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What is patient centred care?

Placing the patient at the centre of their care... duh


The International Alliance of Patients' Organisation's (IaPO) Declaration on Patient Centred Care outlines what five principles?

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


Describe the importance of long term conditions since the birth of the twentieth century?

Increasingly important


Why is the importance of long term conditions since the birth of the twentieth century increasing?

Acute conditions are now often curable and short lived - with its demise a whole cohort of long term conditions have become increasingly prevalent


In what demographic of people are long term conditions more prevalent?

Older people and in more deprived areas


What percentage do long term conditions make up of total GP appointments?



What percentage do long term conditions make up of total outpatient appointments?



What percentage do long term conditions make up of total inpatient days?



What is the definition of incidence?

The number of new cases of a disease in a population oer a specific period of time


What is the definition of prevalence?

The number of people in a population with a single disease at a single point in time/time period


How many people in the UK are there over the age of 16?

81.2 million


Approximately how many new people between 1993 and 2002 describe themselves as having at least one long-standing disease?

4 million


Longstanding diseases are usually the end result of a long-term and complex interaction between which factors?

Genetics and environmental


What is the Burden of Treatment?

Patients and caregivers are often put under enormous stress/demands by healthcare systems


In what ways might a healthcare system increase the burden of treatment?

1. Changing/policing lifestyles (e.g. smoking cessation)
2. Monitoring/managing symptoms at home
3. Complex treatments regimes (polypharmacy)
4. Complex administrative systems


How can biographical disruption occur in longterm disease?

A long term condition leads to loss of confidence in the body

A loss of confidence in social interaction/self-identity possibly resulting in re-negotiating of relationships at work and at home


What does biographical disruption highlight with patient centred care?

The meaning of illness for the individual


What stigmas may be faced with longterm conditions?

Less obvious conditions may be subject to some stigma


Explain the concept of 'the expert patient'

A patient with a longstanding condition may well have a deeper understanding and more personal knowledge - this can be a resource to the clinician


What is the dictionary definition of disability?

Lacking in one or more physical powers such as the ability to walk or coordinate one's movements


What is the legal definition of disability?

Difficulty can be physical, sensory or mental. A disability makes it difficult to carry out normal day to day activities ongoing for more than 12 months


What is the WHO definition of disability?

Refers to International Classification of Impairments, Disability and Handicap (ICIDH):

Body and Structure Impairment: Abnormalities of structure, organ or system function (organ level)

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

Participation restriction: Disadvantage experience by the individual (interaction at social/environmental level)


What is the medical model of disability

1. Individual or personal cause leading to a change in circumstances
2. Individual intervention leading to a change/adjustment in life to compensation for new circumstances


What is the social model of disability?

1. Societal causes e.g. low wage
2. Conditions relating to housing
3. Social/poiitical actions needed e.g. facilities for disabled
4. Societal attitude change e.g. use of politically correct language


What legislation surrounds the fair treatment of the disabled?

Disability Discrimination Acts of 1995 and 2005
Equality Act of 2010


What responsibiity does a doctor have when dealing with a patient with a long term condition?

Listen to your patient
Be aware your own age and culture will affect your views


What factors may determine a patients reaction to a disability?

Nature of the illness
Education of the patients
Coping strategies in place
Mood and emotions of the patient
Time to adapt


What are the Wilson and Junger criteria for effective screening?

Knowledge of disease - disease should be important, recognisable early stage, natural course should be well understood

Knowledge of test - suitable and acceptable

Treatment - established plan with available facilities

Financial - cost of case finding should outweigh costs that the healthcare system would incur if caught at a later stage