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DCCC Model 1.

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Concept
Explanation
Holistic Nursing   An approach based on meeting the needs of the whole person, taking into account mental, physical, emotional, social, cultural and spiritual factors, not just symptoms of a disease.  
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Assessment   needs and preferences of patient. Systematic collection of data. Establishing a data base through: nursing history, physical assessment, Review of records and consult with HCP. Validate the data continuously.  
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Objective Data   Information that is perceptible by the senses. May be verified by another person.  
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Subjective Data   Symptoms perceived by the affected self. Symptoms, covert data  
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Problem Identification   Nursing Diagnosis. Problem as related to medical diagnosis as evidence my "assessment data". Identify strengths and weaknesses. Use NANDA Language. Prioritize list of diagnoses  
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Planning   Establish patient centered goals to prevent, reduce, or resolve the problems. Identified and determination of the related nursing interventions. Individualized measurable goals: Patient will....  
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Implementation   Carrying out a plan to achieve goals. Determine the level of assistance needed. Use of verbs.  
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Evaluation   Measurement of the extent to which the patient has achieved goals specified in the plan of care. Factors that positive or negatively influence the goal achievement. Plan of care is terminated or revised.  
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Nursing Plan of care   Written guide to direct the efforts of the nursing team as they work with the patient to meet health goals. Specifies prioritized nursing diagnoses, patient goals, and nursing orders.  
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Hierarchy of needs   Defined by Maslow, certain needs are more basic than others. Person strives to meet some needs before others.  
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Physiological Needs   Oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest. Most basic of Hierarchy. Nursing interventions: evaluate Oxygen needs, measuring in/out take, measuring Temperature, Physical therapy, and Rest.  
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Safety and Security Needs   Physical & emotional components. Examples of physical safety: cane; emotional safety: security blanket. Nursing Interventions: Proper hand hygiene, & sterile technique, administer medication knowledgeably, skillful ambulation, teaching patient dangers.  
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Love and Belonging Needs   Understanding & acceptance of others in both giving and receiving love, feeling of belonging to groups. Nursing intervention: Mother & baby skin to skin, including family in care, nurse to patient relationship based on trust, referral to support group  
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Self Esteem Needs   Need to feel good about oneself. Pride, sense of accomplishment, self confidence, and independence Nursing intervention: facilitating support from family, remembering perceptions change, setting attainable goals.  
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Self Actualization Needs   Need to reach full potential through development of unique capabilities. Nursing intervention: creativity as a guideline for solving problems, respect for all people, autonomy.  
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Evidence Based Practice   Provide nursing care that is supported by sound scientific rationale. Only 20% of clinical based on EBP. Build scientific foundation. Prevent disease and disability. Manage and eliminate symptoms. Enhance palliative care.  
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Quantitative research   Basic and Applied research. Example: Clinical Trials.  
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Basic Research   Pure or laboratory research. Designed to generate and refine theory. Not often directly useful in practice.  
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Applied research   Practical research. Designed to directly influence or improve clinical practice.  
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Qualitative Research   Methods of research conducted to gain insight by discovering meanings. To understand Human behavior. Descriptive, correlational, Quasi-experimental, or experimental  
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Variable   Something that varies and has different values that can be measured.  
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Dependent Variable   Variable being studied, determined as a result of a study.  
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Independent variable   Causes or conditions that are manipulated or identified to determine the effects on the dependent variable.  
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External Evidence   Systematic reviews, randomized control trials, best practices, and clinical practice guidelines that support change in clinical practice.  
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Internal Evidence   Derived from health care institution based quality improvement projects, outcome management initiatives, and clinical expertise.  
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PICO Format   P: Patient, Population or Person of Interest. I: Intervention of Interest. C: Comparison of Interest. O: Outcome of Interest.  
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How do you implement EBP?   1) develop and answerable ? using PICO format. 2) Search Literature. 3) Evaluate evidence found. 4) Apply Evidence and provide patient with evidence. 5- Evaluate the outcome  
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Communication   A distinct interpersonal interaction that is a process for the creation of shared meanings. a dynamic process through symbols and symbolic expression. continuous, interactive activity  
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SBAR   Consistent, clear, structured and easy to use method of communication between HCP. Organizes communication in to categories of: Situation, Background, Assessment, and Recommendations  
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Situation   Describe the situation. Complaint, diagnosis, treatment plan, and patients wants/needs What is going on? who? where? what? when?  
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Background   Information relevant to the situation. Vitals, mental and code status, meds, lab results  
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Assessment   Current providers assessment of the situation. Analyze situation and isolate the problem. I am concerned......  
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Recommendation   Recommendation of action. What actions can resolve the situation. Pending labs, what needs to be done in the next few hours, other recommendations of care. Should we....?; I need you to come...  
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QSEN   Quality & Safety Education for Nurses. Joint Commission. Prepares future nurses with Knowledge, Skills, and Attitudes (KSAs). Necessary to continuously improve the quality and safety of Health Care Systems.  
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Health Promotion   Encompasses health, wellness, disease, and illness  
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Health   A state of complete physical, mental, and social well-being, not nearly the absence of disease or infirmity. Optimum functioning.  
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Wellness   An active process by which and individual progresses towards the maximum possible potential, regardless of current state of health.  
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Disease   Pathological change in the structure or function of the body or mind.  
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illness   Abnormal process in which any aspect of a person's functioning is altered, in comparison to the previous condition of health.  
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Primary Preventive Care   Care directed toward health promotion and specific protection against illness. Health Education for optimal: nutrition, exercise, immunizations, living and working environments, avoidance of harmful situations, stress management, health risk assessment.  
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Secondary Preventive Care   Health maintenance for those with health issues or to prevent complications or disabilities. Screening & early detection. Assess for normal growth & development. Regular exams and screenings. Direct intervention; wound care and meds.  
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Tertiary Preventative Care   Helping rehabilitate and restore to max level of functioning after an illness. Minimizing the effects of a disease, teaching about disease, PT, support groups, improve quality of life, Meds, therapy, surgery, job training.  
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Prevention   Decreasing occurrence of a disease.  
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Promotion   Educating people and giving them awareness to change their behaviors.  
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Physical activity and Exercise fall into what Levels of Prevention?   Both primary and tertiary because it can optimize health for all.  
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Healthy People 2020 Objectives   1. High-quality long lives free of preventable disease, disability, injury & premature death. 2. Health equality & eliminate disparities, improve health for all. 3. Social & physical environments that promote good health. 4. Quality of life, all stages  
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Disparity   Particular health difference that is closely linked with social, economic, and/or environmental disadvantages.  
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Nursing Practice act   State statute designed to: Protect patients or society. Define the scope of nursing practice, Identify the minimum level of nursing care to be provided to clients. Regulation of practice by a board, including licensing, credentials, disciplinary  
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Patient Education   Process of assisting people to learn health relates behaviors so that they can incorporate these behaviors into everyday life. Domain of learning should match teaching method.  
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Cognitive Learning   Literature, lecture or discussion.  
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Psychomotor Learning   Skills practice. Touch and manipulative with equipment.  
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Affective Learning   Change attitudes. Lifestyle modifications.  
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Risk Factor   Something that increases a person's chance for illness or injury.  
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Age risk Factors   School age= communicable diseases. Menopause= cardiovascular disease. Teen driving accident.  
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Genetic risk factors   Family history of cancer or diabetes. Predisposition.  
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Physiological Risk Factors   Obesity = increased risk of heart disease. pregnancy = mother and child at higher risk.  
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Health Habits Risk Factors   Smoking increased lung cancer. Poor nutrition. Alcohol can cause liver abscess.  
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Lifestyle risk factors   Multiple sexual partners increased for STDs. Stressors such as: divorce, work/school pressure.  
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Environmental Risk Factors   Hazardous materials. poor situations; either working or living.  
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Advance Directive   Written directive that allows people to state in advance what their choices for health care would be if certain circumstances develop.  
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Confidentiality   The process of keeping information private or secret. Respecting privileged information.  
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Durable Power or Attorney   Health care proxy. An appointed agent the person trust to make decisions in the event of subsequent incapacity.  
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Living Will   An advance directive specifying the medical care a person would want or refuse should that person lack the capacity to connect to or refuse treatment.  
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Informed Consent   Knowledgeable, voluntary permission obtained from a patient to perform a specific test or procedure written agreement to participate in a study  
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Libel   Defamatory statement made in writing.  
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Commission   Doing the wrong thing.  
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Omission   Not doing the right thing.  
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execution   Doing the right thing incorrectly.  
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Adverse event   Unintended harm by either commission or omission.  
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Near Miss   Error, commission, or omission that could have a harmed a patient but didn't occur as a result of chance, prevention, or mitigation  
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Sentinel Event   Unexpected occurrence involving death, serious physical or psychological injury, or the risk thereof.  
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Negligence   Performing an act that a reasonably prudent person under similar circumstances would NOT do, or failure to perform an act that a reasonable prudent person under similar circumstances would do. Failure to meet the standards of care  
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Active Errors   Occur at the point of contact between a human & aspect of a larger system. Generally readily apparent (pushing an incorrect button, ignoring warning light), involve someone at frontline. Referred to as Sharp end.  
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Latent Error   Refer to less apparent failures of organization or design that contributed to the occurrence of errors or allowed them to cause harm to patients. Blunt end. Referring to layers of the health care system that affect the person "holding" the scalpel.  
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Autonomy   Right to self-determination, independence, and freedom. Make health care decisions for oneself. Not always absolute.  
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Nonmaleficence   Do no harm, either intentional or not. Protect those who cannot protect themselves. Some harm may be inflicted for the greater good; (chemo or surgery)  
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Beneficence   Obligation to do good by acting in ways that promote the welfare and best intentions of others. Promote good and prevent harm. Patients good may differ from HCP.  
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Justice   To be fair to all people. 1st code of ethics: the nurse practices with compassion and respect for the inherent dignity, worth, and personal attributes of every person; without prejudice.  
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Fidelity   Act in ways that are loyal. Keeping promises, within boundaries of the law, trustworthiness. Main support for accountability.  
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Veracity   Truthfulness. Basic foundations for a trusting relationship.  
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Slander   Defamatory statement made while talking.  
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Assault   Threat, or attempt, to make bodily contact with another person without that person's permission  
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Battery   Bodily contact with another person without that person's permission.  
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Autocratic Leadership   When the leader makes all the decisions. Often used in emergencies or when decisions need to be made in a hurry. Motivate through threat of punishment. rewards as incentives Maintain a distance from followers  
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Democratic Leadership   Leaders involve followers in decision making process; Participatory. Useful when followers are experienced.  
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Laissez-Faire Leadership   Does not interact with followers. Followers left to make own decisions and intervene during crisis . Often the result in employee apathy, inefficiency and chaos.  
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Transactional Leadership   Daily operations focused. Develop exchange relationships with followers. Reward followers when they perform & correct when necessary.  
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Transformational Leadership   Long term focus and high interaction with followers. Transform and change individuals organization and vision.  
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Shared Leadership   Focus on teamwork. Employee empowerment. Project focused or work groups  
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Trust Vs Mistrust   Infant, Birth to 1 years. Biological needs predominant. warmth, food, & comfort. Trust = basic needs meet with consistency . Mistrust = inconsistent, inadequate, or unsafe care.  
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Autonomy vs Shame & Doubt   Toddler, 1-3 years. Motor skills & Language, learn through environment and caregivers encouragement. Autonomy = self control and making choices. Shame & Doubt = over protective, expectations too high, punishments severe. separation anxiety 18-24m  
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Initiative vs Guilt   Preschool, 3-6 years. Environment explored, hows & whys of activities, conscience develops. Initiative = confidence gained as toddler leads to new role exploration. Guilt = restrictive & reprimand with new experiences. hesitant with more challenges  
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Industry vs Inferiority   School-age, 6-11 years. Working with peers. Industry = learn skills valued by society = higher self esteem, Gains pleasure, from finishing tasks and projects. Inferiority = skills are too difficult and learning not supported. lacks self worth.  
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Identity vs Role Confusion   Adolescence, 11-18 years. Matures sexually. Identity = trying new roles, rebellion is normal, develops sense of self and life direction. Role Confusion = unsure of direction and self.  
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Intimacy vs Isolation   Young Adulthood, 18-25 years. Intimacy = commitment to relationships and careers, acting with freedom and responsibility. Isolation = fear of commitment, becomes self absorbed.  
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Generativity vs Stagnation   Middle Adulthood, 25-65 years. Involvement with family, friends, & community. Generativity = expands, kids, ideas, services, products; preserve future generation. Stagnation = no involvement, obsessed with own needs or regress to earlier level to cope.  
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Integrity vs Despair   65 years - death. Adjust to life changes and losses. Integrity = finds order, meaning, and value in life; may not fear death. Despair = believes one's life has been a series of missed directions or failures.  
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Adaptive Development   Gaining of skills that enable independence @ home and in community. dressing/undressing, eating/feeding, toileting, grooming, functioning within community, crossing street, going to store, or politeness when interacting with others.  
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Cognitive Development   Sensory reception, processing and use of information about environments and object within. Understanding relationships between self and information. learning, understanding, problem solving, reasoning, & remembering. Moral & spiritual.  
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Communication Development   Express completely one's thoughts, ideas, and emotions. Receptive language function- understanding what others say. Articulation-pronunciation. Voice-sound by vocal cords. Fluency-rhythm. Language-shared rules to share ideas,thoughts & feelings.  
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Physical Development   Growth & changes to body tissues & organ systems, that result in changes to body proportions. Bilaterally and symmetrical.  
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Cephalocaudally   Growth from head to tail.  
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proximodistally   Growth from midline to periphery.  
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Refinement   Skills developing in order from gross to fine motor skills.  
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Social/Emotional Development   Personality. Interacting with others. Having relationships. Cooperation and responding to feeling of others.  
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Development   Sequence of physical, psychosocial, and cognitive development changes that take place over the human lifespan.  
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Growth   Quantitative changes which increases cell number and size resulting in an increase in over all size or weight of body or any of it's parts.  
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Differentiation   Process by which initially formed cells and structures become specialized. Qualitative changes.  
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Maturation   Qualitative changed associated with aging.  
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Milestones   Functional set of age specific tasks that most children can complete at a certain age.  
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Tasks   Specific set of skills that happen at certain ages that aid individuals in coping with the environment.  
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Arrest   Cessation of 1 or more phases before development reached normal completion.  
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Delay   Failure to meet expected level. Usually 2.5 standard deviations in 1 or more areas.  
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Community   A specific population or group of people in the same geographic area under similar regulation and having common values, interest and needs.  
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Family   Any group of people who live together and depend on one another for physical, emotional, and financial support  
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Family Dynamics   Interrelationships between and among family members. The way a family lives and interacts with one another.  
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Family Systems Theory   The family is part of a larger supra system and is composed of many subsystems. Family as a whole is great that individual members. Change in 1 family member affects everyone. Behaviors best understood in circular view.  
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Structural-Functional Theory   Family is a social system and each member has specific roles to play; i.e. father, mother, daughter... equilibrium established through dynamics function as a family unit and is society  
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Internal family stress   Change in family structure, psychological defenses, and philosophical values and beliefs. Can be controlled by family.  
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External family stress   Family has no control over. Culture of larger society. Time in history. Economic state of society. Maturity of family members. Genetic inheritance. Success of coping with stressors.  
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Family Life cycle   Pass through stages. Relationships with members irreplaceable. Development stressors can disrupt process.  
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Health Belief Model   Focuses on what people perceive to believe to be true about themselves in relation to their health. Perceived susceptibility, seriousness, and benefits of action. Affected by: demographics, sociopsychological, structural and cues to action.  
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Self efficacy   Own belief in the ability to reach goals and complete tasks.  
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Health Promotion Model   How people interact with their environment as they pursue health. Based on: Individual characteristics, behavior, activity, commitment to plan, and immediate competing demands or preferences.  
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Health-illness continuum   Views health as a constantly changing state. Adapting to changes in internal and external environments to maintain a state of well being. How well one is functioning with an illness.  
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Family cohesion   Emotional bonding that couples/families have towards on another. From the extreme of disengaged to overly connected.  
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Family coping   Actions to manage stressors that tax on families resources. Confronting problems. Involving members in decision making. Seeking assistance. Family centered stress reduction.  
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Family functioning   Capacity of the family system to meet the needs of its members through developments transitions. The quality of functioning is proportionate to the quality of communication and interaction.  
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Acute   Rapid onset of symptoms and last for a short period of time. Can still be life threatening.  
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chronic   Permanent change with 1 or more: Irreversible alteration in normal anatomy or physiology, Special patient education for rehabilitation, Long periods of care or support.  
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illness Behaviors   stage 1- experience of symptoms. stage 2- assuming the sick role. stage 3- assuming the role of a dependent. stage 4- achieving recovery and rehabilitation.  
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Biological Risk for Families   Birth defects. Mental retardation. Genetic predispositions to certain diseases, including cardiovascular disease and cancer.  
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Developmental Risks for Families   Families with new baby, especially when there is not a support system. Elderly, living alone or on a fixed income. Unmarried adolescent mothers lacking personal, financial and educational resources.  
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Environmental Risk for families   Air, water, or food pollution. Work and social pressures that cause stress. Lack of knowledge or finances to provide safe and clean living conditions.  
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Lifestyle Risk for Families   Lack knowledge about sexual/marital roles, teenage pregnancy, divorce, STD. Child, spouse, or elder abuse. Lack of prenatal or childcare. Alterations in nutrition. Chemical dependency. Inadequate dental care & hygiene unsafe or unstimulating home  
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Psychosocial Risk for Families   Inadequate child care resources, both parents work (preschool/school aged kids). Inadequate income to provide safe housing, food, clothing, and health care. Conflict between family members.  
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Functional ability   Physical, psychological, cognitive and social ability to carry out the normal activated of life. fulfill roles in family, workplace & community maintain health and well-being  
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Impairment   Varying degrees of an individuals inability to perform the tasks required to complete normal life activities without assistance.  
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Performance   Under what circumstances, with or without assistance, in how much time, and to what degree of effort can a person do an activity.  
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dependency   The amount of assistance of an adaptive device or another person an individual needs to complete a task.  
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Basic Activities of Daily Living (BADLs)   Self care activities and mobility. Eating, hygienic and grooming activities, dressing and toileting.  
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Instrumental Activities of Daily Living (IADLs)   Complex skills essential to living in the community. Managing money, grocery shopping, cooking, house cleaning, laundry, taking medications, using the phone, accessing transportation.  
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Primary Problem   Problems when the ability to perform a function never develops.  
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Secondary Problem   Problem that occurs after functional ability has been attained and then lost.  
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Functional Ability Assessment   The testing on the ability to perform a particular task.  
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Culture   A pattern of shared attitudes, beliefs, self definitions, norms, roles, & values that can occur among those who speak a particular language or live in a defined region. Guides: social relationships, expressions of thought, emotions & morality, religion.  
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Enculturation   A process by which a person learns the norms, values and behaviors of a culture. Similar to socialization.  
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acculturation   Process of acquiring new attitudes, roles, customs, or behaviors as a result of contact with another culture.  
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Assimilation   Process by which a person gives up their original identity and develops a new cultural identity by becoming absorbed into the more dominant culture group.  
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Biculturalism   duel pattern of identification Chose which aspects of the new culture to adopt and which aspects of the old culture to retain.  
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Ethnicity   Common ancestry that leads to shared values and beliefs.  
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Ethnic identity   Transmitted over generation by family and community.  
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Cultural Competency   Conveying acceptance of the patients health beliefs while sharing information, encouraging self-effecency, and strengthening the patient's coping resources.  
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Cultural Diversity   People of varying cultural background, racial and ethnic origin, religion, language, physical size, gender, sexual orientation, age, disability, socioeconomic status, occupational status, and geographical region.  
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Subculture   Large group of people who are members of the larger cultural group, but who have certain ethnic, occupational, physical characteristics that are not common in the larger culture. ie/ nursing subculture of health system culture  
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Culture shock   Feelings person has when they are placed in a new culture when it is perceived as strange.  
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Race   Usually categorized based on a specific physical characteristic, such as skin color, body stature, facial features, or hair texture.  
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Stereotyping   Assuming characteristing to a group without considering specific individuality.  
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Cultural imposition   Belief that everyone should conform to your belief system.  
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Cultural blindness   When one ignores differences and acts as if they don't exist  
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Cultural conflict   Aware of cultural differences and feel threatened, then respond by ridiculing those in different culture to make themselves feel more secure in their own beliefs.  
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Personal space   The area around a person regarded as the person. Individualized to each person.  
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Ethnocentrism   Belief that one's culture ideas, values, and beliefs are superior to others.  
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Motivation   Encompasses self-regulatory process involving the selection, activation, and sustained direction of behavior towards certain goals.  
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Intrinsic Motivation   Act a certain way because of feeling of enjoyment and competence, rather that because of obligations, pressures or rewards.  
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Extrinsic Motivation   Relies on attainment of an award or independent outcome. Self-determined or not. Example: Physical therapy because of the outcome of independence (self) Physical therapy because of pressure from family (not self)  
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Self Efficacy   Proximal determinants of human motivation, affect, and action. HIGH Self-efficacy = approach tasks instead of avoiding. LOW Self-efficacy = anxiety, stress, depression. Determined by level of motivation and how long one will persevere.  
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Intentions   A course of action that once intends ti follow. Based on: individual beliefs, normative beliefs, and control beliefs.  
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Compliance   The degree of consistency and accuracy with which a patient follows ta prescribed regimen.  
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Adherence   A self-inited action taken to promote wellness, recovery, and rehabilitation. Ranging from total lack of adherence, or omission, to total adherence  
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