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