Long Term Conditions Flashcards

1
Q

What is the patient being at the centre of care known as?

A

Patient centred care

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2
Q

Who is the only person in the position to make decisions on what patient centred care means to them?

A

The patient

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3
Q

What are the principles and values that define patient-centreness brought together by?

A

International Alliance of Patients’ Organisation (IaPO) declaration

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4
Q

What are the 5 principles of the International Alliance of Patients’ Organisation (IaOP) declaration?

A

Respect

Choice and empowerment

Patient involvement in health policy

Access and support

Information

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5
Q

Is the prevalence of long term conditions increasing or decreasing?

A

Increasing

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6
Q

What can the handicaps of long term conditions impact in terms of well-being?

A

Physical, social and psychological well-being

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7
Q

Who are chronic conditions most prevalent in?

A

Older people and deprived groups

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8
Q

In terms of GP appointments, outpatient appointments and inpatient bed days, what percentage do chronic conditions account for?

A

50% of all GP appointments

64% of all outpatient appointments

Over 70% of all inpatient bed days

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9
Q

What is incidence?

A

Number of new cases of a disease in a population in a specified period of time

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10
Q

What is prevalence?

A

Number of people in a population with a specific disease at a signle point in time or in a defined period of time (existing cases)

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11
Q

What does incidence tell us about?

A

Trends in aetiology of diseases and can plan for the future (such as increasing staffing for more clinics)

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12
Q

What does prevalence tell us about?

A

Amount of disease in a population and is useful in assessing the current workload

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13
Q

What is chronic disease usually the end result of?

A

Long term complex interactions between genetic and environmental factors (could be both or neither)

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14
Q

In terms of chronic disease, what is meant by vulnerability?

A

Someone’s capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerable

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15
Q

What is an example of an organ that repairs well, and one that does not?

A

The liver repairs well, the brain does not

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16
Q

How can the natural history of diseases vary?

A

May have acute onset

May be gradual with a slow or more rapid deterioration

May be relapse and remission

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17
Q

What are examples of diseases with an acute onset?

A

Stroke or MI

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18
Q

What is an example of a disease with a slow or more rapid deterioration?

A

Angina

19
Q

What is an example of a disease with relapse and remission?

A

Cancer

20
Q

What can treatment be aimed at?

A

The disease, or the effect of the disease

21
Q

What is meant by the “burden of treatment”?

A

Patients and caregivers are often put under enormous demands by healthcare systems

22
Q

What kind of things cause “the burden of treatment”?

A

Changing behaviour or policing the behaviour of others to adhere to lifestyle modifications

Monitoring and managing their symptoms at home

Complex treatment regiments and multiple drugs (polypharmacy) contribute to the burden of disease

Complex administrative systems, and accessing, navigating and coping with uncoordinated health and social care systems

23
Q

What is biographical disruption?

A

Long term conditions lead to loss of confidence in the body

There is then loss of confidence in social interactions, or self-identity

24
Q

What is a consequence of biographical disruption?

A

People need to adapt to their condition, which involves redifining the ideas of what is good and bad such as positive aspects of their lives being emphasized

25
Q

What must be remembered about the visibility of long term conditions?

A

Some are visible and some are invisible, and some are both

26
Q

What can be said about the stigma of long term conditions?

A

Having a chronic condition subjects a person to possible stigmatisation by those who do not have the illness

27
Q

What does coping with stigma involve?

A

A variety of strategies including decision about whether to disclose the condition or attempt to conceal the condition or aspects of the condition and pass for normal

28
Q

Who can the impact of chronic conditions be on?

A

The individual

Family

Community/society

29
Q

What are examples of the impact of chronic conditions on the individual?

A

Can be negative or positive, could include denial, self-pity and apathy

30
Q

What are examples of the impact of chronic conditions on the family?

A

Can be financial, emotional and physical

Other members could become ill as a result

31
Q

What is the patient becoming very knowledgable about their chronic condition, perhaps even moreso than some doctors, called?

A

The expert patient

32
Q

What are the different definitions of disability?

A

Lacking on one or more physical powers such as the ability to walk or coordinate ones movements (dictionary)

Difficulty can be physical, sensory or mental. A disability that makes it difficult for them to carry out normal day to day activities ongoing for more than 12 months (legal, Disability Discrimination Act)

International Classification of Impairments, Disability and Handicap (ICIDH), updated with ICF which removes the terms disability and handicap

33
Q

What does ICF stand for?

A

International Classification of Functioning, Disability and Health

34
Q

What does ICF consider disability to be?

A

Body and structural impairment

Activity limitation

Participation restriction

35
Q

What does ICF mean by body and structure impairment?

A

Abnormalities of structure, organ or system function (organ level)

36
Q

What does ICF mean by activity limitation?

A

Changed functional performance and activity by the individual (personal level)

37
Q

What does ICF mean by participation restriction?

A

Disadvantage experiences by the individual as a result of impairments and disabilities (interactions at a social and environmental level)

38
Q

What are the 2 different models of disability?

A

Medical and social

39
Q

What is in the medical model of disability?

A

Individual/personal cause (such as accident whilst drunk)

Underlying pathology (such as morbid obesity)

Individual level intervention (such as health professionals advice individually)

Individual change/adjustment (such as change in behaviour)

40
Q

What is the social model of disability?

A

Societal cause (low wages)

Conditions relating to housing

Social/political action needed (such as facilities for the disabled)

Societal attitude change (such as use of politically correct language)

41
Q

What legislation protects people with disabilities?

A

Disability Discrimination Acts (1995 and 2005), only applies in N. Ireland now as has been replaced by the Equality Act 2010 in the rest of the UK

42
Q

What are your responsibilities as a doctor towards disability?

A

Recognise your attitudes will pass onto your patients and those who you treat

Listen to your patients and learn

Recognise your own age and culture may affect your views

Co-ordinate the MDT

Intervene in the form of rehabilitation

43
Q
A