OT423: MIDTERM

Speaks, Listening, develops trust ,Having a level of self-awareness helps you have quality therapeutic communication

the systematic application of mental health counselling and other professional skills into every day interactions by health care providers to help individuals who seek mental health care

that places the patient in a position of informed, equal and inevitably responsible for any positive outcomes in the helping process.

“intervention“

Is weakness or the inability to move on one side of the body, making it hard to perform everyday activities like eating or dressing.

• Needs

• Values

• Cognition

• Emotions:

• Sympathy: you feel similar things

• Pity :(with a negative connotation)

1.  self-Transposal

2.  crossing over – find ourselves in the same frame of reference/ their lived world

3.  A momentary merging of another person in a unique moment of shared meaning.

cognitive thinking of myself in the position of the other. Trying to imagine what it must be like for the patient.

** This is not empathy.

sets the stage for empathy to occur.

*appropriate. cog thinking of putting yourself

“ its cold outside” elevator chat

Little pieces of factual information

1. Starting to get to know your client

2. Ask about family members

1. Can be friends with a pt.

2. Rarity

1. Intimate relationship

2. Never be at the level

3. Not appropriate

the purpose of giving and receiving information by means of gestures, words and tone of voice…”. The context must also be considered!

• Verbal expression

• Listening

• Written

• Non verbal expression

• Restatement- repeating the words of the speaker as you have heard them.

• Reflection- verbalizing both the content and implied feelings of the sender. The purpose is to express in words the feelings

• Clarification- summarizing or simplifying the sender’s thoughts and feelings and resolving confused verbalizations into clear, concise statements.

Indicates that the words and the music match. Congruence is present when

what I say matches what I do and what I feel.

• Ownership of your own actions and feelings

• Avoid preconceived notions

Effective helpers are committed to discovering the personal meaning of knowledge and converting it to belief.

Was to know information

frame of reference that emphasizes facts, things, organization, money, etc

Internal: feelings, values belief

External: money, organizational goals.

• A source of satisfaction in professional work rather than a source of suspicion and frustration

• Your goal is really to facilitate

• Therapeutic presence for the other is made possible by a strong sense of self, personal fulfillment, and of personal adequacy.

• Personal boundaries and fulfillment

• They see themselves as altruistic, oriented toward assisting people rather than simply responding to selfish needs.

• The big picture

• Altruism: selfless code of principles

• Effective helpers are more oriented toward people than toward rules and regulations or things.

• Ppl oriented, client-centered

• facilitate someone through their own choice and be masters of their own environment

Is the social behaviors and norms found in human societies.

• As the stress experienced when individuals can not meet their everyday needs as they would in their own culture

• what you learn in your own culture does not work in a new culture

Its important to know race and age bc it gives us insight what population we will be working with .

An example of the federal government safeguarding the rights for the provision of culturally competent care for all children with disabilities.

• Cultural competence = cultural sensitivity= intercultural communication

• a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals to work in cross-cultural situations.

• TALK TO YOUR PTS

• research

• continuing learning

• need to be sensitive to a client’s beliefs, attitudes, and behaviors regarding their illness, injury, or disability.

What people think is true

What people do.

How people feel about something

• Etiology, the onset of symptoms, pathophysiology, course of sickness, and treatment for the particular problem being addressed.

• On the cultural level, there may be differences between the explanatory model of the family and the explanatory model of the healthcare professional

• enhance our PPI(patient practitioner interactions)

Patient Practitioner Interactions

1. How is this client like all human beings?

2. How is this client like some human beings?

3. How is this client like no other human being?

• “You don't tell me you're running late.”

• “You were talking to that client for half an hour.”

• “I felt lonely when you did not come home to have dinner with me all week.”

• “We“ identity

• high levels of communication

• Group goals

• Surrounding circumstances

• Verbal communication

• strong emphasis on relationships

ex: A fam that takes care of one another

Asia, Africa, Central and South America and Pacific Island Societies

Collectivistic

Individualism

• “I” identity

• individual goals

• management of time

• privacy

• task oriented

ex: CEO of a company

Maintaining a claimed sense of self-dignity or regulating a claimed sense of self-humility in interaction.

Low Context Cultures

set schedule from 9-12 lunch 1-5 dinner

high context cultures

Based on human interaction

Low Context Cultures

High Context Cultures

• General Acute and Or Intensive- save my life

• Rehab Hospital – help me achieve max function

• SNF/Sub acute rehab

• HHA/Assisted Living Facility-

• Acute Care

• School-based-

• Hospice – control my pain

• Outpatient- don’t keep me waiting

• Public Health-

• Industry – get me ready to go back to work

high context communication the vast majority of the information is already understood,

ex: The supervisor coming to see the facility, everyone knows the deal and behaviors might change.

ex: the concept of awkward silence

These include gestures, positioning of the body, and tenseness of the facial expressions.

Getting to know the healthcare professional as a person and helps establishing rapport

Reporting physical symptoms when a person is experiencing psychological distress. Bc in some cultures where complaints of anxiety, worries, and depression are perceived as signs of weakness.

1. Healthcare specialist applies a name to a problem

2. The qualities of a healthcare professional are important. The professional must be perceived as caring, competent, approachable, and concerned with identifying and finding solutions to the problem

3. The healthcare professional must establish credibility through the use of symbols and trappings of status that are familiar to the culture.

4. The practitioner places the client’s problems in a familiar framework. **(this implies recognition of the client’s explanatory model by the practitioner).

5. The healthcare practitioner applies a set of techniques meant to bring relief.

6. Interactions between the client and practitioner occur at a special time and place.

• The patients preferred language in writing and verbally offer language assistance services at no cost to each patient consumer with limited English proficiency.

  • Research demonstrated using professional interpreter services significantly increases satisfaction with patient-provider communication.

• Spirituality is a basic human experience.

• Connection with other people and environment

• Literature suggests that spirituality/ religion are linked with health outcomes

• Learning disability

• Amputation

• Schizophrenia

• Paralysis

• Pain

• Bipolar

• We need to remember real people have these disorders.

• Language is a powerful symbol. It demonstrates our understanding of concepts

• Language influences beliefs, attitudes, expectations, and the course of events.

• a negative stigma

• dehumanization

• disempower

• physical barriers

•“being confined to a wheelchair

•Using a wheelchair

•Being a quadriplegic

•Person who has quadriplegia

A condition of the person.

Used to describe the accrued result of multiple barriers (emotional physical social environments) imposed by society which prevents an individual in assuming a desired role in society.

Framework that incorporates health conditions and their effects as well as environmental factors.

•Life expectancy of persons with a disability have increased.

•Age related changes combined with the factors of a disability can lead to long term disabilities

•Asking clients questions about their daily routines habits and patterns can aid in identifying a secondary condition before it becomes a serious threat.

•How are you  sleeping?

•Any pain?

•Feeling tired?

Persons with disability are more likely to report additional conditions.

ex:

•Chronic Pain

•Muscles spasms

•Depression

•Anxiety

•Isolation

•Vision

A society in which all people can achieve their full potential for health and well-being across the lifespan.

•Mission

To promote, strengthen, and evaluate the nation’s efforts to improve the health and well-being of all people.

•Foundational Principles

The following foundational principles guide decisions about Healthy People 2030:

•Raise awareness

•Recognize perceptions and biases

•You are obligated to recognize the abilities of all people.

•Be aware of the influence of your language and general presence

study of moral behavior

right Vs. Wrong

morals of a group or culture

Establishing a moral system

• Changing health care/human service  environments require efficiency, competence, attention to functional outcomes

• Services are commonly provided in fast paced environments – attn. to bottom line

• Need for competence performing multiple tasks and solving multiple problems quickly

• Departments are often small -  limited peer interaction/ supervision

Situations which one believes to have moral challenges

helps identify issues and conflicts between values (often reflect personal, institutional; professional values)

• ex: Code of Ethics, Contracts, policies, etc.

Pt. has to actually make progress → Outcomes

(replacing RUGs)

• Here is my practice act(therefore I cannot do this)

• Give me continuing education credits to do this with further pts.

1. know what to do but you may stand to benefit and don’t want to do the right thing.

2. know what you have to do but may be constrained

Deal with which is better or worse

1. Moral sensitivity – know how you impact others

2. Moral judgment – what is right or wrong

3. Moral motivation – prioritizing moral vs. Personal values

4. Moral Character – implementation skills

situation that requires an ethical compass but not to a high degree

• Value- based care

• Healthcare reform

• Patient demands

• Payer demands

• Financial burdens

• Heavy work load

• Staff skills

• Lack of resources

Next of Kin

Durable medical equipment

1. ETHICAL COMPONENT

2. CODE OF ETHICS

3. TRY TO FIGURE OUT WHAT WILL GIVE YOU THE MOST ETHICAL OUTCOME

has been defined as the lessening of one’s ability to empathize due to exposure to trauma and suffering.

• short

• procedural

• count your time

• not the best listener

• don’t see the bigger pic

• resp filled with emotion

can result from having many opportunities

ex: too many job offers

an result from an inability to solve a problem

Life situation → Perception → Emotion → Physiological Response → Disease

Can dictate your world concept , world view

Is a state of emotional and physical exhaustion that results from intense and long standing professional stress

• You may start with enthusiasm and optimism and then realize the demands of your job exceed your expectations.

• Detachment

• Drawing sharp boundaries between work and home

• Withdrawal

• Less creative treatment sessions

• By the book responses

• Less time spent with patients/ people

• Engaging in compulsive behaviors

  • Applying for other jobs

• Headaches

• Stomach aches

• Workload

  • Understaffed

  • Overload of same type of conditions

  • Unable to be creative due to lack of time

• Role Ambiguity

  • Unclear job description

  • Unclear job expectations

• Role Conflict

  • Large team with minimal communication

  • physicians may make choices about care without the input from other health care professionals

• The professionals self esteem

• Inability to set clear boundaries with patients or staff

• New grads tend to set unrealistic optimistic goals for patients and then fail to meet them

• Stay present/ stay in the now

• Having a realistic perspective

• Ask clarifying questions

• Lowering staff to patient ratios

• Doing less stressful tasks (reading journal articles, planning patient research, student education)  allows one to limit intense interactions.

• Required vacation time

• Reg staff rotations (gaining variety)

• Taking your lunch break away from patient care areas

the process of instructing by precept, example, or experience

• A process where there is change in a subjects behavior to a given situation brought about by his repeated experience in that situation.

• through change in a persons verbal and non verbal behavior.

1. Learning is influenced by the individuals inherent capacities, current assets and limitations, age, sex, interest, past and present culture group membership.

ex:

• teaching a baby to brush their teeth vs for adults

• culture:

2. Attention and perception influence learning

• Make the environment minimally distracting

• Learners perceptions can be based on their past experiences

• Why must you consider this principle when facilitating learning.

  • learning in a loud env vs. quiet

3. The learners motivation is important.

• Motivation is an internal process.

• Motivation to achieve goals

• The teacher will attempt to determine the clients source of motivation

  • facillate motivation is essential to achieve goals

4. Learning goals set by the individual are more likely to be attained than goals set by someone else.

• Client-centered

• client focused attention

• Active participation is the goal setting process

  • doing something you want vs. what someone else wants

5. Learning is enhanced when the individual understands what is to be learned and the reason for learning.

• The therapist will describe what the client should learn and why they are being encouraged to learn this information.

6. Learning is increased when it begins at the individual’s current level and proceeds at a rate that is comfortable for the individual.

• Meet the client at their current level

• Evaluation will allow an OT to determine a client’s capabilities

  • development theory : working on current level of client

7. Active participation in the learning process facilitates learning

• Active participation includes

• (A) Learning through discovery

  • Learning about something that was previously unknown.

  • Or they can lead to frustration, lack of learning

  • If done right cant promote curiosity

• (B) Learning through doing

  • Gaining skills through involvement