1002. Health and General practice

Question 1

What is health?

Answer 1

WHO definition of health: a state of complete physical, social and mental wellbeing and not merely the absence of a disease or infirmity.

Question 2

What are david seedhouses thoughts about health?

Answer 2

David Seedhouse characteristics of positive health ideas:

1. Health is an ideal state
2. Health as a physical and mental fitness
3. Health as a commodity
4. Health as personal strength or ability
5. Health as the basis for personal potential

Question 3

What types of questions do dr’s ask?

Answer 3

1. Open –ended questions
   - Not seeking any particular answer but simply signals patient to tell their own story (tell me about the pain)
2. Direct questions
   - Asks about specific item (where is the pain?)
3. Closed questions
   - Can only be answered with a yes or no (is the pain severe?)
4. Leading questions
   - Presumes the answer and is best avoided (the pain is severe?)
5. Reflected questions
   - Allows doctor to avoid answering a direct question from the patient (you want me to know the cause of the pain?)

Question 4

What are the different approaches of a Dr in a consultation

Answer 4

1. Authoritarian or paternalistic relationship
2. Guidance/ co-operation
3. Mutual participation relationship

Question 5

What influences beliefs about health?

Answer 5

• Age
• Social class
• Gender
• Culture

Question 6

How does age influence health?

Answer 6

• Beliefs about health change with age
• Older people concentrates on functional ability
• Younger people tended to peak of health in terms of physical strength and fitness

Question 7

How does gender influence heath?

Answer 7

• Men and women appear to think about health differently
• Women may find the concept of health more interesting
• Women include a social aspect to health

Question 8

How does social class influence health?

Answer 8

• People living in difficult economic and social circumstances regard health as functional- the ability to be productive, to cope and take care of others
• Women of higher social class or educational qualifications have a more multidimensional view of health

Question 9

What is hollistic care

Answer 9

• consideration of the complete person physically, psychologically and spiritually in the management and prevention of disease.
• It is underpinned by the concept that there is a link between our physical health and our mere general well-being.
• Caring for the whole person as well as their illnesses
• The promotion of healthy life styles
• The first point of contact

Question 10

How do you define a GP?

Answer 10

1. Ability to care about patients and their relatives
2. A commitment to providing high quality care
3. An awareness of one’s own limitations
4. An ability to seek help when appropriate
5. Commitment to keeping up to date and improving the quality of one’s own performance
6. Appreciation of the value of team work
7. Clinical competence
8. Organisational ability

Question 11

What are GP’s responsible for?

Answer 11

o Running the business affairs of the practice
o Providing adequate premises and infrastructure to provide safe patient services
o Employ and train practice staff

Question 12

How are computers used in general practice?

Answer 12

o	Store appointments 
o	Book appointments 
o	Assist in consultations 
o	Support prescribing  
o	Electronic management of hospital letters 
o	Electronic management of blood/other results 
o	Use in audits 
o	E-consultations 
o	Chronic disease management and recall 
o	Patient leaflets/resources 
o	Public health information 
o	Identify patients for screening programmes

Question 13

Who makes up the GP team?

Answer 13

o	Manager 
o	IT/Admin staff 
o	Secretarial staff 
o	Reception staff 
o	Nurses junior/senior 
o	Advanced nurse practitioners/ Physician assistants 
o	Phlebotomists/Health care assistants 
o	GPs

Question 14

What three skills are needed in medical history taking?

Answer 14

1. Content skills
   a. What doctors communicate
   b. The substance of their questions and responses
   c. The information they gather and give
   d. The treatments
2. Perceptual skills
   a. What they are thinking and feeling
   b. Their internal decision making
   c. Clinical reasoning
   d. Their awareness of their own biases
   e. Attitudes and distractions
3. Process skills
   a. How they do it
   b. The way doctors communicate with patients
   c. How they go about discovering the history or providing information
   d. The verbal and non-verbal skills they use
   e. The way they structure and organise communication

Question 15

What is an authoritarian relationship?

Answer 15

• Authoritarian or paternalistic relationship
o The physician uses all of the authority inherent in his/her status and the patient has no autonomy
o The patient tries hard to please the doctor and does not actively participate in their own treatment

Question 16

What is the guidance relationship?

Answer 16

• Guidance/ co-operation
o The physician still exercises much authority and the patient is obedient but has a greater feeling of autonomy and participates somewhat more actively in the relationship

Question 17

What is the mutual participation relationship?

Answer 17

o Greater participation by the patient means they have a feeling of relatively greater personal autonomy
o The patient adopts greater responsibility for their own health through sharing of information and decision making
o Patients are generally more satisfied with consultations where they have been fully informed and are therefore less likely to complain about their care
o May increase compliance with advice/concordance with treatment