EXAM #1 STUDY GUIDE

QALYs

(quality-adjusted life years) - a way of comparing mere survival without vitality to survival with good health

three reasons for initiating end of life discussions

- information changes choices -could receive undesired treatments -healing relationships, goals, wills, preparation

concrete operational stage

7-12 years logical abilities to concrete ideas, arithmetical thinking, death irreversibility

three topics in end of life discussions

-advance directives (will) -DNR orders, mechanical ventilation, feeding tube, antibiotics, hemodialysis -palliative care (pain mgmt, suffering)

what are the aims of palliative care

-control pain -relieve suffering -provide care for all needs -help patients achieve good/peaceful death

What are three sources of caregiver stress?

-feelings of inadequacy -non-reciprocal giving -too many demands -devalued -inability to save a life

List three Urgent Clinical Indications for Discussing End-of-Life Care

-imminent death -talking about wanting to die -inquiries into hospice/palliative care -recently hospitalized for severe progressive illness -severe suffering poor prognosis

What is the approximate death rate per 1000 in the United States today?

8.7 per 1000

respite care

a type of care provided for caregivers of homebound ill, disabled, or elderly patients

identity vs role confusion

b..11-18 who the frick am I, death can affect identity/self-formation, self care, whats important

sensorimotor

birth -2 yrs; focus on senses, motor abilities, object permanence

trust vs mistrust

birth-2: predictability, death can prolong the learning outcome early stages -> death/divorce/changes can prevent development of child, send message that things aren't predictable

According to the text, what is the leading cause of death in the United States today?

chronic illness, heart disease/cancer/stroke

define & one challenge of nonmaleficence

doing no harm -certain medical procedure, CPR, having to be an advocate for the wants and the wishes of the patients foremost

In many traditional societies, death is believed to occur because _______________?

ecological orientation, phenomena like the moon/wind/hereditary/behavior, socioeconomic and psychological, natural/supernatural, social interactions

In which country was the most influential modern hospice established?

england

define & one challenge of justice

fairness, how can you fairly distribute goods & services over population -accessibility

list and describe three agents of socialization

family, school and peers, mass media, religion

Approximately how much has the average life expectancy in the United States increased since 1900?

from 47 to 77 years

define & one challenge of beneficence

greater good for all of us

institutional medical care

hospitals, nursing homes, hospice programs

According to the text, what percentage of Americans are affiliated with a religious tradition?

more than 90%

health care triangle

patient, staff, insitutions

define & one challenge of autonomy

patients right to self determination -individualism -prognosis of at least 6 months, affordability of where you want to be, home, hospice etc - guardian preventing a child from receiving care -information, giving a variety of options to the patient

define hospice care

program of caring that is oriented towards the needs of dying patients/families, comfort over care

Define Epidemiologic transition

redistribution of deaths from the young to the old, historical shift in disease patters

Childhood experiences with death are most likely to

shape a person's attitudes and beliefs about death

Traditional societies tend to view disease and death as ________________?

something is out of balance; supernatural causes

describe three aspects that comprise cultural sensitivity

stereotyping, judging, difference within than between cultural groups

define thanatology

study of death and its practices, needs of terminally ill/families

The sociological theory that most resembles the study of the human body is:

the structural functionalist approach

What does the statement "Death involves causality" mean?

there are biological reasons for the occurrence of death

define & one challenge of fidelity/trust

trusting someone, patient/caregiver relationship, free will

what four aspects does a mature concept of death include

universality, irreversibility, non-functionality, causality

three challenges to hospice care

-presence of primary caregiver who is available 24/7 -adequate funding -6 month rule -underserved populations

three features and goals of hospice care

-provide relief of pain/suffering -promote aura of peacefulness/acceptance of dying -treat patient/family as unit of care -designed for those in final stages of terminal illness who agree to forgo medical interventions intended to extend life

describe three ways religions function in societies

-shared set of beliefs, values, norms that help form common identity for people -answers to big questions about existence and purpose -foundation for norms, laws for society -emotional, psychological support

list 4 principles / goals for a "good death?"

-to know that death is coming, understand what can be expected -able to retain reasonable control over what happens -afforded dignity -adequate relief of pain/other symptoms -choice where death occurs -information -access to desired spiritual/emotional support -time to say goodbye

What are the five major social institutions delineated by sociologists?

1. economy 2. educational 3. family 4. political 5. religion

What percentage of the gross domestic product of the United States in 2000 was spent on health care?

1.3 trillion

formal operational

12+ years abstract reasoning, hypothetical reasoning, interest in synthesizing, chess lmfao

autonomy vs shame

2-3: toddlerhood, letting go and holding on, loss of parent can cause regression to earlier behaviors ie clinging crying crawling, demanding, showing frustration

preoperational stage

2-7 yrs exploration, language and symbols, what makes things die

initiative v guilt

3-5 preschool/kinder years, seek own purpose and direction; looking for approval from adults/parents, placing themselves in society

industry v inferiority

5-11 very active, comparison making, recognition/encouragement, death big impact

define palliative care

active total care of patients whose disease is unresponsive to curative treatment

Hospital health care focuses primarily on which aspect of the patient's well-being?

acute intensive care of a limited duration

What are characteristics of the concept of invisible death?

death-related attitudes and practices

DRGs

diagnostic related groups, involve predetermined schedule of fees for reimbursement to care providers