Flashcards in PCCP 3 Deck (90)
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60
Which conditions promote high adherence?
Hiv, cancer, arthritis
61
Which conditions have low adherence
Pulmonary disease, diabetes
62
What can count as non adherence?
Not taking/doing
Wrong amount
Wrong time
Wrong duration
Taking other meds that interact?
63
How can adherence be measured directly?
Advantages and disadvantages?
Urine/blood tests for drugs
Observed taking
Accurate, but expensive, impractical and not foolproof (eg just taking meds prior to blood test)
64
How can adherence be measured indirectly?
Problems?
Pill counts (lost pills)
Mechanical record eg dispensing machine (doesnt confirm pills are taken)
Self reporting (biased, tends to overreport)
Second hand report (depends on familiarity with patient)
65
Why might you get poor adherence to medications?
Low symptoms
Low severity in less life threatening disease
More severity in more life threatening disease (giving up)
Treatment factors (ADRs, inconvenience, complexity)
Understanding of treatment
Recall
Lay beliefs (see health beliefs model risk v benefit)
Depression
Homelessness
Low social support
Low follow up care
Poor attitude from dr
66
How can we increase adherence?
Increase comprehension
Reduce practical barriers
Adherence over compliance (ie involve patient)
67
What is concordance?
A negotiation between dr and pt with the pts views respected
68
Why do people use drugs?
Pleasure
Entertainment
Peer pressure
Boredom
Stress
Depression
Spirituality
69
Why is it not as simple as classifying bad drugs as strong ones like heroin or mdma and mild ones like cannabis?
Consequence of drug use depends of drug, amount, mindset, setting
Eg 10x cannabis a day as depressed may be worse than occasional cocaine on a night out with friends
70
How can excessive drinking be subclassified?
Hazardous - over sensible limits but no adverse health problems yet
Harmful - as hazardous but with physical or mental harm
71
How can alcohol dependance be sub classified?
Moderate - do not need to drink to avoid withdrawal symptoms
Severe - withdrawal symptoms if stop drinking
72
What is a complex needs alcoholic?
Severely dependant drinker with other needs (e.g. Psychiatric, homeless)
73
Give an alcohol screening tool
C - ever felt the need to Cut down
A - Annoyed if others tell you you need to cut down
G - ever felt Guilty about your drinking
E - ever needed an Eye opener in the morning
74
What drugs are often administered to alcoholics?
Vit B
Thiamine
Disulfiram
Diazepam
75
What is the sexual response cycle?
Stimulation (tactile or psychological)
Activation of arousal reflex
Positive emotions and stimulation activate brain
Brain reinforces arousal reflex
76
Where can the sexual response cycle be broken?
Inappropriate stimulation (insufficient or painful)
Inappropriate emotion (e.g. fear)
Distraction of the brain (spectatoring - i.e. Concentrating on achieving arousal)
77
How can sexual arousal problems be treated?
Counselling
Make patients aware of where things can go wrong in the cycle
Psychosexual therapy (looking for hidden problems in relationship by making a parody of it between couple and councillor
Behavioural - masturbation exercises
Lubricants
Meds
Pumps
Tension rings
78
What are the levels of attachment in a:
Newborn - 3m
3m - 8m
>8m
N-3 = preference for faces
3-8 = preference for non-stranger but happy for any nice contact
>8 = specific to caregiver, wary of strangers, upset if key people leave
79
What are phases of separation from caregiver on a young child?
What is the big problem with this?
Protest - crying/searching
Despair - helpless/withdrawn
Detachment - loose interest but apathetic when carer returns
Detachment seems like improvement but isnt
80
Which age group suffer most from separation from caregiver?
6m to 3 yrs as unable to communicate effectively and lack understanding
Feel like they are being punished
81
What effect does separation of child and caregiver have on treatment?
Decrease adherence
Increases pain and stress
82
How can we decrease attachment problems?
More carer access
Attachment objects
Reassurance
Home like environment
Specialist staff with continuity
83
What are the four stages of piagets development model? What ages apply to each?
Sensorimotor 0-2
Preoperational 2-7
Concrete Operational 7-12
Formal operational >12
84
What occurs in the sensorimotor phase of development according to piaget?
Organising sensations
Developing body schema
Movement coordination
Object consistancy
85
What occurs in the preoperational phase of development according to piaget?
Egocentric speech
Centration
Overgeneralisation
86
What occurs in the concrete operational phase of development according to piaget?
Difficulty with abstract thought
Collecting shit about their favourite topic
87
What occurs in the formal operational phase of development according to piaget?
Abstract logic
Develop and test hypotheses
88
What are criticisms of piagets model of child development?
Focuses on cant do not can do
Suggests if a child is to young then not to try
Partial info can be damaging as most children will try to make sense of what they are given whatever stage they are at
89
