Exam Review Module 8-13 PDF

Module 8 The Canadian Health Care System and Integrative Care ## Medicare and Core Principles Medicare is a fundamental component of Canada's social safety net, providing hospital and medical insurance funded through general taxation. The Canada Health Act (1984) established key principles: - Public...

Module 8 The Canadian Health Care System and Integrative Care ## Medicare and Core Principles Medicare is a fundamental component of Canada's social safety net, providing hospital and medical insurance funded through general taxation. The Canada Health Act (1984) established key principles: - Public administration - Comprehensiveness - Universality - Portability - Accessibility ## Governance Structure ### Federal Government Role - Sets and administers national principles - Provides financing through transfer payments - Delivers health services for specific groups (Indigenous people, veterans, federal inmates, RCMP) - Develops national health promotion and disease prevention policies ### Provincial/Territorial Government Role - Administers health care insurance plans - Manages and finances health care services - Determines hospital organization and location - Reimburses physician and hospital costs ### Professional Jurisdiction Health professions are largely self-regulated, managing their own standards, competencies, ethics codes, and disciplinary actions. ## Primary Health Care Forms the foundation of Canada's healthcare system with four main pillars: - Teams - Access - Information - Healthy living ## Healthcare Delivery Settings ### Institutional Sector - Hospitals - Long-term care facilities - Psychiatric facilities - Rehabilitation centres ### Community Sector - Public health - Physician offices - Community health centres - Home care - Hospice and palliative care - Parish nursing ## Five Levels of Care 1. Health Promotion - Enables control over health improvement - Provides wellness services - Includes health education 2. Disease and Injury Prevention - Focuses on reducing risk factors - Includes clinical actions like immunization - Incorporates behavioral and environmental strategies 3. Diagnosis and Treatment - Primary care (first contact) - Secondary care (specialized medical services) - Tertiary care (complex health problems) 4. Rehabilitation - Improves quality of life post-illness/injury - Includes physiotherapy, occupational therapy, respiratory therapy - Aims to restore previous functioning levels 5. Supportive Care - Serves patients with chronic or progressive conditions - Provides long-term care services - Includes palliative and respite care ## Current Healthcare Challenges - Sustainability - Political Economy of Health - Climate Change - Primary Health Care spending - Healthcare Planning and Delivery - Human Resources - Aging Population - Truth & Reconciliation Commission Calls to Action ## Integrative Care ### Overview Integrative healthcare combines conventional medicine with complementary and alternative approaches, focusing on underlying causes of illness rather than just symptoms. ### Categories of Integrative Care - Natural products - Mind-body-spirit interventions - Manipulative and body-based methods - Energy therapies - Whole systems (Traditional Chinese Medicine, Ayurveda, naturopathy) ### Nursing-Accessible Approaches - Relaxation therapy - Meditation and breathing - Imagery visualization - Therapeutic listening - Massage - Support groups - Music therapy ### Advanced Integrative Approaches - Biofeedback - Therapeutic touch - Chiropractic medicine - Acupuncture - Cupping - Massage therapy ## Future of Nursing Nurses must evolve by: - Taking leadership positions - Developing innovative solutions - Expanding nursing roles - Engaging in health policy development - Contributing to health system reform Module 9 Patient Education ## Health Literacy Overview Health literacy refers to the ability to access, understand, evaluate and communicate health information to promote and maintain health. This encompasses: - Understanding medical information - Describing symptoms - Finding appropriate healthcare help - Managing medications safely ### Current State in Canada - 60% of Canadians struggle to understand and act upon health information independently - 23% have difficulty finding professional help when ill - 54% find it challenging to determine when to seek a second medical opinion - Low health literacy correlates with increased hospitalizations, repeated doctor visits, and medication mismanagement ## Digital Health Literacy ### Definition and Importance Digital health literacy involves skills needed to: - Search and select health information online - Judge and transform health information - Communicate and use online health resources ### Key Factors Affecting Digital Health Literacy - Geographic location: Remote communities score lower than urban areas - Education level: Lower education correlates with lower scores - Age: Adults 65+ score significantly lower - Income: Households earning less than $50k score lower - Healthcare access: Those with online health information access and family doctors score higher - Virtual care experience: Users of virtual care services demonstrate higher literacy ## Patient Education ### Role of Nurses - Primary source of health information - Clarify information from other healthcare providers - Essential for informed decision-making - Increasingly important due to shorter hospital stays ### Basic Learning Principles 1. Learning Environment Considerations 2. Ability to Learn Factors: - Emotional capability - Intellectual capability - Physical capability - Developmental stage ### Teaching Process Components 1. Association and imitation 2. Motivation and spacing of material 3. Recency and primacy effects 4. Prompt feedback 5. Application in various contexts ## Domains of Learning ### Cognitive Domain (Understanding) - Remembering - Understanding - Applying - Analyzing - Evaluating - Creating ### Affective Domain (Attitudes) - Receiving - Responding - Valuing - Organization - Characterization ### Psychomotor Domain (Motor Skills) - Perception - Set - Guided response - Mechanism - Complex overt response - Adaptation - Origination ## Teaching and Learning Process Integration ### Assessment - Identify learning needs - Evaluate ability and motivation to learn - Assess teaching environment - Review available resources ### Implementation Strategies 1. Teaching Approaches: - Telling - Selling - Participating - Entrusting - Reinforcing 2. Teaching Methods: - One-on-one discussion - Group instruction - Demonstrations - Role playing - Simulation ### Learning Barriers - Illiteracy and learning disabilities - Health literacy challenges - Sensory alterations - Language barriers - Cultural diversity - Severe illness complications ### Evaluation - Assess patient learning - Measure performance against expected outcomes - Document progress - Adjust teaching methods as needed ## Health Literacy Assessment Tools The Newest Vital Sign (NVS): - Available in English and Spanish - Three-minute administration time - Uses nutrition label comprehension - Helps providers adapt communication to patient literacy levels Module 10 - Growth and Development part one ## Core Principles - Human growth and development are continuous, intricate processes based on timing and sequence - Progress through developmental stages occurs at individualized rates - Understanding typical patterns helps nurses predict, prevent and detect changes ## Key Components ### Physical Growth - Quantitative, measurable increases in physical measurements - Includes changes in height, weight, teeth, skeletal structures, and sexual characteristics - Influenced by both genetic and contextual factors like socioeconomic status ### Development - Progressive process leading to increased functional capacity - Results from biological and environmental interactions - Qualitative in nature - Shows predictable patterns from simple to complex ## Influencing Factors ### Major Categories 1. Genetic/Natural Factors - Heredity - Temperament 2. Environmental Factors - Family dynamics - Peer groups - Health environment - Nutrition - Rest/sleep/exercise - Living conditions - Political environment 3. Interacting Factors - Life experiences - Prenatal health - Current health status ## Developmental Theories ### Piaget's Theory of Cognitive Development Four stages: 1. Sensorimotor (0-2 years) - Knowledge through sensory experiences - Development of object permanence 2. Preoperational (2-7 years) - Symbol and mental image thinking - Language development 3. Concrete Operations (7-11 years) - Mental operations capability - Understanding others' actions 4. Formal Operations (11+ years) - Abstract thinking - Theoretical reasoning ### Erikson's Eight Stages of Life 1. Trust vs. Mistrust (0-1 year) 2. Autonomy vs. Shame/Doubt (1-3 years) 3. Initiative vs. Guilt (3-6 years) 4. Industry vs. Inferiority (6-11 years) 5. Identity vs. Role Confusion (adolescence) 6. Intimacy vs. Isolation (young adulthood) 7. Generativity vs. Stagnation (middle adulthood) 8. Integrity vs. Despair (old age) ### Kohlberg's Theory of Moral Development Three levels: - Preconventional - Conventional - Postconventional ## Developmental Age Periods ### Infancy (birth-12/18 months) Health Risks: - SIDS - Accidents/falls - Burns - Aspiration/suffocation - Drowning - Poisoning Health Concerns: - Nutrition - Immunizations - Sleep ### Toddler (12-36 months) Focus Areas: - Gross and fine motor skills - Object permanence - Language development - Autonomy development ### Preschooler (3-5 years) Developments: - Motor skills refinement - Cognitive concepts (artificialism, animism) - Language expansion - Play-based learning ### School-Age (5-12 years) Key Areas: - Puberty onset - Concrete operations - Peer relationships - Moral development ### Adolescence (12-19 years) Major Changes: - Sexual maturation - Abstract reasoning - Identity formation - Health risks including mental health, substance abuse, STIs ## Important Considerations ### Building Healthy Habits - Nutrition - Physical activity - Sleep - Literacy - Oral health - Immunizations - Digital media use ### Hospital Care Principles - Minimize family separation - Reduce hospitalization trauma - Allow child control where possible - Development-based care - Honest communication - Family-centered approach The role of play is emphasized throughout development as a stress reducer, expression outlet, and growth facilitator. Technology's impact on learning and socialization is also recognized as increasingly important in modern development. Module 11 - Growth and development part two ## Young Adulthood (Late Teens to Late 30s) ### Physical and Cognitive Development - Growth completion by age 20 - Few physical illnesses - Improved critical thinking - Focus on career choices - Increased health literacy ### Psychosocial Development - Emotional health tied to personal and social task resolution - Key areas: gender roles, career, sexuality, gender identity - Family development: marriage/common law, childbearing, parenthood - Alternative family structures ### Health Considerations - Health risks: lifestyle choices, computer use, accidents, substance abuse - Health concerns: infertility, exercise needs, job stress, family stress - Acute care needs: accident treatment, respiratory infections, minor surgery - Social support importance, including peer support workers ## Middle Adulthood (Mid-30s to Mid-60s) ### Physical and Cognitive Changes - Adaptation to physiological changes - Impact on self-concept and body image - Perimenopause and menopause - Limited cognitive changes unless affected by illness/trauma ### Psychosocial Aspects - Sandwich generation responsibilities - Career transitions - Family dynamics: singlehood, marital changes - Care for aging parents ### Health Focus - Stress management - Wellness maintenance - Obesity prevention - Mental health: anxiety and depression - Primary health care emphasis on prevention and promotion ## Older Adulthood (65+ Years) ### Population Overview - Categories: youngest old, old, oldest old (85+) - Growing demographic - Significant variation in health and functional abilities ### Common Misconceptions - Stereotypes about illness, disability, and cognitive ability - Ageism in healthcare - Need for dignity and independence recognition ### Developmental Tasks - Adjustment to health changes - Retirement adaptation - Spouse loss coping - Relationship redefinition with adult children - Quality of life maintenance ### Healthcare Considerations - Various care settings: private homes, assisted living, long-term care - Assessment focus on physical-psychosocial interrelationships - Normal vs. pathological changes - Common conditions: cancer, heart disease, respiratory issues ### Physiological Changes - Systems affected: integumentary, respiratory, cardiovascular - Functional changes in daily activities - Cognitive changes versus impairment - Common conditions: delirium, dementia, depression ### Nursing Interventions - Fall prevention - Medication management - Environmental safety - Restorative care focus - Palliative care when needed - Interprofessional collaboration ### Health Promotion - Preventive measures for common conditions - Physical activity encouragement - Nutrition monitoring - Social engagement support - Therapeutic communication - Cognitive stimulation Module 12 - Population health, Global health, and Cultural safety ## Population Health Strategies - Focus on improving health of entire populations while reducing health inequities - Based on principles of social justice, equity, and mutual trust - Requires collaboration between stakeholders to address health determinants - Emphasizes active participation in policies and programs - Combines health care, protection, and disease prevention with health promotion ## Community Health Nursing - Encompasses public health nursing, home health, mental health nursing, street health, outpost nursing, and parish nursing - Based on primary health care principles including education, rehabilitation, support services - Emphasizes empowerment at individual and collective levels - Focuses on improving population health through community-level actions ## High-Priority Populations - People living in poverty - Homeless individuals - Those with chronic conditions and disabilities - Indigenous peoples - New immigrants and refugees - 2SLGBTQIA+ communities - Requires culturally competent care and trauma-informed approaches - Implements harm reduction strategies to reduce consequences of high-risk behavior # Global and Planetary Health ## Global Health Framework - Aims for optimal wellbeing of all humans - Guided by Millennium Development Goals and Sustainable Development Goals - Uses metrics like global burden of disease to measure population health - Focuses on reducing health disparities and inequities ## Key Global Health Issues - Communicable diseases and pandemics (HIV, cholera, COVID-19) - Non-communicable diseases (cardiovascular diseases, cancer) - Gender equality and discrimination - Immigration and migration trends - Environmental sustainability and climate change ## Planetary Health - Focuses on relationship between human health and natural systems - Emphasizes environmental sustainability - Considers One Health approach: interconnection of humans, plants, and animals - Addresses climate change as major public health threat # Cultural Safety and Competence ## Cultural Concepts - Culture includes patterns of behavior, norms, traditions affecting group thinking - Encompasses race, ethnicity, ancestry, beliefs, and shared experiences - Cultural competence involves effective interaction across different cultures - Cultural safety focuses on power redistribution in relationships - Cultural humility requires lifelong learning and self-reflection ## Diversity and Inclusion - Diversity represents variety in dimensions like race, ethnicity, gender, orientation - Equity ensures treatment according to diverse needs - Inclusion creates culture of respect and acceptance - Addresses conscious and unconscious bias ## Indigenous Health - Represents 4.9% of Canadian population - Faces historical impacts of colonialism, cultural genocide, structural racism - Experiences health inequities and access challenges - Requires holistic and culturally appropriate health services - Global perspective shows Indigenous peoples represent 15% of poorest people worldwide ## Healthcare Professional Role - Nurses crucial in advancing health equity - Need for cultural competence and safety in practice - Importance of trauma-informed care - Advocacy for health equity and social justice - Continuous learning and development of cultural sensitivity