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Flashcards in Long term conditions Deck (51)
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What is person centred care?

Only the patient is in a position to make a decision on what patient centered healthcare means to them, as an individual, in the treatments of their condition and the living of their life. (Treatment options, therapies and models of care)

The provision of care that places the patient at the centre ensuring that the healthcare system is designed to meet the needs and preferences of patients as defined by patients themselves.


What brings together the principles and values of patient centred care?

These principles and values are brought together in the International Alliance of Patients’ Organizations (IaPO) Declaration on Patient- Centered Healthcare.


What examples are there that a patient can decide on in patient centred care?

Treatment options, therapies, and models of care


What are the five principles of patient centred healthcare?

1) Respect
2) Choice and empowerment
3) Patient involvement in health policy
4) Access and support
5) Information


What are the complications of long term conditions

Physical, social and psychological well-being.

Constraints on family life,

Capacity to work

Unremitting physical discomfort (often chronic pain)


Who is most commonly affected by long term conditions?

The elderly - 58% of people >60yrs, compared to 14% <40yrs

More deprived


What percentage of GP appointments are due to long term conditions?



What percentage of outpatient appointments are due to long term conditions?



What percentage of inpatient bed days are due to long term conditions?



What examples of degenerative chronic disorders?

- Parkinson's disease
- Multiple sclerosis
- Arthritis
- Many others


What is incidence?

The number of new cases of a disease in a population in a specific time period

Tells us about trends in causation and the aetiology of disease.


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

Tell us about the amount of disease in a population.


What can be the aetiology of a chronic disease?

- Genetic factors
- Environmental factors
- Both or neither


In terms of aetiology what effect is smoking on chronic disease?

An environmental factor - It will lead to a decrease in FEV1


What is vulnerability?

An individuals capacity to resist disease, repair damage and restore physiological homeostasis.


How can natural history describe variance in chronic disease?

- Acute onset = MI or stroke
- Gradual onset = COPD
- Rapid deterioration = Angina
- Relapse and remission = Cancer


What is the target of treatment in chronic disease?

- Directly at the disease
- Effect of the disease
- Coming to terms with the disease


What is the burden of treatment?

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


What components are there in the burden of treatment?

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

- Monitoring and managing symptoms at home

- Adhering to complex and often multiple drug treatment regimes

- Navigating the complexities of administrative systems with NHS

- Accessing, navigating and coping with uncoordinated health and social care systems


What is biographical disruption?

When a long term condition leads to a loss of confidence in the body, and from this follows loss of confidence in social interaction and self identity


What can biographical disruption lead to?

Loss of confidence leading to re-negotiating existing relationships


What needs to occur in terms of biographical disruption before a patient can adjust and cope better with their illness?

They need to come to terms with their condition/disease. This can involve redefining ideas of what good and bad is, such that the positive aspects of their lives are emphasised and the negative impact of the illness lessened


Example of an invisible long term condition?



Example of a visible long term condition?



Example of a condition that is both visible and invisible?

Multiple sclerosis


How can someone cope with stigma of long term conditions?

A variety of strategies:
- The decision about whether to disclose the condition and suffer further stigma

- Attempt to conceal the condition or aspects of the condition to pass as normal.


What are the impacts of long term conditions on an individual?

- Can be negative or positive
- Can be in denial
- Self pity
- Apathy


What are the impacts of long term conditions on an family?

- Financial
- Emotional
- Physical
- Can become ill themselves


What are the impacts of long term conditions on a community/society?

Isolation of an individual

It is said that the success of a community can be judged on how it looks after its infirm members


What is an expert patient?

A patient who understands a great detail of their disease.

This knowledge should be used as a resource with the patient being listened to and becoming a key decision maker in the treatment process.