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Flashcards in Tutorial 1 Deck (48):
1

Why may a patient whose GP has recently retired not have attended the practice?

Retirement - longstanding relationship, trust
Has been well
worrying symptoms that concerned her and is avoiding presenting due to the worry of a problem being found

2

What is person centred care?

Provision of healthcare placing the patient at the centre ensuring the healthcare system is designed to meet needs of patients defined by them

3

Who is the only person in a position to make a decision on what patient centred healthcare means?

the patient - as an individual, in terms of treatments and their condition and living of their life

4

When can treatment options, therapies and models of care be said to be patient centred?

based on principles and values that define patient centredness

5

What document are the principles and values of patient centred care brought together?

International alliance of patients organisations (IaPO) declaration on patient centre healthcare

6

5 principles of IaPO declaration

respect
access and support
information
choice and empowerment
patient involvement in health policy

7

Why are long term conditions more prevalent?

acute illnesses short lived and amenable to cure
acute illness demise
LTC more prevalent

8

What type of people are LTC more prevalent in?

older and deprived

9

% of LTC of all GP appoinments?

50

10

% of LTC of all outpatient appointments

64

11

% of LTC of all inpatient bed days?

70

12

Why is concern as much to do with the causes and consequences of LTC?

degenerative chronic disorders are increasingly prominent and major sources of disability

13

Incidence

The number of new cases of a disease in a population in a specified period of time

14

Prevalence

The number of people in a population with a specific disease at a single point in time or in a defined time period

15

What does incidence tell us about?

trends in causation and aetiology

16

Why can incidence be helpful?

planning

17

Prevalance - what does it tell us?

amount of a disease in population and useful for assessing current work load

18

What is prevalence less useful for?

studying causes of diseases

19

LTC - long term complex interaction of what 3 factors?

genetic
environmental
both or neither

20

Vulnerability

An individuals capacity to resist disease, repair damage and restore physiological homeostasis

21

Can certain organs vary in vulnerability?

yes - repair to a different extent

22

3 natural histories of diseases

acute onset
gradual with slow/rapid deterioration
relapse and remission

23

4 examples of "burden of treatment"

Changing behaviour or policing behaviour of others to adhere to lifestyle modifications
Monitoring and managing their symptoms at home
complex treatment regimens and polypharmacy
complex administrative systems and accessing, navigating and coping with unco-ordinated health and social care systems

24

Biographical distribution

LTC --> loss of confidence in body
Leads to loss of confidence in social interaction or self identity

25

Why are LTC not simply personal?

biographical distribution
re-negotiating existing relationships at work and home

26

What does the patient or disabled person need to do to adjust to their LTC?

make sense of condition
redefine ideas
positive aspects of life are emphasised
negative impact lessened

27

Coping with stigma

deciding to disclose condition and suffer further stigma
conceal condition or aspects of condition and pass for normal

28

Impact of LTC on 4 groups of people and explanation

individual - negative or positive and can include denial, self pity and apathy
family - financial, emotional, physical
other family members ill as a result
community/society - isolation

29

What can the success of a community be based on?

how it looks after infirm members

30

Dictionary definition of disability

Lacking in 1 or more physical powers eg ability to walk

31

3 publications which define disability

dictionary
WHO
legal

32

Legal definition of disability

Disability discrimination act
more than 12 months
difficult to undertake normal activities

33

WHO disability

ICIDH --> updated with ICF

34

3 parts of WHO disability definition

body and structure impairment
activity limitation
participation restriction

35

Body and structure impairment

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

36

Activity limitation

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

37

Participation restriction

disadvantage experiences by individual as a result of impairment or disability
interaction at social and environmental level

38

Medical model of disability

individual/personal cause eg accident whilst drunk
underlying pathology eg morbid obesity
individual level intervention
individual change/adjustment

39

Social model of disability

societal cause eg low income
conditions relating to housing
social/political action needed
societal attitude changes

40

Legislations

disability discrimination acts 1995 and 2010
equality act 2010

41

3 ways doctors are not spectators

we assess disability
we co-ordinate MDT
we intervene - rehab

42

10 things personal reaction to disability relies on

nature of disability
reaction of others around them
personality
mood and emotional reaction
support network
information base of individual
coping strategies
additional resources available to patient
time to adapt
role of individual

43

The sick role

possible benefits of illness
eg social, family, psychological, financial, medications, responsibilities

44

3 levels of disruption of disability and the family

personal
economical
social

45

epidemiology of disability worldwide causes

congenital
injury
communicable
non-communicable
obesity
malnutrition
mental illness
drugs - iatrogenic
alcohol

46

what fraction of those with a disability are in employment?

1/3

47

Criteria for screening name?

Wilson junger

48

Wilson junger criteria for screening

condition latent or early stage
suitable test or exam
accepted treatment
facilities available
cost