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FOPC > 2nd year > Flashcards

2nd year Flashcards

1
Q

what does Wilsons criteria for screening describe as cost considerations

A

costs of case findings economically balanced in relation to possible expenditures on medical care as a whole

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2
Q

what do macmillan nurses specialise in

A

cancer and palliative care - provide support and information to people with cancer as well as their families, friends and carers

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3
Q

what framework do descriptive studies follow

A

time, place, person

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4
Q

what are some causes of disability

A 
congenital
injury
alchohol/ drugs 
malnutrition/ obesity 
mental illness
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5
Q

what is information bias

A

arises from systematic error in measuring exposure or disease

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6
Q

what does the public body/ joint working act 2014 say

A

“improve the quality and consistency of services for pateitns, carers, device users and their families; to provide seals, joined up, quality health and social care services in order to care for people in their homes or a homely setting where it is safe to do so- and to ensure resources are used effectively and efficiently to deliver services that meet increasing number of people with longer term and often complex needs”

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7
Q

when is the population of older people (>60) supposed to exceed younger

A

2050

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8
Q

what may be some impacts of long term conditions (individual, family, community)

A

individual - self pity, apathy , denial
family - financial, emotional, physical
community - isolation

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9
Q

what percent of GP appointments, outpatient appointments and inpatient bed days do long term conditions make up

A
  • 50%
  • 64%
  • 70%
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10
Q

what is the difference in definitions of disease and illness

A

disease - symptoms, signs for diagnosis (bio-med)

illness - ideas, concerns & expectations from experience (patients experience)

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11
Q

list 4 types of bias

A

selection bias
information bias
follow up bias
systematic error

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12
Q

what are the 3 components of the WHO international classification of functioning, disability, health

A 
body and structural impairment (organ level)
activity limitation (personal level)
participation restrictions (social/ environment level)
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13
Q

list some common confounding factors

A

age, sex, social class

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14
Q

list some burdens of treatment

A
  • changing behaviour of others to adhere to lifestyle modifications
  • monitoring and managing symptoms at home
  • complex treatment regimes & polypharmacy
  • complex admin systems
  • uncoordinated health and social care
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15
Q

what is a challenge of expanding PHCT

A

teamworking

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16
Q

what are SIGN guideline intended to do

A
  • help health/ social care proffessionals and patients understand medical evidence and use it to make decisions about healthcare
  • reduce variations in practice
  • allow all patients to get the best care, regardless on where they live
  • improve healthcare across scotland
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17
Q

what political pressures influence the PHCT

A

reduce cost of treatments

provide more treatments closer to where patient lives

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18
Q

how many people in the UK are carers

A

6.5 million

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19
Q

what do changes to the PHCT affect it

A
  • which professionals are part of it
  • which professionals work alongside it
  • working relationships between different groups
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20
Q

when interpreting results of trials, why would you consider standardisation

A

techniques used to remove/ adjust the effects of differences in age or other confounding variables when comparing 2 or more populations eg age:sex

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21
Q

what is relative risk a measure of

A

the strength of an association between a suspected risk factor and the disease under study

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22
Q

what changes in population are expected from 2004-2031 (age category related)

A 
<16 - decrease by 15%
16-29 - decrease by 12%
30-49 - decrease by 17%
\+50 - increase by 28%
\+65 - rise by 58% 
\+75 by 75%
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23
Q

what responsibilities does the doctor have towards disabled people

A

neutral attitude, listen and learn form patient, empathise

assess disability , organise a multi- disciplinary care team, rehabilitation

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24
Q

what is the explanation aim of epidemiology

A

elucidate the natural history and identify etiological factors for a disease, usually by combining epidemiological data with data from other disciplines such as biochemistry, occupational health and genetics

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25
Q

what are the medical aspects of an anticipatory care plan

A 
assessment of capacity/ competence
home care package
wishes re DNA CPR
scottish palliative care guidelines 
communication which has occurred with other professionals 
details of ' just- in - case' medications 
electronic care summary 
current aids and appliances
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26
Q

what is the description aim of epidemiology

A

describe amount and distribution of disease in human populations

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27
Q

what are the 4 components of Wilsons criteria for screening

A

1 - knowledge of disease
2 - knowledge of test
3 - treatment for disease
4 - cost considerations

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28
Q

what is the absolute criteria for causation

A

temporality - exposure before disease

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29
Q

who makes up the integrated joint board

A

same number of representatives form NHS (non- executive directors) and local authorities (councillors)
representatives - carer, GP, nurse, secondary care practitioner, service user, 3rd sector, financial officer, chief officer, chief social worker

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30
Q

what roles may a practice nurse have within a practice

A 
ECGs
minor/ complex wound management e.g leg ulcers
travel health advice and vaccinations
child immunisation 
family planning/ women health
sexual health screening
smoking cessation
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31
Q

what ways are trials developed to deal with confounding factors

A
  • randomised
  • restrict eligibility criteria
  • match subjects in different groups for likely confounding factors
  • results stratified according to confounding factors
  • results adjusted to take account of suspected confounding factors
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32
Q

list some sources of epidemiological data

A 
mortality data
reproductive health statistics
cancer statistics
hospital activity statistics
drug database
general practice morbidity 
health and household surveys 
social security 
accident statistics 
expeniture data from NHS
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33
Q

list some of the criteria for causality

A

strength of association
consistency (repeated observation)
specificity (single exposure - single disease)
temporality - exposure before disease
biological gradient - agrees with disease biology
coherence - no conflict with disease biology
analogy
experiment

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34
Q

what is the role of an occupational therapist

A

assessment and treatment of physical & psychiatric conditions using specific activity to prevent disability and promote independent function in daily life

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35
Q

what are the SIGN guidelines rated on

A

quality of evidence of alphabetical scale - A is best

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36
Q

define a trial

A

experiments used to test idea about aetiology or to evaluate intervention

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37
Q

what are the 5 principles of patient centred care

A 
respect
choice and empowerment
patient involved in health policy
access and support
information
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38
Q

which new proffesional roles affect to PHCT

A

healthcare assistants
advanced nurse practitioners - triage/ prescribing
extended role of pharmacists

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39
Q

what is dietetics

A

interpretation and communication of nutritional science to enable people to make informed and practical choices about food and lifestyle in health and disease

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40
Q

what are the 3 main aims of epidemiology

A

description , explanation, disease control

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41
Q

what is the aim of a randomised control trail

A

to determine whether modification of the factor (removing/ reducing. increasing exposure) alters the incidence of the disease

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42
Q

list some members of the primary healthcare team

A 
GP partners
receptionists
community nurses
practice nurses
health visitors
practice manages
nurse practitioners
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43
Q

what is the definitive method of assessing any new treatment in medicine

A

randomised controlled trial

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44
Q

what does the WHO international classification of functioning, disability, health describe as body and structural impairment

A

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

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45
Q

what is the role of the pharmacist

A

ensure patients get maximum benefit from their medicines

  • advice on prescription
  • advice to patient on how to manage
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46
Q

when should an anticipatory care plan be done and who by

A

any time that seems appropriate/ continuous

anyone with an appropriate relationship

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47
Q

what are the legal aspects of an anticipatory care plan

A

welfare power of attorney
financial power of attorney
guardianship

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48
Q

what does a personal reaction to disability depend on

A 
nature of disability 
information/ education of individual 
personality / coping strategies
support network of individual and reaction 
time to adapt 
additional resources - support groups
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49
Q

how is a randomised control trail carried out

A

2 groups at risk of developing disease are assembled - one alteration given to intervention group and none to control group
date on outcomes collected - relative risk calculated

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50
Q

list come options for care

A
  • living in own home with support from family
  • living in own home with support from carers
  • sheltered housing
  • residential home (24hr support but no medical cover)
  • nursing home
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51
Q

what are anticipatory care plans

A

ACP promotes discussion in which individuals, their care providers and often those close to them, make decisions with respect to their future health or personal and practical aspects of care

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52
Q

what is the role of a midwife

A

provide care during all stages of pregnancy, labour and early post natal period

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53
Q

what are responsibilities of dieticians

A
  • work with special dietary needs
  • inform public about nutrition
  • offer unbiased advice
  • evaluate and improve treatments
  • educate patients/ clients
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54
Q

describe a cross sectional analytical study

A

observations at a single point in time - conclusion drawn on relationship between diseases and other variables of interest in a defined population

55
Q

why may a patient have issues with going to the GP

A

believes to be healthy
looks physically fit
proud not using tablets

56
Q

what do descriptive studies attempt to do

A

describe the amount and distribution of disease in a given population

57
Q

define incidence

A

the number of new cases of a disease in a population in a specific period of time
tells about trends in causation/ aetiology
can be helpful when planning

58
Q

what is biographical disruptions

A

process where a long term condition leads to a loss of confidence in the body and then in social interaction or self identity

59
Q

what are advantage and disadvantage of a descriptive study

A

adv - clues to possible risk factors, cheap, quick

dis - no evidence of disease causes, don’t test hypothesis

60
Q

what is the fastest growing population group in the world

A

80+ (>65s in the UK)

61
Q

what are the differences in populations in more developed and less developed regions

A

more - 20% >60 in 2000, 33% in 2050

less - 8% >60 in 2000, 20% in 2050

62
Q

what is multi- morbidity

A

the co-existnece of two or more long term conditions in an individual

63
Q

what is an expert patient

A

someone who completely understands their disease - knowledge/ experience is a good resource and can greatly impact their quality of care/ life and treatment process

64
Q

what are descriptive studies useful in

A
  • identifying emerging public health problems through monitoring and surveillance of disease patterns
  • signalling presence of effects worthy of further investigation
  • assess effectiveness of measures of prevention and control (screening)
  • asess needs for health service planning
  • generate hypothesis about disease aetiology
65
Q

what are the personal aspects of an anticipatory care plan

A

statement of wishes regarding treatment
next of kin
consent to pass on information to relevant others
preferences and priorities regarding treatment
who else to consult/ inform
preferred place of death
religious/ cultural beliefs regarding death
current level of support

66
Q

what is the role of a physiotherapist

A

help and treat people with physical problems caused by illness, accident or ageing
maximise movement through health promotion, preventative care, treatment and rehab

67
Q

when interpreting results of trials, why would you consider case definition

A

to decide whether or not individual has the condition - medical terms may change

68
Q

what does the WHO international classification of functioning, disability, health describe as activity limitation

A

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

69
Q

what is a care manager

A

expert in working with individuals to identify their goals and locate the specific support services that enhance well- being (highly trained social workers)

70
Q

when interpreting results of trials, why would you consider ascertainemnt

A

if data is complete or is subjects are missing

71
Q

what is the disease control aim of epidemiology

A

provide basis on which preventative measures, public health practices and therapeutic strategies can be developed, implemented, monitored and evaluated for the purposes of disease control

72
Q

what does Wilsons criteria for screening describe as treatment for disease

A

accepted treatment for patients with recognised disease
facilites for diagnosis and treatment available
agreed policy concerning who to treat as patients

73
Q

what is patient centred care

A

placing the patient at the centre, ensuring that the healthcare system meets their needs/ preferences defined by themselves

74
Q

how is strength of association measured when determining causality

A

relative risk or odds ration

75
Q

which groups of people are long term conditions more prevalent in

A

old and socially deprived

76
Q

what is the integrated joint board model

A

NHS and local authorities delegate responsibilities for planning and resourcing service provision for delegated adult health and social care service to the IJB

77
Q

what are SIGN guidelines based on

A

systematic review of the scientific literature and are aimed at aiding the transition of new knowledge into action

78
Q

what factors affect the uptake of care

A
  • concept of lay referral (granny knows best)
  • sources of info - peers, family, internet/ TV, NHS, leaflets
  • medical - visible symptoms, increasing in severity and duration
  • non-medical - peer pressure, patient beliefs, expectations, social class, economic, age, gender, media
79
Q

in case- control analytic studies, what is compared in the 2 groups

A

average exposure to suspected aetiological factors - clues to factors which elevate/ reduce risk of disease

80
Q

what is the most common relationship for a carer

A

40% parent

1/4 spouse

81
Q

what is selection bias

A

when study sample is not truly representative of the whole study population about which conclusions are to be drawn

82
Q

what is health literacy about

A

people having the knowledge, skills, understanding and confidence to use health information, be active in their care and navigate health/ social care systems

83
Q

why is there estiamted to be such a difference in population ages from 2004- 2031

A

baby boomers born after WWII will be 80 in 20131

older people are increasingly healthy + preserve fitness

84
Q

what are some health related implications of an ageing population

A
  • increased number of geriatricians & health professionals for elderly
  • increased facilities for elderly health care requires
  • care of many long term conditions moving to primary care for palliative care
  • specific health promotion campaigns aimed at elderly
85
Q

how do health visitors contribute to safeguarding and protecting children

A

trained in recognising risk factors, triggers of concern and signs of abuse and neglect in children
support families going through formal safeguarding
sometime appear in court

86
Q

what 2 acts give rights for disabled people

A

disability discrimination act 1995/ 2005

equality act 2010

87
Q

what does Wilsons criteria for screening describe as knowledge of test

A

suitable test or examination available
test acceptable to population
case finding should be continous

88
Q

when interpreting results of trials, why would you consider coding and classification

A

when data collected it is often converted into codes to assist in data storage and analysis - the rules for the codes may change

89
Q

what does the WHO international classification of functioning, disability, health describe as participation restrictions

A

disadvantage experiences by the individual as a result of impairments and disabilities (social/ environmental level)

90
Q

define bias

A

any trend in the collection, analysis, interpretation, publication or review of data that can lead to conclusions that are systemically different from the truth

91
Q

what is the social model of a disability

A
  • society cause
  • conditions relating to housing
  • social/ political action needed eg. facilities
  • societal attitude change eg use of politically correct language
92
Q

what do cohort studies allow

A

calculation of cumulative incidence, allowing for differences in follow up time

93
Q

list some factors to consider when interpreting results of trials

A 
standardisation 
standardised mortality ratio
quality of data
case definition 
coding and classification 
ascertainment
94
Q

describe the process of a cohort study

A

baseline data on exposure from group of people who don’t have disease - group followed through time until sufficient number have developed disease
split into subgroups depending on exposure status - compared to determine how incidence relates

95
Q

what is the role of district nurses

A

visit people in their own homes - provide care and support families
teaching/ supportive role (keep hospital admission minimum)

96
Q

which contract do the majority of GPs have

A

independent form NHS - responsible for premises and employing their own staff

97
Q

what services to macmillan nurses offer

A
  • pain and symptom control
  • emotional support for both patient and family/ carer
  • care in variety of setting
  • information on cancer treatments and side effects
  • advice to other members of caring team
  • coordinate care between hospital and home
  • advice on other forms of support, incl financial
98
Q

what is the dictionary definition of disability

A

lacking in one or more physical powers such as the ability to walk or co-cordiante ones movements

99
Q

what handicaps may a long term condition have

A

affect physical, social and psychological well-being

  • constraints on family life
  • no functional capacity to work
  • unremitting physical discomfort (chronic pain)
100
Q

what are some economic related implications of an ageing population

A
  • retirement / pension age increasing
  • harder to find employment for younger
  • proportionally less people paying into tax and pension funds
  • state pension may not be adequate
  • increasing cost of ‘free personal care for elderly’ policy
101
Q

what is the current demographic trend

A

increase in older people (>60) and declines in young (<15)

102
Q

what percentage of carers say their financial circumstances were affecting their health

A

45% (30% saw a drop in more than £20,000)

103
Q

what are some political related implications of an ageing population

A
  • decision making/ workforce planning must take into account aging population
  • increasing elderly population will influence votes in relation to their concerns
104
Q

list different types of analytical studies

A

cross sectional
case control
cohort

105
Q

list some allied health professionals

A 
physiotherapy 
occupational health 
diets
podiatry 
pharmacy
counselling
106
Q

when interpreting results of trials, why would you consider quality of data

A

care to ensure that the data is trustworthy

107
Q

how are results of case- controlled studies expressed

A

odds ratios or relative risks

108
Q

what is a confounding factor

A

a factor which is assoicated independently with both the disease and with the exposure under investigation and so distorts the relationship between the exposure and disease

109
Q

what is systematic error

A

form of measurement bias where there is a tendency for measurements to always fall on one side of the true value (instrument calibration/ operator differences)

110
Q

what format does a case controlled analytical study take

A

two groups of people compared - one with the disease (cases) and a group without (controls)
- data gathered to determine if people have been exposed to suspected etiological factors

111
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
can by used to assess workload for health service

112
Q

what is the purpose of the public bodies joint working act 2014

A

created integration authorities to break down barriers to joint working between NHS boards and local authorities, and integrate health and social care budgets (nationally agreed outcomes)

113
Q

what differences in groups does epidemiology detect

A

aetiological clues
scope for prevention
identification of high risk or priority groups in society

114
Q

what are the differences in life expectancy for people born in 2004 and 2031

A

2004 - 74.3 (M) , 79.4 (F)

2031 - 79.2 (M), 83.7 (F)

115
Q

what percentage of carers receive the disability living allowance for themselves

A

27%

116
Q

what ratio is used for epidemiology

A

events / population at risk

risk 0 everyone in denominator must have potential to enter numerator

117
Q

what is the purpose of descriptive studies

A

gaining insight into the aetiology of the condition/ planning health services to meet clinical need

118
Q

what does Wilsons criteria for screening describe as knowledge of the disease

A

condition should be important
must be a recognisable latent or early symptomatic stage
should understand the natural course of the condition

119
Q

what roles may a health visitor have

A

parenting support on minor illness
advice on feeding, weaning and dental health
physical and developmental checks
support on subjects eg PND
work closely with nursery
lead child services team
refer to specialists eg speech and language

120
Q

list some roles of carers

A 
keep an eye on
keep them company 
take person out
help deal with financial matters
help deal with care services and benefits 
help with personal care
121
Q

what are some social related implications of an ageing population

A
  • aging population dependent on families
  • demand for home carers/ nursing homes
  • role of elderly as grandparents
  • housing demands change as elderly people likely to live alone
122
Q

when interpreting results of trials, why would you consider the standardised mortality ratio

A

figure of standard reference population = 100, standardised death rate is a proportion of 100

123
Q

what is follow up bias

A

arises when one group of subjects is followed up more assiduously than another when measuring outcome

124
Q

what are long term conditions

A

persistant conditions that do not lead to early death.

125
Q

what is the legal definition of disability

A

difficulty can be physical, sensory or mental

a disability that makes it difficult for them to carry out normal day to day activities, ongoing for more than 12 months

126
Q

what ratio is used for relative risk

A

incidence of disease in exposed group / incidence of disease in unexposed group

127
Q

list some economic factors that influence the PHCT

A
  • existing premises too small for growing number of GPs
  • trend form small traditional GP to larger building developed by private companies
  • trend to wider services provided within a practice
128
Q

what is the medical model of a disability

A
  • individual cause
  • underlying pathology
  • individual level intervention form health profession
  • individual changes to behaviour
129
Q

what are benefits of a cross sectional sectional analytic study

A

provides results quickly (usually impossible to infer causation)

130
Q

list some secondary care services

A

consultants
diagnostic imaging
operating services

131
Q

list some of the ways PHCT should work as a team

A
  • patient centred care
  • agree common objectives/ goals
  • agree teamworking conditions including conflict policy
  • ensure every member knows their role and the roles of each other
  • communicate well
  • select a leader with good leadership skills
  • joint conferences, education and training
132
Q

what factors other than age affect population

A

migration, health education, public health improvements (housing/ clean water/ nutrition) ,

133
Q

what is the iceberg of illness

A

no disease in 50% of GP appointments - some reported, some unreported

134
Q

what is the role of a health visitor

A

lead and deliver child and family health services form pregnancy to 5 years - assess the support parents need and develop appropriate programs to help give the child the best possible start in life

FOPC (3 decks)

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