Tutorial 1 - Long-Term Conditions Flashcards

1
Q

define person-centred care

A

Person-centered care places patient at center

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2
Q

who decides what person-centered care means

A

Only the patient is in a position to decide this

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3
Q

what makes care patient centered

A

if it is based on the principles and values that define patient-centeredness

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4
Q

the principles and values of patient centered care are brought together by which organisation in what declaration?

A

International Alliance of Patients’ Organizations (IaPO)

Declaration on Patient- Centered Healthcare.

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5
Q

Name the 5 principles outlined in the Declaration on Patient- Centered Healthcare by the IaPO

A
  1. Respect.
  2. Choice and empowerment.
  3. Patient involvement in health policy.
  4. Access and support.
  5. Information.
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6
Q

Long-term conditions now account for what proportion of GP appointments?

A

50%

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7
Q

long-term conditions are more prevalent in what two groups of people?

A

older people

deprived groups

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8
Q

what is equally as important as establishing the causes of a long term illness?

A

the consequences of such long-term illness

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9
Q

define incidence

A

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

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10
Q

define prevalence

A

the number of people in a population with a specific disease at a single point in time or in a defined period of time (existing cases)

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11
Q

aetiology - name the 2 broad factors

A

genetic

environmental

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12
Q

define vulnerability

A

an individuals ability/inability to resist disease, repair damage and restore physiological homeostasis

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13
Q

describe 3 categories of natural history of diseases

A

acute onset

gradual onset

relapsing remitting

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14
Q

what 2 things should any treatment aim to cure/allay ?

A

disease

effects of disease

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15
Q

briefly define the burden of treatment

A

patients and caregivers are often put under enormous demands by healthcare systems

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16
Q

give 4 examples of the burden of treatment

A
  1. changing behaviour (of patient) or policing behaviour (doctor) of others (i.e. to adhere to lifestyle modifications)
  2. monitoring + managing their symptoms at home
  3. complex treatment regimens and multiple drugs (polypharmacy)
  4. complex administrative systems - accessing, navigating + coping with uncoordinated health and social care systems
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17
Q

define the process of biographical disruption

A

a 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

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18
Q

define stigma

A

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

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19
Q

outline why stigma might exist for those with a chronic illness

A

having a chronic illness or condition subjects a person to possible stigmatization by those who do not have the illness

20
Q

what is the biggest decision in coping with the stigma of a condition?

A

the decision about whether to:

1) disclose the condition and suffer further stigma

or

2) attempt to conceal the condition and pass for normal

21
Q

the long term condition of a particular individual may impact what people/groups of people

A

patient

family

community

22
Q

discuss the impact of long term conditions on the individual

A

can be negative or positive

negative may be denial, self-pity, apathy

23
Q

an individual’s long-term condition can impact their family in what 3 broad ways?

A

financial

emotional

physical

24
Q

what might happen to an individual that has a long term condition with regards to their community

A

isolation of that individual

25
Q

an observation often made by doctors/nurses who care for people with some long term conditions is “my patient understands their disease better than I do”

what is this concept known as?

A

the “expert patient”

26
Q

name 3 conditions that typically creates a lot of these “expert patients”

A

diabetes mellitus

arthritis

epilepsy

27
Q

describe the relevance of the “expert patient” in modern care

A

patient’s knowledge/experience has long been untapped

could greatly benefit patient care + quality of life

research/experience shows today’s patients with chronic conditions need not be mere recipients of care

they can become key decision-makers in treatment process

28
Q

the WHO definition of disability may be split into what 3 categories

A
  1. Body and Structure Impairment
  2. Activity Limitation
  3. Participation Restrictions
29
Q

define “body and structure impairment”

A

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

30
Q

define “activity limitation”

A

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

31
Q

define “participation restrictions”

A

disadvantage experienced by the individual as a result of impairments and disabilities

(interaction at a social and environmental level)

32
Q

describe 4 concepts in the medical model of disability

A

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

33
Q

describe 4 concepts in the social model of disability

A

▪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.

34
Q

describe 2 legislations that have been drawn up to support those with a disability

A

disability discrimation acts 1995 and 2005

equality act 2010

35
Q

describe 3 roles of a doctor in the care of those with a disability

A
  1. assess disability
  2. co-ordinate MDT care
  3. intervention with rehabilitation
36
Q

personal reaction to a disability depends on many factors

give 10 examples

A
  1. nature of disability
  2. information base of individual, ie education, intelligence and access to information
  3. personality
  4. coping strategies
  5. (previous) role of individual – loss of role, change of role
  6. mood and emotional reaction
  7. reaction of others around them
  8. support network of individual
  9. additional resources available to the individual? e.g. good local self-help group, socio-economic resources
  10. time to adapt (how long they have had the disability?)
37
Q

consider 6 possible categories of “benefits” of illness

A
  1. social
  2. familial
  3. psychological
  4. financial
  5. medications
  6. responsibilities.
38
Q

outline the concept of the sick role

A

a concept that concerns the social aspects of becoming ill and the privileges and obligations that come with it

39
Q

describe 3 ways disability might cause disruption within a family

A

personal

economic/financial

social

40
Q

with regard to the epidemiology of disability:

give 9 different causes worldwide

A
  1. congenital
  2. injury
  3. communicable disease
  4. non-communicable disease
  5. drugs-iatrogenic and/or illicit use
  6. mental Illness
  7. alcohol
  8. malnutrition
  9. obesity
41
Q

in the uk, what proportion of those with a disability are in employment?

A

1/3rd

42
Q

what happens to the prevalence and severity of disability with age?

A

rises

43
Q

Wilson and Jungner criteria for screening

testing/examination for a disease - 3 factors

A
  1. suitable test or examination.
  2. test acceptable to population.
  3. case finding should be continuous (not just a ‘once and for all’ project as there’s limited evidence for single-ocasion screening).
44
Q

Wilson and Jungner criteria for screening

treatment of disease - 3 factors

A
  1. Accepted treatment for patients with recognised disease.
  2. Facilities for diagnosis and treatment available.
  3. Agreed policy concerning whom to treat as patients
45
Q

Wilson and Jungner criteria for screening:

knowledge of the disease - list 3 factors

A
  1. condition should be important.
  2. must be a early symptomatic stage or recognisable latent stage
  3. natural history should be adequately understood.