design and study of instructional strategies and tools" (DBRC, 2003, p. 5). References: DBRC (Design-Based Research Collective). (2003). Design-based research: An emerging paradigm for educational inquiry. Educational Researcher, 32(1), 5-8. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 4 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version There is a design methodology called rapid prototyping, which has been used successfully in software engineering. Given similarities between software design and instructional design, we argue that rapid prototyping is a viable method for instructional design, especially for computer-based instruction. References: Tripp, S. D., & Bichelmeyer, B. A. (1990). Rapid prototyping: An alternative instructional design strategy. Educational Technology Research and Development, 38(1), 31-44. Rapid prototyping could be an advantageous methodology for developing innovative computer-based instruction. Software engineers have been successful in designing applications by using rapid prototyping. So it also could be an efficient way to do instructional design. References: Tripp, S. D., & Bichelmeyer, B. A. (1990). Rapid prototyping: An alternative instructional design strategy. Educational Technology Research and Development, 38(1), 31-44. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 5 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version The goal of instruction for the behaviorist is to elicit the desired response from the learner who is presented with a target stimulus. To accomplish this, the learner must know how to execute the proper response, as well as the conditions under which that response should be made. Therefore, instruction is structured around the presentation of the target stimulus and the provision of opportunities for the learner to practice making the proper response. References: Ertmer, P. A., & Newby, T. J. (1993). Behaviorism, cognitivism, constructivism: Comparing critical features from an instructional design perspective. Performance Improvement Quarterly, 6(4), 50-71. According to behaviorism, instruction should provide necessary stimulus in order for learners to produce desired response. It is important that the learner must know how to execute the proper response under the required conditions in order to produce the desired response (Ertmer & Newby, 1993). Instruction should provide learner with opportunities that the learner practice to elicit the desired outcome. References: Ertmer, P. A., & Newby, T. J. (1993). Behaviorism, cognitivism, constructivism: Comparing critical features from an instructional design perspective. Performance Improvement Quarterly, 6(4), 50-71. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 6 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version A teacher is one who guides or leads. To guide does not necessarily mean to instruct directly. We often think of teaching as direct instruction (presenting information, asking questions, giving feedback, demonstrating some procedure, evaluating student progress, and so on). But a teacher can guide without instructing directly. A good example is the Montessori system of education. In a Montessori school, most of what a child learns is through interacting with a variety of curriculum materials in a particular context. A Montessori teacher does much less direct instruction than do teachers in traditional schools. References: Frick, T. (1991). Restructuring education through technology. Bloomington, IN: Phi Delta Kappa Educational Foundation. Teachers should be guides or leaders. In the role of a guide, a teacher does less presenting of information, demonstrating and providing feedback. For example, in a Montessori school, most student learning occurs through interaction with a variety of class materials, rather than interaction with a teacher. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 7 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version The philosophical position known as constructivism views knowledge as a human construction. The various perspectives within constructivism are based on the premise that knowledge is not part of an objective, external reality that is separate from the individual. Instead, human knowledge, whether the bodies of content in public disciplines (such as mathematics or sociology) or knowledge of the individual learner, is a human construction. References: Gredler, M. E. (2001). Learning and instruction: Theory into practice (4th Ed.). Upper Saddle River, NJ: Prentice-Hall. Does knowledge exist outside of, or separate from, the individual who knows? Constructivists argue that human knowledge, such as what is known in the fields of mathematics or sociology, as well as knowledge about learning itself, is a human construction (Gredler, 2001). References: Gredler, M. E. (2001). Learning and instruction: Theory into practice (4th Ed.). Upper Saddle River, NJ: Prentice-Hall. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 8 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version There is a desperate need for theorists and researchers to generate and refine a new breed of learning-focused instructional design theories that help educators and trainers to meet those needs, (i.e., that focus on learning and that foster development of initiative, teamwork, thinking skills, and diversity). The health of instructional-design theory also depends on its ability to involve stakeholders in the design process. References: Reigeluth, C. M. (1999). What is instructional design theory and how is it changing? In C. M. Reigeluth (Ed.), Instructional-design theories and models volume II: A new paradigm of instructional theory. Mahwah, NJ: Lawrence Erlbaum Associates. We need theorists and researchers to generate and refine learning-focused instructional design theories. Such theories will help educators and trainers to meet needs that focus on learning and that foster development of initiative, teamwork, thinking skills, and diversity. Instructional-design theory must involve stakeholders in the design process. References: Reigeluth, C. M. (1999). What is instructional design theory and how is it changing? In C. M. Reigeluth (Ed.), Instructional-design theories and models volume II: A new paradigm of instructional theory. Mahwah, NJ: Lawrence Erlbaum Associates. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 9 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version Learning is a complex set of processes that may vary according to the developmental level of the learner, the nature of the task, and the context in which the learning is to occur. As already indicated, no one theory can capture all the variables involved in learning. References: Gredler, M. E. (2001). Learning and instruction: Theory into practice (4th Ed.). Upper Saddle, NJ: Prentice-Hall. A learning theory, there, comprises a set of constructs linking observed changes in performance with what is thought to bring about those changes. References: Driscoll, M. P. (2000). Psychology of learning for instruction (2nd Ed.). Needham Heights, MA: Allyn & Bacon. A learning theory is made up of a set of constructs linking observed changes in performance with whatever is thought to bring about those changes. Therefore since "learning is a complex set of processes that may vary according to the developmental level of the learner, the nature of the task, and the context in which the learning is to occur," it is apparent that no one theory can capture all the variables involved in learning (Driscoll, 2000, p.10). References: Driscoll, M. P. (2000). Psychology of learning for instruction (2nd Ed.). Needham Heights, MA: Allyn & Bacon. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints Item 10 In the case below, the original source material is given along with a sample of student work. Determine the type of plagiarism by clicking the appropriate radio button. Original Source Material Student Version It is helpful to think in terms of two basic kinds of change: piecemeal and systemic. Piecemeal change leaves the structure of a system unchanged. It often involves finding better ways to meet the same needs, such as using an analogy to help your students learn the science concepts you taught in an otherwise similar manner last year. In contrast, systemic change entails modifying the structure of a system, usually in response to new needs. References: Reigeluth, C. M. (1999). What is instructional-design theory and how is it changing? Instructional-design theories and models: A new paradigm of instructional theory (Vol. 2, pp. 5-29). Mahwah, New Jersey: Lawrence Erlbaum. Reiguleth (1999) mentions two different kinds of change: Piecemeal and Systemic change. Systemic change entails modifying the structure of a system, in order to meet new needs. In contrast, piecemeal change leaves the structure of a system unchanged. For example, new innovations instead of traditional methods could be used to engage students in learning. Which of the following is true for the Student Version above? Word-for-Word plagiarism Paraphrasing plagiarism This is not plagiarism Hints

HLTH344 Chapter Notes - Chapter 1: Social Anthropology, Deductive Reasoning, Health Promotion

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