Case 15- SAP Flashcards
A family
A married, civil partnered or cohabiting couple with or without children, or a lone parent with at least one child who live at the same address. Children may be dependent or non-dependent.
Nuclear family
Traditional family structure. Two biological parents (or adoptive) and children
Nuclear blended family
After a couple get divorced, the blending of two separate families. It consists of the blending of one biological and one non-biological husband, wife, or spouse and their children from previous marriages or relationships.
Types of family
1) Nuclear
2) Nuclear blended family
3) Same sex family- can be through conception methods
4) Single parent family- normally women
5) Extended family
6) Childless family- two partners living and working together without children
7) Grandparent family- when the grandparents are raising the children, parents are not present in the kids life
Extended family
2 or more adults related by blood or marriage living in the same home. They tend to work towards common goals like raising children. Can include cousins, grandparents etc. Can be due to financial difficulties or when older relatives cant care for themselves.
Age range of young people
10-24
Why do we need to think about young people specifically in healthcare engagement
- Engagement can be difficult yet is crucial for many health issues e.g. STIs + mental health
- Young people frequently drop out of healthcare systems after they leave paediatric care
- Failure to monitor + treat chronic illness can lead to irreversible disease-related complications + more emergency hospital admissions
Give the patient factors that challenge young people engaging in care
- Fear of confidentiality breach
- Parental presence
- Shyness, unfamiliar situation without parent
- Maturity level = affects ability to express themselves + understand given information
- Might not attend follow-up appointment, ongoing care is difficult
- Adolescence is a time of physical, social + psychological changes
- Sensitive issues may be hard to raise i.e. sexually active
- Personal organisation effects concordance with treatment
- Coming to terms with diagnosis may effect identity- may affect concordance
Give the doctor factors that challenge young people engaging in care
1) Lack of awareness
2) Increased time often needed to put the patient at ease
3) Time pressure can make consultations less effective, causing strain and distraction
From what age can a healthcare professional prescribe contraception without parental involvement
- At 16 a young person can be presumed to have the capacity to consent
- Under 16 a young person may have the capacity to consent, depending on their maturity + ability to understand what is involved = if they are assessed as competent + meet Fraser guidelines they can be given contraception
- Under 13 has to be reported to Social services as they can’t legally consent to sex + its a child protection issue
The fraser guildines relevant to prescribing contraception
- The young person understands the professional’s advice
- The young person cannot be persuaded to inform their parents
- The young person is likely to begin, or to continue having, sexual intercourse with or without contraceptive treatment
- Unless the young person receives contraceptive treatment, their physical or mental health, or both, are likely to suffer
- The young person’s best interests require them to receive contraceptive advice or treatment with or without parental consent
How family can affect wellbeing
- Organisation
- Clear rules, expectations + boundaries
- Good generational boundaries, i.e. parental hierarchies
- Good marital relationship
- Good communication
- Modelling healthy habits i.e. diet and exercise
- Can provide proper nutrition and shelter
- Support network
Family stress can increase your risk of illness
Better outcome’s for managing chronic illness within the family
- Good expressive communication
- Routines- but with ability to be flexible
- Balancing needs of person with chronic illness with the needs of the rest of the family
- Emotional stress of conflict within the family can cause physiological responses that may worsen outcomes
Importance of the lay referral system
The decision to act upon symptoms is often due to discussions with a range of people, either immediate members of a persons family or their friends and colleagues
Significance of the lay referral system
People re-interpret medical and social information within a lay framework, conflict between lay and medical ideas can affect the patient/doctor relationship. Lay ideas are an important influence on the experience of health and illness. Its linked to Zola’s triggers and sanctioning
What influences the decision to use or avoid professional healthcare systems
- The extent of ‘close knit social relations’ between the members who make up a person’s lay referral system, and
- The predominant values and attitudes to professional health care within that lay referral system
Primary Amenorrhea
Menses has not started after 13 years if secondary sexual characteristics have not developed or after 15 years if secondary sexual characteristics are present.
Secondary amenorrhea
Absence of menses for 3-6 consecutive months
Causes of primary amenorrhea
• Idiopathic/constitutional delay in growth and puberty (diagnosis of exclusion)
• Impaired HPO axis i.e. Kallman’s syndrome
• Chronic illness i.e. Crohn’s
• Malnutrition i.e. Coeliac
• Excessive exercise
• Stress
Malnutrition, excessive exercise and stress are linked to an eating disorder
Stress and the menstrual cycle
• Increased stress may stimulate the HPA (Hypothalamic-pituitary-adrenal) axis
• This causes an increase in cortisol releasing hormone (CRH)
• CRH increase causes an increase in adrenal production of cortisol
• Activation of the HPA axis has an inhibitory effect on the Hypothalamic-pituitary-ovarian axis (HPO axis)
Could be what causes Amenorrhea in eating disorders
Functional Hypothalamic Amenorrhea
A form of chronic anovulation, not due to an identifiable organic cause but is associated with stress, weight loss and exercise
• The ovary is functional but stressors are impeding its function
• Linked with HPA axis, i.e. adrenal release of cortisol
• Linked to metabolic components i.e. leptin, insulin, ghrelin
• Causes reduced GnRH release which may be linked to kisspeptin release
Age range for adolescent
12-20
