2014 Flashcards

1
Q

What effects might working offshore have on the worker’s, and their family’s, physical health?

A

Might be too tired to do long shifts
Dangers of working on an oil rig
Dangers of transportation to the oil rig
Adjustment to day / night shift patterns
Potential for obesity due to abundance of food in canteen
Potential for improved physical health in James if he makes use of healthy eating options & facilities offshore
Partner might be tired of the ‘single-parent’ role when James

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2
Q

What effects might working offshore have on the worker’s, and their family’s, psychological health?

A

Anxiety & stress due to dangerous working environment / separation from family
Both might be anxious about the security of his employment in the current economic climate
Anxiety & stress about uncertain return home (weather delay)
Anxiety & stress about helicopter journeys
Possible depression in either due to repeated periods of isolation
Anxiety & stress in children due to separation / father’s job

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3
Q

What effects might working offshore have on the worker’s, and their family’s, social health?

A

Relationship difficulties due to nature of job
Able to spend additional time with family and friends during onshore periods
Discipline problems in children due to ‘absent’ father figure
Substance misuse due to stressful nature of job
Well paid employment allows family to afford good lifestyle, decent car, to go on holiday
No smoking / alcohol when offshore
May binge drink when onshore

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4
Q

Categories of hazard

A
Mechanical 
Physical 
Chemical 
Biological 
Psychological/stress
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5
Q

An offshore worker is made redundant, what effect might this have on his wife’s health?

A

Exhaustion due to working extra hours to maintain family finances
Worry / stress about the entire family’s future
Anger that the husband has been made redundant
Stress at husband being at home all the time = change of friendly dynamics
Enjoyment of increased time to spend with husband
Positive future outlook with possibility of husband gaining more family-friendly employment

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6
Q

An offshore worker is made redundant, what effect might this have on his health?

A

Feelings of worthlessness
Guilt that he is no longer supporting his family
Anxiety about finding another job / retiring
Depression
Anger at his employer’s
Positive outlook for new future employment
Enjoyment of more time with family
Substance misuse as coping mechanism

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7
Q

A patient attends for a routine appointment and asks you about her husbands health; how would you deal with this enquiry?

A
Maintain her husbands confidentiality 
Consider need to maintain the husband's trust 
Consider GMC guidelines 
Acknowledge her concern 
Ask why she is concerned
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8
Q

Ethical principles

A

Beneficence
Non-maleficence
Justice
Autonomy

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9
Q

Define culture

A

Complex whole which includes knowledge/beliefs/art/morals/law/customs
or
Systems of shared ideas, systems of concepts, rules and meanings that underlie and are expressed in the ways that human beings live

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10
Q

Define ethnicity

A

Cultural practices and outlooks that characterise and distinguish a certain group of people; characteristics identifying an ethnic group may include a common language, common customs and beliefs and tradition; term preferred over ‘race’

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11
Q

Define race

A

A group of people linked by biological/genetic factors

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12
Q

Difficulties which may arise in a consultation as a result of cultural differences

A
lack of knowledge about health issues
fear / distrust 
racism
bias / ethnocentrism
stereotyping
ritualistic behaviour 
language barriers
3rd part presence (family members etc)
differences in perceptions / expectations 
examination taboos
gender difference between doctor / patient 
religious beliefs 
difficulties using language line
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13
Q

Aspects of social health that you might want to discuss in a consultation

A
Smoking 
Sexual health 
Alcohol 
Illicit drugs
Exercise 
Diet/eating patterns 
Family influence 
Peer pressure to smoke
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14
Q

What are the social classes according to the 1911 Census?

A
Professional 
Managerial and technical 
Skilled non-manual 
Skilled manual 
Partly skilled
Unskilled
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15
Q

How might culture influence smoking behaviour in different social classes?

A

Lower social classes see larger numbers of people around them smoking and are more likely to accept it as normal behaviour
Those around them are also more likely to accept the start of another individual smoking as normal behaviour (no stigma attached)

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16
Q

Reasons for differences in trends of obesity in different cultural groups

A
early life experience 
education
cooking facilities / ability 
cost of healthy food 
cultural expectations
access to good quality food provision 
carry-out culture 
unhealthy budgeting choices
17
Q

Primary care professionals who have a role in obesity management and what they might do

A

Dietician = individual dietary advice
Pharmacist = general advice; OTC anti-obesity medication; weight management programmes
Health visitor = health education; advice on healthy diet
GP = advice; prescription of weight reducing drugs
Practise nurse = weight clinics; general dietary advice
Midwife = encourage breast feeding; early dietary advice

18
Q

What are the 3 models of stress?

A

Engineering model
Medico-phsyiological model
Psychological/transactional model

19
Q

Describe the engineering model of stress

A

Stress acts as a stimulus which the individual must resist

If the stimulus becomes too intense or prolonged, the individual breaks

20
Q

Types of coping mechanism

A

Problem focused
Emotion focused
Combination of problem/emotion focused

21
Q

Define incidence

A

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

22
Q

Define prevalence

A

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

23
Q

Describe the guidance/co-operation style of doctor-patient relationship

A

The doctor exerts a degree of authority and the patient is obedient
The patient does have a little feeling of autonomy and participates to a small degree in the relationship

24
Q

What are the styles of doctor-patient relationship described by Szasz and Hollender (1956)

A

Authoritarian/paternalistic
Mutual participation
Guidance/co-operation

25
Q

Questions that may be used in medical interviewing and describe them

A

open questions = not seeking any particular answer but simply signals the patient to tell their own story
direct questions = asks about a specific item
closed questions = can only be answered by yes or no or an equivalent
reflected questions = allows the doctor to avoid answering a direct question from the patient / aids the doctor in exploring the patient’s own thoughts and perceptions
leading questions = presumes the answer; best avoided

26
Q

What is a gatekeeper?

A

A person who controls patients’ access to specialist or secondary care

27
Q

Advantages of GP as a gatekeeper

A

keep people out of expensive secondary care
continuity of care (knowledge of the patient)
personal advocacy
patient does not know where to go
referral to appropriate department
limiting exposure to certain investigations (e.g MRI scan)

28
Q

Disadvantages of GP as gatekeeper

A

patients have less choice in secondary care
places stress on GP to know everything about every disease / symptom
dependent on individual GP knowledge, attitudes, skills (and practise organisation)
referral may be hampered by bad doctor-patient relationship
seeing a GP might increase the time it takes to see a specialist and receive treatment
dissatisfied patients may inappropriately present to A&E or the private sector

29
Q

How any patients are registered on average with each GP in the NHS in the UK?

A

1200-2000 patients each

30
Q

What percentage of illnesses presenting to primary care are referred on to secondary care?

A

3%