rest of MIS Flashcards
What is grief?
natural response to loss
Emotional suffering one feels when something/someone the individual loves is taken away. Reaction to the action
What is bereavement?
a period of mourning after a loss, especially after the death of a loved one. Also, an intense feeling of grief.
What is mourning?
observable expression of grief as well as social conventions such as funerals and clothing
What does Kublar Ross 5 stages of grief say?
1) Denial - ‘not me’, prevents person being overwhelmed by initial shock, may lead to taking second opinion.
2) Anger - ‘its not fair, why me’ this may be directed at medical staff and healthy people who’ll go on living
3) Bargaining - negotiating with god - an attempt to postpone death
4) Depression - ‘how can i leave all this behind’ realisation death is inevitable. Grieving for the losses that death represents. Often happens in terminally ill patients that can no longer deny their illness, when they have to endure more surgery etc
5) Acceptance - ‘leave me be, I am ready to die’ embrace mortality, either becoming isolated or calm and retrospective. It is often the stage where the family needs more support than the patient.
Stages are not linear and not everyone experiences all the stages. Family can experience anticipatory grief e.g. anticipation of impending loss can involve: grief, anxiety, irritability and sadness.
What can affect grieving?
Cultural differences e.g. religions have periods of morning preset.
What does Kleinmann’s model of healthcare systems say?
3 sectors: popular, folk and professional.
Popular - media, family friends, internet
Folk - traditional and alternative medicines
Professional - formal healthcare
There can be overlap between sectors e.g. complementary medicine e.g. acupuncture.
Dynamic model - usually in the pop sector they self treat and ask friends –> consult professional –> go back tell friends and families, further interpretation –> if this isnt what the patient wanted might move to folk sector –> then back to pop sector
Who consults the most?
increase with age - more conditions and more time females more than males asian>white>chinese levels of deprivation: more consult more smokers
What is batch processing?
definition: when patients are feeling depersonalised by the hospital experience. If each person is dealt with individually and empathetically the will be a better outcome. However, if medical professionals are empathetic with every patient –> compassion fatigue.
Examples: waking times, eating times, restricted mobility, lack of personal items and in the hands of others, depersonalisation and institutionalism.
Why do some patients not get on with their doctors?
similarity/attraction theory - people attracted to people who are similar to themselves. Most important factors include: attitudes, values, activity, personality it weaker, preferences, attractiveness.
social distance theory - measure of social separation between groups caused by perceived or real differences between group of people. Characterised:
-affective - degree of which a person from one group feels sympathy/empathy to another in the group
-normative - recognising differences in norms between social groups ‘us vs them’. Can be positive
-interactive - extent to which different groups of people interact with each other, in terms of frequency and intensity
What are the reasons for complaints? Why do complaints happen?
Usually due to a breakdown in communication. Becoming more common due to consumerist nature of modern healthcare. Reasons for complaints: perceived lack of empathy expectations not met (ICE) system or GP delays
What are the methods of complaint?
PALS, letter or direct to GMC
How do complaints get dealt with?
3 levels
-Local resolution - between patient and lay conciliator at hospital trust
-independent review - patient must state a case for why their complaint has not been dealt with successfully. Consists of 3 lay members advised by clinical specialist. A report is sent to chief executive of the trust who to the complainant. The chief decides if further action e.g. referral to reg bodies should be taken
Ombudsman - a civil servant, independent of NHS, who is responsible for reporting to parliament about the NHS. This is civil justice system
What does the GMC say about doctors declaring illness
If you know/suspect you have serious condition that could be passed onto patients or judgement/performance could be affected due to condition or treatment you must consult qualified colleague. Must follow their assessment and dont rely on own assessment of the risk to patients.
Immunised against common serious communicable disease
register with GP outside of family
declare illness/condition to GMC if: 5 statements apply
What does Burgess’ model of delay 2005 say?
3 types of delay in healthcare system
- Patient - attributing symptoms to other conditions, fear, consulting behaviour
- Doctor - symptoms being missed, incorrect referral, temporalising
- System - incorrect referral system
What does the social convoy model say?
Unique to individual and may change over time. Give us an understanding of the support that the patient has and their likely ability to deal with certain situations. In some cases professionals may fit into patient’s social circle.
