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Flashcards in Session 5 Deck (9):

Understand how self management impacts on LTC management

Decreased adherence
Decreased QOL
Online/in person/telephone management


Define the term 'stigma'

The extreme disapproval of a person or group on socially characteristic grounds that are perceived, and serve to distinguish the, from other members of a society


Define the terms 'discreditable', 'discredited', 'enacted' and 'felt stigma'

Discreditable - nothing seen e.g. mental health, HIV +ve
Discredited - physically visible characteristic/well known e.g. epilepsy, attempted suicide
Enacted - real experience of prejudice, discrimination
Felt - fear of enacted stigma, feeling of shame --> selective concealment


Explain different ways of conceptualising disability

Medical - deviation from medical norms, disadvantages are consequences of impairment, needs medical intervention to cure or help
Social - failure of environment to adjust, social oppression, policies action/social change needed


Discuss reasons for the rise of patient based measures as outcomes of healthcare

Health start of population
Indication of need
Target resources
Assess effectiveness, quality
Monitor patients' progress
Assess wellbeing from patient's point of view e.g. HRQoL, PROMSs
Used clinically, to assess benefits in relation to costs
Used in clinical audit


Understand what is meant by HRQoL and why it's measurement is seen as valuable

Quality in clinical medicine represents the functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient
Determines social wellbeing, global judgements of health, satisfaction with care, physical function, symptoms, cognitive functioning, personal constructs


Identify different tools available for measuring HRQoL, and the strengths and limitations of each

Generic - EQ-5D, SF36
Specific - site (hip, shoulder), disease (arthritis, asthma), dimension (depression, pain)
Generic ++ - not disease specific, comparisons across treatment groups, used with any population, including healthy people, cover perceptions of overall health
Generic -- - less detailed, too general
Specific ++ - relevant content, sensitive to change, acceptable
Specific -- - can't use for people without disease, limited comparison


Define the terms 'reliable' and 'valid'

Reliable - accurate instrument over time and internally consistent
Valid - actually measure what it's intended to measure


Describe sociological research on how chronic illness/long-term conditions and/or disability may impact on a person's life and identity

Illness work - managing symptoms, dealing with physical manifestations, self conception changes
Everyday life work - coping, the cognitive processes involved in dealing with illness, strategy, actions and processes involved in managing the condition and its impact, mobilisation of resources, balancing demands, remaining independent, normalisation
Emotional work - protect emotional wellbeing of others, downplaying pain, presenting cheery self, impact on role
Biographical work - loss of self, former self image crumbles, grief for a former life
Identity work - how people see themselves, how others see them, actual and imagined reaction of others, scrutinise reactions of others for signs of discreditation