N138 Final
Which types of studies carry the most weight in nursing?
Descriptive or qualitative studies may inform practice, but well-executed, randomized, controlled trials carry much weight in immediate change in practice
In Leninger's theory, what is the focus? What is another name for this theory?
Focus: What are the best ways to provide care to my patient that are culturally congruent? Transcultural Care Theory
What is nursing research and why is it important?
Nursing research: systematic investigation of phenomena related to improving patient care Research builds nursing knowledge and leads to safer and more effective patient care.
Distinguish open systems from closed systems
Open systems promote the exchange of matter, energy, and information with other systems and the environment (suprasystem), and closed systems don't.
Distinguish among Orem's model, King's model, and Roy's model
Orem: focus is "What deficits does this patient have in providing his or her own self-care?" King: focus is on "what goals can we set together to restore the patient to health?" Roy: focus is on "how can I modify this patient's environment to facilitate his or her adaptation?"
How does the suprasystem affect homeostasis?
The environment can either promote or interfere with homeostasis and the well-being of individuals. In Maslow's hierarchy of needs, there is a dynamic interaction between a person's needs (internal) and the satisfaction of those needs (often external).
What are the assumptions of Maslow's hierarchy of needs (human needs theory)?
- Basic needs have to be at least partially satisfied before higher-order needs can become relevant to the individual - Individuals meet their needs in different ways - The manner the needs are met and the extent by which these are considered needs vary according to each individual (importance of individualized nursing care)
Describe the concept of "locus of control." How does it relate to healthcare behaviors?
- Internal locus of control: belief that your health is internally controlled by what you do. People with an internal locus of control are more likely to change their healthcare behaviors. - External locus of control: belief that your health is controlled by outside factors or chance. People with an external locus of control are less likely to change their health behaviors.
Under what three conditions might a problem be amenable to being addressed by research?
1) A conceptual framework exists or can be constructed from previous research 2) Based on related research findings published in professional, peer-reviewed journals or is supported by similar ongoing research in other settings 3) Carefully designed - the results will be applicable in similar situations, or will generate hypotheses for further research and testing
What are the three fundamental concepts of professional nursing practice?
1) A person is an open system with human needs 2) A person is influenced by their environment (the suprasystem in which they live) 3) A person's health is on a continuum
In Henderson's theory, what are the 14 basic needs of patients? What are they centered around?
1) Breathe normally. 2) Eat and drink adequately. 3) Eliminate body wastes. 4) Move and maintain desirable position. 5) Sleep and rest. 6) Select suitable clothes—dress and undress. 7) Maintain body temperature within normal range by adjusting clothing and modifying the environment. 8) Keep the body clean and well-groomed and protect the integument (skin). 9) Avoid dangers in the environment and avoid injuring others. 10) Communicate with others in expressing emotions, needs, fears, or opinions. 11) Worship according to one's faith. 12) Work in such a way that there is a sense of accomplishment. 13) Play or participate in various forms of recreation. 14) Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. All: Centered around the goal of the patient achieving independence
What are the the three steps of valuing? What aspects of valuing are they associated with?
1) Choosing is the cognitive (intellectual) aspect of valuing 2) Prizing is the affective (emotional) aspect of valuing 3) Acting is the kinesthetic (behavioral) aspect of valuing Note: All three steps must be taken or the process of valuing is incomplete.
What are the six steps of ethical decision making?
1) Clarify the ethical dilemma 2) Gather additional data 3) Identify options 4) Make a decision 5) Act 6) Evaluate
What are three categories of beliefs:
1) Descriptive or existential: can be shown as true or false (e.g. the sun will come up tomorrow morning) 2) Evaluative beliefs: include a judgment about what is good or bad (e.g. believing that advanced life support for a 90-year-old is immoral) 3) Prescriptive beliefs (encouraged, e.g. every voter should vote in every election) and proscriptive beliefs (prohibited, e.g. people should not have sex outside of marriage)
In Orem's theory, what three operations are used to develop appropriate care for a patient?
1) Diagnostic: beginning with nurse-patient relationship, determine the patient's ability to provide effective self-care, identify self-care deficits 2) Prescriptive: Nurse formulates plan of care 3) Regulatory: Nurse designs, plans, and produces system for care - Can be wholly compensatory (for patients with little or no self care abilities) to supportive-educative (for a patient who already has the ability to provide care for self)
What are 6 types of ethical dilemmas?
1) Dilemmas resulting from personal value systems (e.g. a nurse's personal values conflict with hospital policy) 2) Dilemmas involving peers and other professionals' behavior (e.g. a colleague who is working under the influence of drugs) 3) Dilemmas regarding patients' rights (e.g. of people who are "mentally retarded", disabled, dying, pregnant, seniors) 4) Dilemmas regarding immigration and migration (e.g. language barriers and migration of nurses) 5) Dilemmas created by institutional and social issues (e.g. health insurance, ethics committees) 6) Dilemmas created by patient data access issues (e.g. HIPAA, computer ethics)
In Watson's theory, what are the 10 caritas processes to guide the nurse to act and think within a caring-focused paradigm?
1) Embrace altruistic values and practice loving kindness with self and others. 2) Instill faith and hope and honor in others. 3) Be sensitive to self and others by nurturing individual beliefs and practices. 4) Develop helping-trusting-caring relationships. 5) Promote and accept positive and negative feelings as you authentically listen to another's story. 6) Use creative scientific problem-solving methods for caring decision making. 7) Share teaching and learning that addresses the individual needs and comprehension styles. 8) Create a healing environment for the physical and spiritual self which respects human dignity. 9) Assist with basic physical, emotional, and spiritual human needs. 10) Open to mystery and allow miracles to enter.
In Watson's theory, what are the five elements of healing?
1) Environment: one that supports human caring 2) Person: both the patient and the nurse 3) Health: in terms of health promotion and illness prevention 4) Nursing: what nurses contribute to the encounter with the patient 5) Caring
What four things does Benner and Wrubel's theory of nursing propose?
1) Expert nurses develop skills and understanding of patient care over time through a proper educational background as well as a multitude of experiences. 2) Caring is essential in healing 3) Nursing is an independent practice 4) Body and mind are not separate
What are 5 types of systems found in the suprasystem? Define and note challenges of each.
1) Family systems - Definition: as defined by the patient, includes nuclear and extended - Challenges of single-parent families and increase in geographic mobility 2) Cultural systems - Definition: the attitudes, beliefs, and behaviors of social or ethnic groups that have been perpetuated through generations - Challenges: avoiding ethnocentrism and focusing on patient-centered care and integration of cultural beliefs. 3) Social systems - Definition: can include family, neighborhood, schools, churches, civic groups, recreational groups, etc. - Challenges: factors affecting social systems are family income, proximity to neighbors, access to medical care, whether people have children, etc. People with many changes in social support are more likely to get sick. 4) Poverty - Definition: Living with depravation and the scarcity of necessities like food and adequate housing - Challenges: people in poverty have lower access to healthcare, adequate nutrition, food insecurity, inability to pay rent/utilities 5) Community, national, and world systems - Definition: anything from a neighborhood to the universe - Challenges: Nurses can contribute to a healthier world environment by supporting, promoting, and, when possible, participating in humanitarian responses to national and international disasters
The uniqueness of an individual is determined in these three ways
1) Genetically 2) Environmentally 3) Experientially
What are three limitations of the strict definition of the scientific method in nursing?
1) Health settings are not comparable with laboratories 2) Human beings are far more than collections of parts that can be dissected and subjected to examination or experimentation 3) The claim for objectivity (freedom from bias). For example, things like questionnaires can't incorporate the full patient experience, and patient responses can be based on a lot of things that have nothing to do with the question being asked.
Name and describe two national health initiatives
1) Healthy People 2020 - surgeon general report on health promotion and disease prevention. 42 topics (mental and physical), re-done every 10 years 2) Public Health 2030 - published in 2014, recommendations for public health agencies to help them protect the health of the public
In Neuman's theory, what are the three categories of stressors?
1) Intrapersonal: occurring within the individual 2) Interpersonal: between one or more individuals 3) Extrapersonal: outside of the individual
What are three services offered as part of secondary care?
1) Management of patients with suspected or new diagnosis of a complex illness 2) Evaluate patients with chronic illnesses who may need treatment changes 3) Provide counseling or other therapies that are not available in primary care settings
What are the eight factors contribute to the holistic approach to learning?
1) Nursing is an open system. 2) Nursing is the provision of health care services. 3) Nursing involves collaborating with patients and their families. 4) Nursing is integrally involved with people. 5) Nursing care is provided regardless of diagnosis, individual differences, age, beliefs, gender, sexual orientation, or other factors. 6) Nurses require advanced knowledge and skills. 7) Nursing requires concern, compassion, respect, and warmth, as well as comprehensive, individualized planning of care, to facilitate patients' growth toward wellness. 8) Nursing links theory and research.
What are the four key concepts of Roy's Adaptation Model?
1) Physiological 2) Self-concept 3) Role function 4) Interdependent
What are the part's of Maslow's hierarchy of needs (human needs theory)?
1) Physiological needs: food, oxygen, rest, activity, shelter, and sexual expression 2) Physical and psychological safety and security: reasonably predictable environment with which one has some familiarity and relative freedom from fear and chaos 3) Love and belonging: close intimate relations, social relations, a place in the social structure 4) Self-esteem: need to feel self-worth, self-respect, and self-reliance 5) Self-actualization: realized maximal potential
Differentiate between the five levels of services provided
1) Primary care services: when the patient first enters the healthcare system 2) Secondary care services: management of a condition by a specialist after being referred by a primary care provider. 3) Tertiary care services: Provided to acutely or terminally ill, those requiring long-term care, and those needing rehabilitation services. 4) Quaternary care: Research facilities or a highly specialized area of surgery requiring specialized care before, during, and after (e.g. fetal surgery) 5) Subacute care services: Goal-directed, comprehensive, inpatient designed for acute illness, injury, or exacerbation of disease process (more intensive than a SNF, but not as intensive as a hospital)
In Neuman's theory, what are the three kinds of prevention?
1) Primary: used when stressor is suspected or identified 2) Secondary: after symptoms from stressors occurred 3) Tertiary prevention: occurs after treatment or secondary stage
Which seven roles make up the nursing staff in a hospital?
1) RNs 2) LVNs 3) UAPs (unlicensed assistive personnel) 4) Clerks 5) Unit managers 6) Clinical directors or supervisors (middle managers) 7) Combined responsibilities: something else combined with direct patient care (e.g. nurse educators, researchers, clinical nurse specialists, infection control)
Define scientific method and bias
1) Scientific method: systematic way of thinking, research based, based on previous work of other experts in the area 2) Bias: systematic distortion of a finding from data, often resulting from a problem with the sample
How can nurses stay aware of new evidence? (5 things)
1) Seek out continuing education courses 2) Attend professional conferences 3) Read professional journals 4) Be a member of a professional organization 5) Seek out and critique research findings to implement best practices in nursing practice
Name and describe four kinds of social support
1) emotional (caring, love, encouragement) 2) companionship (belonging, people to share activities with) 3) informational (advice, guidance) 4) material/tangible (financial, providing materials/services).
What are the 5 goals of primary care services?
1. Entry into the system 2. Emergency care 3. Health maintenance 4. Management of long-term and chronic conditions 5. Treatment of temporary health problems that do not require hospitalization
Describe deontology and distinguish between act deontologists and rule deontologists
An act is moral if its motives or intentions are good, regardless of the outcome (e.g. Kant) - Act deontologists: determine the right thing to do by gathering all the facts and then making a decision - Rule deontologists: emphasize that principles guide our actions
Explain the dynamic nature of systems
A change in one part of the system creates change in other parts. There is continuous exchange of energy and information within open systems, between open systems, and in the suprasystem. If they all work well together, we have homeostasis.
What is a code of ethics for nursing? Give three examples.
A code of ethics is a social contract through which the profession informs society of the principles and rules by which it functions. 1) 1893: Nightingale Pledge 2) ANA Code of Ethics for Nurses (latest: 2015) 3) ICN Code of Ethics for Nurses (latest: 2012)
What is the Luminary Project?
A collaboration to "light the way to environmental health" in healthcare settings. For example, it includes having bins in hospitals to be able to redistribute unused supplies (rather than throw them away)
What is General Systems Theory?
A common framework for studying several similar disciplines, allows scientists and scholars to organize and communicate findings, making it easier to build on the work of others
Within the category of "health promotion and maintenance," what four services are provided? What assumption is this category based on?
Assisting patients to: 1) remain healthy. 2) prevent diseases and injuries. 3) detect diseases early. 4) promote healthier lifestyles. Assumption: Patients who adopt healthy behaviors are more likely to avoid certain illnesses. E.g. prenatal classes, breast self-exams, mammograms
Distinguish beliefs from values
Beliefs: Represents our intellectual acceptance of something as either true or correct. They serve to guide our thinking and decision-making. Values: - Freely chosen principles, ideals, or standards held by an individual, class, or group that give meaning and direction to life. - An abstract representation of what is right, worthwhile, or desirable. - They define ideal modes of conduct and reflect what the individual endorses and tries to emulate. Both are relatively stable and resistant to change
What are bioethics?
Bioethics is the application of ethical theories and principles to moral issues or problems in health care (e.g. outlined in code of ethics)
What is evidence based practice (EBP)? What does it prevent?
EBP is an approach to the delivery of healthcare that integrates the best evidence from research studies and patient care data with clinician expertise and patient preferences and values. It is an element of critical thinking, and a good means of clinical judgment. EBP prevents nursing from deteriorating into just routine or traditional care.
Describe virtue ethics. What are its limitations?
Emphasizes the character of the decision maker. Individuals' actions are built from a degree of inborn moral virtue. Virtues are tendencies to act, feel, and judge that develop through appropriate training but come from natural tendencies. Limitations: assumption that every nurse has moral motives, requires a case-by-case approach, no defined decision making process
Distinguish between fidelity and veracity
Fidelity: faithfulness, or honoring one's commitments or promises - e.g. Fidelity to patients: practicing within scope of practice, keeping our skills current, following employer's policy, etc. Veracity: telling the truth, not lying - e.g. what to tell a patient who is asking if results are back, and they are, but you can't share them with them.
In Roy's theory, what is the focus? Under which conditions is a patient unable to cope?
Focus is "How can I modify this patient's environment to facilitate his or her adaptation?" When the demands of environmental stimuli are too high or the person's adaptive mechanisms are too low, the person's behavioral responses are ineffective for coping
What is the focus of Orem's theory? What are some names that this theory goes by?
Focus is "What deficits does this patient have in providing his or her own self-care?" Other names: Theory of Self Care, Theory of Self Care Deficit, Theory of Nursing System
In Watson's theory, what is the focus? How does Watson define health?
Focus is "how can I create an environment of trust, understanding, and openness so that the patient and I can work together in meeting his or her needs?" Defined health as harmony resulting from unity of body, mind, and soul, for which the patient is primarily responsible
In Henderson's theory, what is the focus?
Focus is on "what can I help this patient do that he would do for himself if he could?"
What is the focus of King's theory? What is the goal?
Focus is on the concerns of the patient and "what goals can we set together to restore the patient to health?" The goal of nursing is to attain or regain health.
What are health care disparities? What are the nine most common causes of health care disparities?
Health care disparities are differences in access to and the quality of health care provided to different populations. Causes of disparities: race, ethnicity, gender, age, income, education, disability, sexual orientation, and rurality
How is health defined in Benner and Wrubel's theory?
Health is more than just being free from illness and injury (physical health). Health is also social, mental, emotional, and spiritual.
Distinguish between Henderson's philosophy and Watson's philosophy
Henderson: focus is on "what can I help this patient do that he would do for himself if he could?" Watson: focus is on "how can I create an environment of trust, understanding, and openness so that the patient and I can work together in meeting his or her needs?"
What is homeostasis in systems theory?
Homeostasis is a dynamic balance achieved by effectively functioning open systems. It is attained by coordinated responses of organ systems that automatically compensate for environmental changes.
How does illness prevention differ from health promotion and maintenance?
Illness prevention services address health problems after risk factors are identified. Health promotion services seek to prevent development of risk factors, and in that way, decrease their effects.
How does homeostasis (in systems theory) apply to nursing?
Individuals, as open systems, endeavor to maintain balance between external and internal forces. When balance is achieved, the person is healthy or resistant to illness. If adaptation is unsuccessful, disequilibrium may occur, setting the stage for the development of illness or disease.
Distinguish between inductive and deductive reasoning
Inductive reasoning: the process beginning with a particular experience and proceeding to generalization. Inferences are made that lead to further research. Deductive reasoning: a process in which conclusions are drawn by logical inference from given premises. It proceeds from the general case to the specific. Conclusions that are drawn are "valid" but not necessarily true.
In King's theory, what are the three interacting systems?
King's theory provides a view of people from the perspective of their interactions with other people at three levels of interacting systems: 1) Personal system: Identifies concepts that provide an understanding of individuals, personality, and intrapersonality (e.g. pay attention to the patient's perspectives) 2) Interpersonal system: Deals with interactions and transactions between two or more people (e.g. explore the patient's roles and the stressors in each role) 3) Society system: presents concepts that consider social contacts (e.g. consider influences on the patient's decision making)
In Leninger's theory, what kind of knowledge should nursing care be based on?
Knowledge that is culturally defined, classified, and tested
Distinguish Kohlberg's stages of moral reasoning with Gilligan's.
Kohlberg only used males in his studies and Gilligan listened to women's experiences Kohlberg has a justice perspective ad Gilligan has a care perspective Congruent with nursing because of the focus on care, though nurses use both a justice and care perspective in moral decision making
Who are the medical staff in a hospital? How are they governed?
Medical staff is made up of physicians (either employed by the health care organization or independent), house staff (interns, residents, fellows), and hospitalists. They are often organized by service (e.g. cardiology, rheumatology, etc.) and they are governed by a chief of staff, bylaws, and a board of directors (including a credentials committee who ensures competence).
Distinguish among metaethics, normative ethics, applied ethics.
Metaethics— focuses on universal truths; where and how ethical principles are developed Normative ethics—focuses on the moral standards that regulate behaviors Applied ethics—focuses on specific difficult issues such as euthanasia, capital punishment, abortion, and health disparities
What is "diagnosis and treatment"? What are some pros and cons.
Modern technology helps refine methods of diagnosing and managing illnesses. Examples: Imaging and detection of cancers, minimally invasive surgery - Con: High-technology services can lead to dehumanization of patients. - Pro: Enables patient to go back to a normal life more quickly.
What is moral distress?
Moral distress is typically described as a response to a situation when nurses are faced with ethical dilemmas but also encounter institutional constraints that limit their actions
What are non-government organizations? Give examples.
Non-governmental groups of people that deliver resources or serve a social or political purpose E.g. Doctors without Borders, International Committee of the Red Cross
Distinguish between not-for-profit and for-profit agencies. Give examples.
Not-for-profit: use their profits to pay personnel or improve services, advertise, or educate. E.g. the Joint Commission For-profit: More of a risk that they won't treat people who can't pay. E.g. home health care
How are nurses governed? How are experts saying nursing should be governed?
Nursing government is currently founded on the principle that employees have the right and responsibility to govern themselves when it comes to work and time (shared governance). Research shows that this leads to improved patient outcomes and job satisfaction. Experts are saying it's time that nursing starts to use a professional governance model, which adds the attributes of accountability, professional obligation, collateral relationships, and decision making.
Distinguish among Peplau's theory, Neuman's theory, Leninger's theory, and Benner and Wrubel's theory
Peplau: Focus is on "Within the relationship with my patient, how can I best help him or her understand his or her health problems and develop new, healthier behaviors?" Neuman: Focus is on "How can I identify and address my client's stressors to restore their system and help them maintain stability and optimal wellness?" Leninger: Focus is "What are the best ways to provide care to my patient that are culturally congruent?" Benner and Wrubel: "How can I move from a novice to an expert, holistic, and caring nurse?"
What are voluntary (private) agencies? Give examples.q
Private volunteers who support agencies to promote or restore health Examples: March of Dimes, ACA, AHA, American Red Cross
Give an example of illness prevention?
Promoting cessation of alcohol use in patients with known liver disease
Distinguish among pure science, applied science, and transitional research.
Pure science (bench science): summarizes and explains the universe without regard for whether the information is immediately useful. It's just new knowledge. 2) Applied science (critical science): Practical application of scientific theory and laws. 3) Translational research: Conduit between bench research and bedside research. Can also take findings from clinical research and ask a new question to direct new research at the bench level.
Distinguish among quantitative research, qualitative research, and mixed methods research.
Quantitative research: standardized experimental designs with hypothesis, measurable variables and outcomes, and statistical analysis. Qualitative research: naturalistic inquiry or interpretivism - relies on data collection techniques like narrative interviews and participant observation. Commonly used in social sciences where measurement of phenomena may not be possible. No variables are being manipulated; rather, qualities of the human experience are described and interpreted Mixed methods research: combination of qualitative and quantitative.
What is "rehabilitation and long term care"
Rehabilitation services help restore the patient to the fullest possible level of function and independence after injury or illness. Rehabilitation with disease management services focuses on helping patients understand and manage chronic conditions. Long-term care provides services that the patient or family cannot provide but at levels that maintain individual independence as long as possible. Both patients and their families are going to have to be long-term participants E.g. congestive heart failure, diabetes
What are the four responsibilities of a hospital chief executive officer (CEO)? What minimum level of education do they have?
Responsibilities: 1) Ensures the institution runs efficiently 2) Promotes cost-effective options 3) Addresses health care issues in the community 4) Usually sits and reports to the board of directors Minimum education: Master's degree in business or hospital administration
What are the four responsibilities of the director of nursing (also known as the chief nurse executive [CNE], the chief nurse officer [CNO], or the vice president for nursing)? What minimum level of education do they have?
Responsibilities: 1) Oversee all nursing care provided at the institution 2) Serve as clinical leaders and administrators 3) Administrative responsibilities for departments other than nursing (surgery, pharmacy, respiratory, social, etc.) 4) Responsible for the nursing staff Minimum education is a master's degree in nursing, business, or health administration. Some hold joint masters (e.g. MSN and MBA or MHA and MBA)
What do local agencies do? Give examples.
Serve paying and non-paying citizens within a community or county. They give immunizations, prenatal care, well baby or child checks, STI clinics, etc. Example: Public health department is in this category
What are state agencies? Give examples.
Similar to federal agencies, but focus is on serving residents of a particular state. Examples: State departments of health and environment, departments of mental health, regulatory bodies (like SBNs), agencies that administer Medicaid services for those in poverty
What two organizations help to reduce mercury waste in healthcare?
The World Health Organization and Health Care Without Harm
In Neuman's theory, how is the patient viewed? What is the goal of nursing?
The patient is an open system that responds to stressors in the environment. The primary goal of nurses is the restore client system, maintain stability, and help attain optimal wellness.
Describe the concept of a hospital as a system with subsystems
The subsystems (all the working parts of the hospital, e.g. nurses, doctors, pharmacy, cafeteria) make up the overall hospital system, and the whole is greater than the sum of its parts. Synergy is only going to occur when all the subsystems work well together, and they create a result that they couldn't create on their own.
What are the components of General Systems Theory?
The suprasystem and subsystems under it. Each system has 5 parts: 1) Input: any material that enters a system 2) Throughput: the processes a system uses to convert the input into a form that can be used 3) Output: the end result or product of a system 4) Evaluation: measures the success/failure of the output (and consequently, the effectiveness of the system) 5) Feedback: the process of communicating what is found in evaluation of the system, the information given back into the system to determine if the end result was achieved
Who does a hospital board of directors represent? What are their 5 primary responsibilities?
They are expected to represent various business and political interests of the community. Primary responsibilities. 1) Determination of the organization's mission 2) Strategic planning 3) Financial oversight 4) Selection and evaluation of the CEO 5) Board self-evaluation and education
What do federal agencies do? Give examples.
They are involved in illness research. They provide funding to train healthcare workers and assist communities in planning and evaluating the healthcare services that they have in place Examples: Centers for Medicare and Medicaid Services (CMS), the national institutes of health, us department of health and human services, occupational safety and health administration, center for disease control and prevention
Describe Gilligan's theory of moral development. What are the stages? What describes a moral person, and moral dilemmas? What helps people transition up the levels?
Three levels of moral development 1) Orientation to individual survival 2) A focus on goodness with recognition of self-sacrifice 3) The morality of caring and being responsible for others, as well as self "The moral person is one who responds to needs and demonstrates a consideration of care and responsibility in relationships." Moral dilemmas are due to conflicting responsibilities Each transition resulted in a critical reevaluation of the conflict between selfishness and responsibility.
Describe Kohlberg's theory of moral development. What are the stages? What helps people move from one level to the next?
Three stages: 1) Preconventional (self-centered, not paying attention to the rules/norms of society) 2) conventional (moral decisions conform to family/group/society, most adolescents and adults) 3) postconventional (independent modes of thinking, people ignore their own interests and only look at group norm, only minority of adults get here) A person's movement up to a higher level can be stimulated by 1) Intellectual levels 2) Environment with opportunities for group participation, shared decision-making, and responsibility for consequences of actions 3) Conflict
What is the shared goal of government and voluntary health agencies? How are they supported? Who administers them?
To contribute to the health and wellbeing of US citizens Supported by taxes Administered by elected/appointed officials who address the specific healthcare needs of their community
What is the goal of subacute care?
To provide lower cost health care and create a seamless transition of patients moving through the healthcare system.
What is the P-I-C-O-T framework? What is it used for?
Used to eliminate research that is not specific enough to the particular problem or intervention that you are interested in. - Population if interest - Intervention - Comparison - Outcome - Time
Describe principalism. What are its limitations?
Uses key ethical principles of beneficence, nonmalfeicence, autonomy, and justice in resolution of ethical conflicts or dilemmas Limitation: no guidance on which principle is more important than any other
During a disaster, the sick and the injured were classified by severity of condition and treatment priority. The decisions are most likely applications of which ethical philosophy: Deontology, principalism, utilitarianism, or virtue ethics
Utilitarianism
Describe utilitarianism. What are it's downsides?
Utilitarianism: moral rightness of an action is determined solely by its consequence. Useful actions bring about the greatest good for the greatest number of people (e.g. David Hume, Jeremy Bentham, John Stuart Mill) Downsides: impossible to predict all consequences, the needs of the minority will not be met
Distinguish "valid" from "true"
Valid: soundly founded, note that both deductive and inductive reasoning are needed for something to be valid Truth: accordance with fact or reality
Distinguish among values, morals, and ethics
Values are attitudes, ideals, or beliefs that an individual or a group holds and uses to guide behavior. They are freely chosen based on what we find important (e.g. honesty) Morals provide standards of behavior that guide the actions of an individual or social group, and are established rules of conduct to be used in situations where a decision about right and wrong must be made. They are behaviors and actions about what to do and what not to do. (e.g. people shouldn't lie) Ethics is a term used to reflect what actions an individual should take and may be "codified," as in the ethical code of a profession (e.g. ethicists would codify what it is to lie and then assess whether it is ever okay to lie in any situation.)
In Peplau's theory, what are the three phases?
Within the relationship with my patient, how can I best help him or her understand his or her health problems and develop new, healthier behaviors?
In Peplau's theory, what is the focus?
Within the relationship with my patient, how can I best help him or her understand his or her health problems and develop new, healthier behaviors?
How does the WHO define health?
a state of complete physical, mental, and social well-being and not merely the absence of disease
In Peplau's theory, what are the 6 roles of nurses?
counselor, resource, teacher, technical expert, surrogate, and leader
List seven different categories of healthcare agencies
federal, state, local, voluntary, non-governmental, not-for-profit, for-profit
What are the four major categories of healthcare services?
health promotion & maintenance, illness prevention, diagnosis and treatment, rehab and long-term care
