Block 5 Flashcards

(61 cards)

1
Q

Name 3 activities of daily living (ADL)

A

Tying shoelaces

Getting out of bed

Walking to the shop

Walking upstairs

Making a cup of tea

Turning a key in the door

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2
Q

what is an ADL

A

Anything that is an essential part of life that we tend

to do nearly every day.

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3
Q

Name 3 common neurological

conditions which are likely to affect ADLs

A

Neurological = stroke, Parkinson’s disease,
cerebral palsy, MS, paraplegia/tetraplegia,
traumatic brain injury, motor neurone disease

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4
Q

Name 3 common musculoskeletal

conditions which are likely to affect ADLs

A

Musculoskeletal = arthritis, back pain, neck
pain, plantat fasciitis, frozen shoulder,
tendinopathy, tennis elbow, fractures, sprains
etc.

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5
Q

Define:

Impairment

A

Any temporary or permanent loss or abnormality of a body structure or function whether physiological or psychological. (Eg. Amputated leg)

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6
Q

Define

Disability

A

Restriction or lack of ability to perform an activity in the manner or within a range considered normal mostly resulting from impairment (E.g. difficulty walking)

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7
Q

Define Handicap

A

A disadvantage for a given individual, resulting from an impairment or a disability that limits or prevents the fulfillment of a role that is normal for that individual

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8
Q

What is the role of occupational therapists?

A

Functional assessment
Goal setting
Occupational issues
Quality of life

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9
Q

What is a SMART goal? (mnemonic)

A
goals are usually used by allied health professionals such as occupational therapists/physiotherapists etc
Specific
Measurable
Achievable
Realistic
Time specific
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10
Q

What global measures can be used to assess ADL?

A

Barthel Index
Functional assessment measure (used in the UK)
Self report questionnaires such as the Nottingham Health Profile

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11
Q

What kinds of things does the Barthel Index measure specifically?

A

It is out of 100, and each criteria has different points available based on how well the individual can carry out each criteria.
Criteria include: Feeding, bathing, grooming, dressing, bowels, bladder, toilet use, mobility, stairs, transfers from bed to chair etc.

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12
Q

How many working days are lost due to musculoskeletal disorders?

A

10 million working days equating to a cost of absence of £7Bn (Our aging population will increase this number in the years to come..)

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13
Q

How much do depression, anxiety and stress related health problems cost the NHS per year?

A

£28Bn

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14
Q

What psychosocial problems could contribute to back pain?

A

Fear, distress, worry, stress, anxieties, financial issues, concerns about relationship etc.

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15
Q

Why was the medical model detrimental to the
social status and wellbeing of disabled people in
previous years?

A

The medical model of disability emphasized what
was wrong/abnormal with the person and what
the person could not do. It resulted in separate
education, employment and living situations as
well as exclusion from society.

It had an impact on the language used when
talking about disabled people (‘confined to a
wheelchair/wheelchair bound)

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16
Q

In what decade did disabled rights movements

begin to develop?

A

1960s

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17
Q

What are some of the critiques of the medical

model?

A

It individualizes disability and does not account
for social barriers

If treatment of the illness is unsuccessful, the
doctor fills out forms to legitimize the illness as
a disability making it a part of their personal
identity

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18
Q

What does the social model of disability claim, in
regard to the reasons for the disadvantages that
disabled people face?

A

They do not face disadvantage as a result of their
physical or mental impairments but more likely
face these disadvantages as a result of the way our
society is organized.

This happens if society fails to make education,
work, leisure and public services accessible, fails
to remove barriers of assumption, stereotype and
prejudice and fails to outlaw unfair treatment in
our daily lives.

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19
Q

What aspects of society does the social model put

emphasis on?

A

Badly designed buildings, segregated
education, poverty and low income,
inaccessible transport, no lifts in certain place

Hypocrisy, lack of awareness, prejudiced and
patronising attitudes

Poor job prospects, lack of enablers such as
interpreters etc.

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20
Q

What are some criticisms of the social model?

A

It is an image of an idyllic society where
impairments cause individuals no problems at
all

Some argue that the model was developed for
white middle class heterosexual men with
spinal injuries and so it does not recognise the
complexity of different disabled people’s lives
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21
Q

In 2000, WHO produced a document called ‘The
International Classification of Functioning,
Disability and Health’ (ICIDH-2). What did this do?

A

It showed that disability was a continuum and
people lie on different points of the continuum
It identified 3 factors that affected the disability:
the human body and its organs, the human
being as a whole and the social environment in
which they live

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22
Q

What did the Disability Discrimination Act

(DDA 1995) give disabled people?

A

Gave new rights to people who have had a

disability in order to make ADLs easier

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23
Q

What does the Equality Act (2010) define

‘disabled’ as?

A

If you have a physical or mental impairment
that has ‘substantial’ and ‘long term’ negative
effect on your ability to do normal daily
activities

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24
Q

What percentage of people in the world have had

moderate or severe disability?

A

15.3% - This number is increasing due to the aging

population

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25
What is the ‘radical disability model’?
‘Those who are externally identified as disabled and those who self identify as not disabled’ Some members of the deaf community have attempted to distance themselves from other disabled groups by arguing that ‘there is nothing wrong with them’. They believe that they are not disabled but instead, are a linguistic minority and think and experience the world in a different way.
26
Define ‘justice’
The requirement that we treat other people in | a way that is fair or equitable
27
Define ‘distributive justice’
How to distribute scarce resources in a way | that is just or fair
28
Distinguish between moral, legal and human | rights
Human = legal instruments which represent fundamental human interests and are therefore aligned with ethical practice. Based on dignity, fairness, equality, respect and autonomy.
29
What is a needs based assessment in relation to | resource allocation?
It measures a person’s needs and states that we should make resource allocation decisions based on people’s needs: therefore needs should go to those who need it most
30
What is the ‘difference principle’ (John Rawls) ?
When joining a society, you would choose the one where the worst off people were reasonably well off
31
What are some objections to needs based | approaches?
‘Needs’ are difficult to measure and define Who’s needs count? What types of needs are relevant? Meeting need is not the only thing to consider- the well off need healthcare too! Bottomless pit objection = the very worst off will absorb almost all of our healthcare resources as we can always spend a little bit more and make them a bit better off
32
What are some criteria for healthcare delivery that | have been suggested or even implemented?
QALY calculation = a measure of the state of health of a person or group in which the benefits, in terms of length of life are adjusted to reflect the quality of life (quality of life adjusted year) Place on the waiting list (‘first come, first served’) Likelihood of complying with/responding to treatment Types of lifestyle choices that the patient has made Ability of the patient to pay (private healthcare)
33
What are some arguments for lifestyle based | assessments?
Those who make bad lifestyle choices are less deserving of treatment They are aware of the dangers attached to such behaviour and so have forfeited their right to receive treatment or healthcare They are more likely to be deterred from bad lifestyle choices if they are not prioritised Treating those who do not contribute to their ill health are likely to be more substantial and long lasting than those with bad lifestyle choices
34
What are some arguments against lifestyle based | assessments?
Many who engage in high risk behaviour may not be responsible for their decisions due to lack of education or bad living environments It is hard to ascertain whether ill health is directly a result of the lifestyle choice It is far from clear that the treat of non treatment may deter (drug addicts are unlikely to stop abusing) Violation of professional codes of ethics (GMC 2013)
35
What are Positive rights
someone has a duty to do something
36
What are Negative rights
others have a duty to refrain from doing | something
37
What are Active rights
allows people to act or not act as they | choose
38
What are Passive rights
rights not to be done by others in certain | ways
39
Why are rights important?
Security of expectations Protective boundaries Conductive to goods (dignity, respect, equality) Minimum standards Ideal directives
40
What were the main aims of the Human Rights Act | 1998?
To make it possible for people to directly raise or claim their human rights within complaints and legal systems in the UK To bring about a new culture of respect for human rights in the UK
41
Which rights from the Human Rights Act are | relevant to healthcare?
Article 2 = Right to life Article 3 = prohibition of torture (or inhumane/degrading treatment or punishment) Article 5 – Right to liberty and security Article 6 = Right to a fair trial Article 8 = Right to respect for private and family life Article 9 = Freedom of thought, conscience and religion Article 10 = Freedom of expression Article 12 = Right to marry and found a family Article 14 = Prohibition of discrimination
42
What are the 3 types of rights in regard to rules on | their derogation?
Absolute = no derogation is permitted though even these rights are open to interpretation (Article 3) Limited = limitations are explicitly stated in the wording of the article (Article 2,5,6) Qualified = derogation is permitted but any action must be based in law, meet convention aims and be necessary and proportionate in a democratic society (Article 8,9,10,11,12)
43
What percentage of the population of the UK | are carers?
10%
44
What are the most common carer ethnicities?
Bangladeshi, Pakistani, Indian and finally | White British
45
Which part of England has the lowest | proportion of carers?
London
46
In what types of areas do the most carers live?
Places with higher levels of deprivation and | long term illness
47
What is the definition of an ‘informal carer’?
Someone who, without payment, provides help and support to a partner, child, relative, friend or neighbour, who could not manage without their help (due to age, physical/mental illness, addiction or disability)
48
What do carers do?
Provide practical help (preparing food or shopping), ‘keeping an eye’ on the care recipient, providing company, providing help with personal care (bathing, grooming etc), giving medication, providing physical help (getting in and out of bed)
49
What are the effects of caring on the carers | health?
High levels of physical and mental health problems (2x more likely to have bad health than non carers) Co resident carers are more at risk than extra resident carers Do not have time to look after their own health
50
What rights do carers have?
Right to an assessment of needs which must consider carers’ wishes about employment, training, education and leisure Carers special grant = funding for respite and short breaks Carers allowance = £61.35 per week for carers who regularly spend at least 35 hrs per week caring for someone with a severe disability who receives disability benefit Work and families act 2006 = carers of adults can request flexible work
51
What are the criteria for carers allowance?
The person you care for is getting attendance allowance or disability living allowance You are caring for at least 35 hours a week You are 16 years old or over If you are working, earnings must be below £100 a week You are not in receipt of overlapping benefit You are studying no more than 21 hours a week
52
What are the challenges for carers of: | People with dementia
Practical support, alleviation of emotional | stress, respite care and short term breaks
53
What are the challenges for carers of: | People with mental health problems
Fluctuating needs, stigma and discrimination, | medication control, confidentiality
54
What are the main things that carers want and | that we should be able to provide?
Quality of life for the person they care for Quality of life for themselves Accurate and honest information about services and what is on offer Support and training To know that someone will take over care in an emergency
55
What is a clinical trial?
A planned experiment involving patients, designed to determine the most appropriate treatment of future patients with a given medical condition Does not assume a control group or randomisation like a randomised controlled trial
56
Why do we randomise in randomised controlled | studies?
To eliminate systematic bias in allocation of interventions To ensure balance across comparative groups for known and unknown baseline factors that may affect outcome It is more ethical as the placebo/treatment is not decided by the researcher
57
What is stratification?
A process that can be built into randomization to ensure that important factors that affect the outcome are balanced across the groups being compared
58
What is performance bias?
Systematic difference in the care provided to the participants in the comparison groups other than the intervention under investigation
59
what is a right
Justified claims on others: can be legal, moral or | human rights
60
what is equality
being the same in quantity, amount, value etc. (The healthcare system should be EQUITABLE)
61
what is equity
fairness or impartiality