Long-term Conditions Flashcards
(35 cards)
75yo lady, retired headteacher, no recent appointments at surgery since usual GP retired. Why might she not have attended recently?
Retirement of previous GP: longstanding relationship, trust, person-entered approach
Worries about new relationship with new GP
Might have been in good health
May have developed symptoms and be worried about what might be found
What is person centred care?
Places the patient at the centre, only the patient is in a position to make a decision on what this means to them
Designed to meet the needs and preferences of patients as defined by patients themselves
What are the principles and values that define patient-centeredness?
International Alliance of Patients’ Organisations (IaPO) Declaration on Patient-Centered Healthcare
What are the five principles the Declaration on Patient-Centered Healthcare outlines?
- Respect
- Choice and empowerment
- Patient involvement in health policy
- Access and support
- Information
What are some long-term diseases?
Osteoarthritis
Ischaemic heart disease
Repiratory disease e.g. COPD
How do long-term diseases impact patients lives?
On individual can be negative or positive: denial, self-pity, apathy
May endure multiple handicaps that affect social, physical and psychological well-being
Constraints on family life: financial, emotional, physical
Other family members may become ill as a result
Failure to re-establish functional capacity to work
Community/society: isolation
Unremitting physical discomfort/chronic pain
What percentage of GP appointments do long-term conditions account for?
50%
Who are long-term conditions more prevalent in?
Older people
Deprived groups
What is incidence?
The number of new cases of a disease in a population in a specified period of time
What is prevalence?
The number of people in a population with a specific disease at a single point in time or in a defined period of time
How can knowing incidence of a disease help?
Tells us about trends in causation and aetiology of disease
Can be helpful for planning staffing and services for the future
How can knowing prevalence of a disease help?
Useful in assessing the current workload for the health service but is less useful in studying the causes of diseases
Long term conditions are usually the end result of a complex interaction of factors, what are the main categories of factors?
Genetic factors
Environmental factors
Both or neither
What is vulnerability?
An individuals capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerability
How does natural history of a disease vary?
Some may have acute onset e.g. stroke or MI
Some have gradual onset with a slow or more rapid deterioration e.g. angina
Relapse and remission e.g. cancer
What can treatment be aimed at?
The disease or the effect of the disease
What demands can the burden of treatment put on patients or caregivers?
Changing behaviour or policing the behaviour of others to adhere to lifestyle modifications
Monitoring and managing symptoms at home, can include collecting and inputting clinical data
Complex treatment regimes and multiple drugs
Complex administrative systems, and accessing, navigating and coping with uncoordinated health and social care systems
What is biographical disruption?
Loss of confidence in social interaction or self-identity
How do patients cope with stigma?
Decision about whether to disclose the condition or suffer further stigma
Attempts to conceal the conditions or aspect of the condition and pass for normal
What is an expert patient?
Patients with long-term or chronic conditions who understand their disease very well
What is the dictionary definition of disability?
Lacking in one or more physical powers such as the ability to walk or coordinate ones movements
What is the legal definition of disability?
Disability Discrimination Act - 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.
What classification does the WHO use for disability?
ICIDH = International classification of impairments, disability and handicap has been updated with ICF which removes the term disability and handicap.
= International classification of functioning, disability and health (ICF)
What are the components of the WHO ICF?
Body and structure impairment: abnormalities of structure, organ or system function
Activity limitation: changed functional performance and activity by the individual
Participation restrictions: disadvantage experienced by the individual as a result of impairments and disabilities (at social and environmental level)
