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