WEEK 6

Question 1

Define self-care

Answer 1

The care taken by individuals towards their own health and well-being, including the care extended to their children, family, friends and others in the community

Question 2

What are the 4 functions of self-care (Barofsky’s model)?

Answer 2

1) Restorative: to alleviate illness
2) Reactive: to alleviate symptoms
3) Preventative: to prevent disease
4) Regulatory: to regulate body processes

Question 3

What is self-care maintenance?

Answer 3

Behaviours performed to improve well-being, preserve health or to maintain physical and emotional stability

Question 4

What is self-care monitoring?

Answer 4

Process of routine, vigilant body surveillance/listening

Question 5

What is self-care management?

Answer 5

Evaluation to determine if action is needed

Question 6

What is “Healthism”?

Answer 6

The representation of good health as a personal choice

Question 7

Characteristic population associated with “Healthism”

Answer 7

Young/middle-aged, well educated, vocal/articulate, middle class (high consumer choice)

Question 8

What is the predominant feature of the movement towards “healthism”?

Answer 8

Consumers looking externally and internally towards holistic/biopsychosocial approach to health

Question 9

What is orthorexia?

Answer 9

Obsession with healthy eating

Question 10

What are examples of being a DIY doctor?

Answer 10

Measuring body weight (scale), BP monitor, cholesterol monitor

Question 11

What are the positives of being a DIY doctor?

Answer 11

Saves time (for you and GP)
Confidential beyond HCPs

Question 12

What are the negatives of being a DIY doctor?

Answer 12

+ve test can result in unwarranted complacency

-ve test can result in unnecessary anxiety/stress

Question 13

Detail the 12 factors contributing to self-care

Answer 13

1) symptom management
2) definitions of health and illness
3) healthism/consumerism
4) body maintenance
5) changing beliefs about medical power/expertise
6) internet use
7) technology (self-testing kits)
8) OTC medication
9) increase in chronic conditions
10) expert patients
11) patient choice/empowerment
12) need to reduce NHS cost

Question 14

What is co-morbidity?

Answer 14

Someone with two conditions

Question 15

What is multi-morbidity?

Answer 15

Someone with three or more conditions

Question 16

What are synergistic conditions?

Answer 16

Conditions with a common cause

Question 17

What are non-synergistic conditions?

Answer 17

Conditions with no common cause

Question 18

What is the most common disease related to multi-morbidity?

Answer 18

Hypertension

Question 19

What is the Master Status in medicine?

Answer 19

The condition that people focus on the most

Question 20

Why has the focus on patient expertise increased in recent times?

Answer 20

Rise in chronic conditions due to an ageing population resulting in increased health service demand

Question 21

7 assumptions and characteristics of acute illness

Answer 21

1) Ongoing
2) Cure expected
3) QoL highly dependent on professional care
4) QoL highly dependent on acute healthcare services
5) HCP knowledge>Pt knowledge
6) Short-term goals set
7) Compliance expected

Question 22

7 assumptions and characteristics of chronic illness

Answer 22

1) Episodic
2) Incurable
3) QoL highly dependent on Pt’s self-care and decision-making skills
4) QoL highly dependent on ongoing support services
5) Pt knowledge>HCP knowledge
6) Short-term goals for long-term outcomes
7) Compliance and self-reliance expected

Question 23

What are the 12 self-management tasks in chronic disease?

Answer 23

1) Recognising and responding to symptoms
2) Using medications
3) Maintaining acute episodes and emergencies
4) Maintaining good nutrition and appropriate diet
5) Maintaining adequate exercise and physical diet
6) Not smoking
7) Using relaxation and stress-reducing techniques
8) Interacting appropriately with HCPs
9) Seeking information and using community resources
10) Adapting work and other role functions
11) Communicating with significant others
12) Managing negative emotions and psychological responses to illness

Question 24

Define confidentiality

Answer 24

The need for the physician to keep secret all information a patient gives them

Question 25

Why is confidentiality extremely important?

Answer 25

To maintain the trust and confidence of the patient in you and the profession

Question 26

What is the result of a breach in confidentiality?

Answer 26

A lack of trust and collaboration which affects the practitioner’s ability to treat the patient to the best of their ability

Question 27

Why is trust so central to the Dr-Pt relationship?

Answer 27

Healthcare information is inherently sensitive

Question 28

Describe principlism in relation to confidentiality

Answer 28

Autonomy: Patient’s right to distribute personal information as they wish
Beneficence: rarity that breaching patient’s confidentiality would be in their interest
Non-maleficence: disclosure=potential harm
Justice: what if all doctors disclosed patient information?

Question 29

What is the difference in response to confidentiality given by act and rule utilitarians?

Answer 29

Rule=support confidentiality generally

Act=assess on a case-by-case basis

Question 30

Where does the principle of confidentiality arise from?

Answer 30

The Common Law

Question 31

What does the Common Law detail about confidentiality?

Answer 31

All patient information received in the healthcare setting should remain confidential

Question 32

What three things constitute a legal breach of confidentiality?

Answer 32

1) Information disclosed must have the quality of confidentiality
2) Information must have been gained in confidential circumstances
3) Plaintiff must show that there was unauthorized use of information

Question 33

What would a successful legal case need to show?

Answer 33

Harm resulted from the breach but doesn’t have to be deliberate

Question 34

Which four situations can confidentiality be breached only with patient consent?

Answer 34

1) Research
2) Publication
3) Teaching
4) Third party requests (eg. insurance companies)

Question 35

Which two situations can confidentiality be breached without patient consent?

Answer 35

1) Disclosure required by law

2) Disclosure in the public interest

Question 36

What are three examples of disclosures required by law?

Answer 36

1) Notifications of specific infectious diseases
2) Terrorism Act 2000
3) Medical Act 1983 (GMC can access Pt’s records to investigate fitness to practice)

Question 37

What are possible justifications of breaching confidentiality in the public interest?

Answer 37

Risk of serious harm:

serious crime or serious communicable disease

Question 38

What would you weight up when assessing disclosures in the public interest?

Answer 38

Public interest in maintaining confidentiality vs breaching confidentiality

Question 39

What should you ensure you do when disclosing patient details?

Answer 39

Inform the patient unless it compromises reason for disclosure

Question 40

What is the Data Protection Act (2018)?

Answer 40

Act covering all healthcare records of living patients (paper and electronic)

Question 41

Who is the owner of medical records in the UK?

Answer 41

The NHS

Question 42

Why might patients be refused access to their records?

Answer 42

Unsure of identity, disclosure relating to a third party would result, disclosure would cause serious harm or is not in the best interests of the data subject

Question 43

What are Caldicott Guardians?

Answer 43

People responsible for safeguarding patient data

Question 44

What are the 6 principles of the Caldicott Guardians?

Answer 44

1) Justify the purpose for use of confidential information
2) Only use it when absolutely necessary
3) Use minimum required
4) Access should be on a strict need-to-know basis
5) Everyone must understand his or her data protection responsibilities
6) Understand and comply with the law