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Who is the best judge at deciding what patient centred care is?

The patient


Who decides the principles and values of patient centred care?

The International Alliance of Patients' Organisations (IaPO) They have a declaration on patient -centred healthcare


What are the five principles of the declaration made by the IaPO?

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


Which health groups have more long -term conditions?

Older people and more deprived groups


What percentage of GP appointments are for long-term conditions?



What is just as important as understanding the cause of a health condition?

Understanding the consequence of a condition


What is the definition of incidence?

Incidence - the number of new cases of a disease in a population in a specific period of time


What is the definition of 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


What are the two large subcategories of aetiology?

Genetic Environmental


What is meant by vulnerability?

An individuals capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerability.


What are the types of onset for long-term conditions?

Acute (stroke or MI) Slow onset (Angina) Relapse and remission such as cancer


What is meant by 'The Burden of Treatment'

Changing behaviour or policing the behaviour of others to adhere to lifestyle modifications. Monitoring and managing their symptoms at home. Complex treatment regimens and multiple drugs (polypharmacy) contribute to the burden of treatment.  Complex administrative systems, and accessing, navigating, and coping with uncoordinated health and social care systems add to this


What is meant by biographical disruption?

Long term condition leads to a loss of confidence in the body, there is then a loss of confidence in social interaction or self-identity.


How might someone's mindset change with the onset of a long term-condition?

Need to re-negotiate existing relationships at work and at home They need to understand their condition before 'adjusting to it' Involves redefining ideas of what is 'good' and bad' such that the positive aspects of their lives are emphasised, and the negative impact of the illness is lessened.


Define stigma

a mark of disgrace associated with a particular circumstance, quality, or person.


What kind of strategies exist to cope with stigma

Coping with stigma involves a variety of strategies including the decision about whether to disclose the condition and suffer further stigma, or attempt to conceal the condition or aspects of the condition and pass for normal. 


What is the impact of long - term conditions?

On the individual – can be negative or positive. Can include denial, self pity and apathy. On Family – can be financial, emotional and physical Other family members may become ill as a result. Community/society. Isolation of an individual may result. It has been said that the success of a community can be judged on how it looks after its infirm members.


What term is used to describe the patient that knows the disease better then the doctor does?

The expert patient - they become key decision makers in the treatment process - their quality has been largely ignored in the past


What conditions may be associated with expert patients?

Diabetes Arthritis Epilepsey


What are the categories of disability as defined by WHO?

Body and structure impairment Activity limitation Participation restrictions


Define Body and Structure impairment

Abnormalities of structure, organ or system function (organ level)


Define activity limitation

Changed functional performance and activity by the individual (personal level)


Define participation restriction

Disadvantage experienced by the individual as a result of impairments and disabilities (interaction at a social and environmental level)


What is the medical model of disability?

Medical Individual/personal cause e.g. accident whilst drunk Underlying pathology e.g. morbid obesity Individual level intervention e.g. health professionals advise individually Individual change/adjustment e.g. change in behaviour


Illness or accident 

Needs individuals to change 


What is the social model of disability?

Societal cause e.g. low wages Conditions relating to housing Social/Political action needed e.g. facilities for disabled Societal attitude change e.g. use of politically correct language.


Wages, housing, social / political action required, change of societal attitude required


What acts are in place to protect the rights of those who are disabled?

Disability discrimination acts 1995 and 2005 Equality act 2010


What does the personal reaction to disability depend on?

The nature of the disability

The information base of the individual, ie education, intelligence and access to information

The personality of the individual

The coping strategies of the individual

The role of the individual – loss of role, change of role

The mood and emotional reaction of the individual

The reaction of others around them

The support network of the individual

Additional resources available to the individual e.g. good local self-help group, socio-economic resources

Time to adapt i.e. how long they have had the disability


What are the rights and responsibilities of those who are ill as described by Talcott Parsons in 1951 in the sick role theory?

Rights: They have the right not to be blamed for his or her illness They have the right right to be given some leeway by others in regards to normal obligations. Responsibilities: Making getting well a priority. Seeking the appropriate treatment for his or her condition


What levels does disability cause disruption?

Personal Economic Social


What are the different causes of disability?

Congenital Injury Communicable disease Non-communicable disease Alcohol Drugs (iatrogenic / illicit) Mental illness Malnutrition Obesity