cue cards
Sociological imagination: awareness of the relationship between who we are as individuals & the social forces that shape our lives. Cultural: things in our culture that impact on our lives & define how we behave. Historical: things in the past that have influenced the present. Structural: how particular forms of social organisation shape our lives. Sociological perspectives: different ways sociologists view society & explain how it functions.Conflict (Marxism): Conflict + strife is a basic element of society. It occurs between two social classes in society. Unequal power results in inequity. Symbolic interactionism: social structures are created through human interaction (verbal & non-verbal). Symbols & communication shape our perception. Functionalism: society is like an organ system that works together to maintain balance & harmony. Has shared values & needs moral consensus for society to function well.Feminism: claims that gender issues are the cause of much social inequity. Legal, health, & educational system reflect sexist values & support male privilege. Social structure: interrelationships & interactions of individuals within the population. These interactions produce recurring patterns of behaviour & define how individuals should behave within that society. Structure: populations are made up of groups. Within groups individuals have a status. Status is the position that a person has in a society & that status gives the individual a role (expected behaviours) that they will perform within the group & within society. Socialisation: ways which people learn to conform to their society’s norms, values, & roles because society expect people to behave according to the norms of their culture. Occurs throughout life, primary, secondary, & adult socialization. People are socialised by direct instruction, imitation, & reinforcement of behaviours.Agencies of socialisation: groups who influence a person’s development throughout life. Usually family, schools, peer group, mass media & religion. Social institutions: groups with statuses & roles designed to perform major social functions & are devoted to meeting the basic needs of the people of society.NZ health system: gov organisation (MOH & Disability) that works to improve health & wellbeing. Levels of care: Primary, health care services in local community. Secondary, medical specialists referred via GP. Tertiary, inpatient specialised care eg. ICU. Māori health strategy: He Korowai Oranga, NZ’s Māori Health strategy, guides the Gov & the health & disability sector to achieve the best health outcomes for Māori when implementing health related actions. Pae Ora (healthy futures) is the Gov’s vision which builds on the initial foundation of Whānau Ora (Healthy Families) to include Mauri Ora (Healthy Individuals) & Wai Ora (Healthy Environments). Te Whatu Ora/Health NZ:‘the weaving of wellness’ Combining people, resources, organisations, thoughts & actions for better wellbeing. New & fresh perspective to how health services are planned, delivered, & assessed. Te Aka Whai Ora (Maori health authority): works with MOH on strategy & policy issues relevant to Māori, providing direction for the health system, ensuring that commitment to Te Tiriti o Waitangi continues to underpin approaches to Haora. Hauora report 2019: addressed 2 claims concerning administration, funding & monitoring of the PHO. It had breached the Treaty by failing to address inequities & upholding Treaty obligations. It made recommendations to explore Māori Health Authority, methodology, review & redesign of PHO.Health promotion: becoming aware of problems in other countries & making sure health issues are understood/ publicised. Involves community assessment, working together with other groups & agencies to lobby gov for better services, & providing health education to individuals & groups in local communitiesOttawa Charter: international health promotion document. Prerequisites are peace, shelter, education, food, income, a stable eco system, social justice, & equity. 5 Key action strategies are to build healthy public policy, create supportive environments, strengthen community action, develop personal skills, & reorientate health services. PHC strategy: framework for the health sector that directs services to areas providing the greatest benefits for our population, particularly focusing on tackling inequalities in health. Identifies 7 Principles- accessible healthcare, appropriate technology, health promotion, cultural sensitivity & cultural safety, intersectoral collaboration, & community participation.Social justice: redressing politically, socially, & economically unacceptable health inequalities in all countries.Health literacy: able to obtain understand & use basic health information to navigate health services & make appropriate health decisions. It is about communication & understanding information in the health context.Level 1:poor literacy skills, unable to determine from a package label the correct amount of medicine to give a child.Level 2: a capacity to deal only with simple, clear material involving uncomplicated tasks,may develop everyday coping skills, but their poor literacy makes it hard to conquer challenges (learning a new job or skill).Level 3: adequate skills to cope with the demands of everyday life & work in an advanced society, denotes theskill level required for successful secondary school completion & entry into tertiary education. Level 4/5: strong skills, canprocess information of a complex & demanding nature.Barriers to health literacy (client perspective): age, culture, education, lower socio-economic groups, technology (generational difficulties), disabilities eg. vision, hearing. Health literacy strategies: accessible & appropriate written, oral, & visual communication. Provide easy to understand information, relevant for the individual with inclusion of culture& language. Rationale (give reasons for instructions), nurture & engage in partnership, protection, & participation.Ensure patient has understood, use teach back method, teach people to ask three simple questions (diagnosis, treatment, context), use models, non-traditional methods, cultural language, & images. 3 steps to improve health literacy: 1. Find out what people know. 2. Build health literacy skills & knowledge. 3. Check you were clear. Evaluation written information: Simple, clear, plain English.Definitions & patterns of health: health is a balance in all areas of life, being active, health includes physical, social, & mental wellbeing & not merely the absence of disease or infirmity.Health model:pattern or framework that helps us to understand a definition concept or issue. Biomedical: identification of a disease or illness through a doctor’s observation, or using specific diagnostic tests eg, x-rays, scans, blood test, ultrasound, mammograms, pap smears, surgery, hospitalisation.Socio-ecological: acknowledges the influences of; political, economic & cultural conditions which have an impact on their health & community. Holistic health is a social & ecological phenomenon, ecological is the idea that everything is connected, its dynamic & constantly changing.Complementary & Alternative Healthcare: healing resources/ methods that are alternative. Differs from the dominant health system of the society, & each has its own belief/philosophy or system, only a few are regulated. Complementary medicine (alternative health care), Tai Chi (energy therapy), homeopathy (body has ability to cure itself), traditional Chinese medicine (harmony results from yin & yang supporting health). Te whare tapa whā: ‘the house with four walls’. Health is maintained through balance of all 4 aspects. Taha Tinana, physical well-being, incorporates the physical body, how it moves, grows & develops, involves learning how to care for the body. Taha Hinengaro, mental & emotional well-being, include coherent thinking processes, acknowledging & expressing thoughts/feelings & responding constructively. Taha Whanau, social well-being, encompasses personal relationships (family relationships, friendships & other interpersonal relationships), brings feelings of belonging, compassion & social support. Taha Wairua, spiritual well-being, includes values, personal identity & life purpose, may or may not include person’s religious beliefs. If one of four dimensions be missing/damaged a person may become unbalanced or unwell. Fonofale: system of wellbeing that acknowledges & embraces Pacific Perspectives. Built around the idea of the Samoan fale (house). The floor/foundation, represents aiga (family). Not just immediate relatives, but extended family & anyone you are linked to by partnership or agreement. The roof is culture, your beliefs & value system that provide protection & shelter. Structure is supported by four pou (pillars) representing spiritual, physical, mental & ‘other’ aspects of wellbeing. Other includes elements like sexuality, socio-economic status & gender. Morbidity: measures the disease rate & the susceptibility of a population to a disease. The number of people diagnosed with the disease. Mortality: measures the death rate. The number of deaths per year from a certain disease or condition. Health Disparities: differences in health between groups of people – considered to be unfair or unjust & is often linked to economic, social, historical, cultural, or environmental disadvantage. Health Inequities: differences in health status of different groups. May be avoidable so disparities & inequities can be used to mean the same thing. Stratification: the way a society is arranged in layers including wealth, income, ethnicity, gender, religion. Often about power & money or people with no money. Status of people is determined by their stratification & can cause many problems in society such as racism, discrimination, prejudice, patriarchy, sexism, ageism, hegemony, & assimilation. Closed Stratification: rigid boundaries allow no movement between social layers. Open Stratification: individuals, families & even communities can move from one social layer to another. Life Chances: the place in society’s stratification system into which you are born has an enormous impact on what you will do or become throughout life. Racism: discrimination against a person based on their racial or ethnic group. Prejudice: preconceived opinions about somebody not based on reason or actual experience. Discrimination: unjust treatment of different categories of people, especially on the grounds of race, age, sex, or disability. Patriarchy: system of society or gov in which males hold power & women are largely excluded. Sexism: prejudice, stereotyping, or discrimination on the basis of sex. Ageism: prejudice or discrimination on the grounds of a person’s age. Hegemony: leadership or dominance, especially by one group over another. Assimilation: process in which a minority group or culture comes to resemble a society’s majority group or assume the values, behaviours, & beliefs of another group whether fully or partially.
Health Determinants: Factors that promote & affect health & wellness in individuals, families & communities. Includes: income, employment, education, housing, culture, & ethnicity, population-based services & facilities, social cohesion. NZ Health Strategies (Hauora): acknowledges that health is not just about the physical body but is also about social situation, home environment, communities, & sense of control. The approach of NZ view on health is referred to as a ‘life-course approach’ eg. parents who have good health & mental wellbeing can support the social development, educational outcomes & lifelong experiences of their children, & of their wider families & whānau. This strategy is focused on health but within a wider context, recognizing the connections between health & other aspects of people’s lives. Actions for Health: 1. Treaty-informed practice, partnership, participation & protection. 2. Culturally responsive practice, knowledge, actions & integration. 3. Collaboration, working together, common goals & recognising collaboration is a journey. 4. Community, knowledge of the community, leaders & resources. 5. Build on strengths & existing health-promoting behaviours, identify the health promotion activities strengths of individuals, whānau & communities. Whanau Ora: benefits whānau as a group. Indigenous health initiative driven by Māori cultural values. Main principles: building whanau capability, putting whānau needs & aspirations at the centre, building trusting relationships, developing culturally competent & skilled workforce. Goal: positive changes in health, employment, housing, & cultural identity by building on whānau strengths. Whānau are supported to realise their confidence, mana, & self-belief. Work with non-gov agencies to ensure it is community based. Idea of strategy: for Māori to be able to self-manage, live healthy lifestyles, participate fully in society, participate in Māori language, economically secure, stewards of the natural & living environment, engage in collaboration, & build strength. Poverty: the state of having few material possessions or little income. Poverty can have diverse social, economic, & political causes & effects. Absolute Poverty: when a person does not have sufficient resources to meet basic day to day needs, lack of the essential such as food & water, as well as problems with housing, land, & healthcare. Leads to hunger & physical deprivation. Relative Poverty: Relative poverty within a nation is calculated as the proportion of the population with an income below a certain fraction of the median income (below the poverty line). Measured as a family having an income that is: less than 60% of yearly median income ($33,696).Effects of Poverty: negative impacts on children’s health, social, emotional & cognitive development, behaviour & educational outcomes. Individuals become marginalised, are labelled, subject to victim blaming, excluded & isolated, experience rejection, loneliness, fear, anxiety, & depression. Labelling: assign to a category, especially inaccurately or restrictively. Stigma: a set of negative & often unfair beliefs that a society or group of people have about something. Exclusion: being cut off from full participation in society, prevented from having the same opportunities as others. Inclusion: People are involved in society & have the same opportunities as others. Living Wage ($23.75 an hour): for workers to survive & participate in society, reflects the basic expenses of workers & their families such as food, transportation, housing & child care.Empowerment: process of becoming stronger & more confident, especially in controlling one’s life & claiming one’s rights. Power: Being able to influence the actions of others, able to carry out own will despite resistance, getting own way, intertwines with knowledge. Power in Healthcare System: Medicalisation, gov, commercialisation. Medicalisation: process by which non-medical/ common problems (behaviours, activities, conditions) come to be defined & treated as if they were medical issues eg. sleeplessness, menopause, childbirth. Commercialisation: increasing provision of health care services where users pay, the associated investment in & production of health services for the purpose of income or profit, an increasing number of systems being bases on individual payment or private insurance. Creates inequity & exclusion.Creating an inclusive environment: advocate for clients, consider income & options when planning care, help clients be empowered, enable them to have choices & engage in decision making.Family Violence: abuse of any type perpetrated by one family member against another (partners, parents, siblings). 3 R’s: recognise, respond, refer.Elder abuse: when harm or distress is caused to an older person, act or lack of appropriate action/care in a relationship where there is an expectation or trust (physical, sexual, emotional, neglect).Child abuse: harming (whether physically, emotionally, or sexually), ill-treatment, abuse, neglect or deprivation of any child or young person.Physical abuse: any physical force causing harm to another person. Sexual abuse: any sexual activity forced upon a person who does not give their consent. Social abuse: isolating the victim from friends & familySpiritual abuse: not allowing freedom of religious beliefs, denying the right to express traditional beliefs.Financial abuse: forcing victim to be financially dependent, not allowing access to money. Emotional abuse: abuse that is mainly verbal & can have an impact on a person’s confidence & self-esteem.Indicators of abuse: Physical – unexplained bruises, welts, cuts, abrasions. Emotional – severe symptoms of depression, anxiety, withdrawal, or aggression. Sexual – Bizarre, sophisticated, or unusual sexual knowledge. Neglect – demanding of affection or attention. Prevention: seeking help, learning to control triggers, finding strategies to manage triggers, changing attitudes & behaviours, speaking up. Responsibilities: be supportive, open, non-judgemental, believe them, reassure they’re not to blame. Agencies: NZ police, Oranga Tamariki, Child Matters. Campaigns/ frameworks: Pacifica proud, Nga Vaka o Kaiga Tapou, E Tu Whānau, it’s not OK. Nursing knowledge & theories: theoretical, practical (nurse’s experiences & inquiry, achieved through personal knowledge & reflection), knowledge based on research or science. Link between nursing knowledge & theories: theory helps understanding & to find meaning in nursing experience, helps to describe, explain, predict nursing care. Nursing knowledge may evolve from nursing theory. 4 metaparadigms: Person: individuals, families, communities, & other groups who are participants in nursing & receive nursing care. Environment/ Situation: patient’s environment includes any stetting & influencing factors that can alter the setting where the patient receives care (room temp, family members). Health: patient’s state or wellbeing. Patient’s health is influenced by many physical & psychological factors. Nursing: involves the use of the nursing process to assess, diagnose, plan, implement & evaluate an individualised plan for providing patient care & education. Theorists: Peplau (1952), interpersonal relations: focuses on client. Neuman (1972), holistic nursing care: factors impacting person’s health status. Watson (1979), transpersonal caring: designed around caring process, assisting clients. Benner (1984), novice to expert. Florence Nightingale, environment theory. Carper (1978) & White (1995), 5 patterns of knowing. Johnson (1980), behavioural systems model. Nightingale: founder of educated & scientific nursing, first nursing notes became the basis of nursing practice/ research. Main idea: utilised patient environment to achieve desired effect. Began from her time in the war with infection control & the effect of environment (clean water & air, basic sanitation, cleanliness & light)has on recovery. Later applied to hospitals, correct ventilation, sanitation of linen, sufficient food supplies were essential. Uses person cantered care & environment metaparadigms. Carper/ White Patterns of knowing:Empirical knowing: the science, anatomy & physiology, observations. Ethical: moral knowledge, right v wrong, values. Personal: self-discovery, connections, communication respect, cultural safety. Emancipatory: power balance, equality/ equity, status, society. Aesthetics: the art, practice, knowledge. Ethics: approaches of thinking about, understanding, & examining how best to live a moral life. Reflective activity concerned with system examination of living/ behaving morally, reconsider actions, judgement, & justifications. Ethics of care 6 C’s: Compassions: about living in solidarity with others, simple presence, valuing others for who they are. Competence: state of having knowledge, judgement, skills, energy, experience, & motivation required to respond to demands of one’s professional responsibilities. Confidence: creates trusting & respectful relationships & communicated effectively. Nurses need to be confident/ comfortable in themselves so they can be comfortable/ open with clients. Conscience: moral sense of right & wrong. General sense of value, personal responsibilities, & self-directions. Commitment: willingness to do something, investing in tasks, people relationships, choices. Comportment professionalism: values, beliefs, & attitudes about your manner. Determines a nurse’s effectiveness in relating communicating & collaborating with their team. Nursing ethics: moral guideline sin contexts which they work, principles or values that guide nursing care. Principles of ethics NZNO: Autonomy: respecting choices & health consumers as dignified & rational chooser. Non-maleficence: above all, do no harm. Nott putting anyone, including yourself, in harm’s way. Beneficence: above all, do good. Promotes welfare & wellbeing. Justice: fairness to all health consumers. Equal distribution of benefits & burdens. Confidentiality: respecting patient privacy at all costs. Veracity: actions, speech, & behaviour that ensure communications between individuals &/or groups are honest & truthful. Fidelity: being loyal, keeping promises. Guardianshipof the environment & its resources: the assumption that society has responsibility to respect & protect the environment & its resources. Cultural/ contextual variation in the relationship between person & environment will influence the value or guardianship. Being professional: professionalism. Māori world view: have the right to be Māori, Tikanga include traditional values, beliefs, & practices. Māori values: Rangatiratanga: self-determination. Manaakitanga:: express aroha & acknowledge mana. Tika: importance of truth, correctness, justice, fairness, & rights. Whanaungatanga: understanding & believing there is spiritual existence, acknowledge, & respect the right of all spiritual freedom. Kotahitanga: solidarity, togetherness, nurses will work in unity & harmony with each other. Kaitiakitanga: guardianship of stewardship, policies, & practices will reflect the role we have on this planet.