Block 9 - part 3 Flashcards

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1
Q

Conclusions of eurocare-II report

A

Despite limitations for the methodology, cancer survival in the UK in 1980s/90s was one of worst in Europe.
Expert advisory group formed to the chief medical officer in 1995, which generated the calman-hine report

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2
Q

What did the Calman-Hine report (1995) do

A

Examined cancer services in the UK and proposed a restructuring of cancer services to achieve a more equitable level of access to high levels of expertise throughout the country

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3
Q

6 consequences/aims of Calman-hine report

A

All pts have access to uniformly high qual of care
Public/professional education to recognise early cancer symptoms
Clear information about treatment options and outcomes for pts, families, carers
development of cancer services should be pt centred
Primary care central to cancer care
psychological needs of cancer sufferers and carers recognised

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4
Q

Calman-hine solutions

A

3 levels of care: primary, cancer units serving district hospitals, cancer centres
key to managing pts would be MDT

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5
Q

Role of cancer units

A

Treat common cancers, diagnostic procedures, common surgery, non-complex chemo

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6
Q

Role of cancer centres

A

Treat rare cancers, radiotherapy, complex chemo

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7
Q

National service framework

A

National standards, support program implementation, establish performance measures (progress within agreed timescales)

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8
Q

Main aims of NHS cancer plan (2000)

A

Save more lives
Ensure cancer pts get right professional support, care and treatments
Tackle health inequalities
Build for the future

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9
Q

NICE guidlines which followed the cancer plan (2000)

A

Manual of cancer (2000) and (2004)

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10
Q

6 key areas for action in the cancer reform strategy (2007)

A
Prevention
Early diagnosis
Better treatment
Living with and beyond cancer
Reducing cancer inequalities
Appropriate care setting
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11
Q

Which cancers are screened for?

A

Cervical, breast, bowel

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12
Q

National cancer survivorship initiative

A

partnership with cancer charities, clinicians and patients, considered a range of approaches to improving services and support available for cancer survivors

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13
Q

Main outcomes for ‘improving outcomes: a strategy for cancer’ (2011)

A

Prevention and early diagnosis, quality of life and patient experience, better treatments, reducing inequalities

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14
Q

Some inequalities experiences amongst cancer patients

A

White pts report more positive experience
younger people least positive about experience
men generally more positive about care
non-hetero patients less positive experience
Patients with rarer forms of cancer poorer experience of treatment and care

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15
Q

Outcomes from the independent cancer taskforce (2015)

A

Spearhead radical upgrade in prevention and public health, drive national ambition to achieve earlier diagnosis, establish patient experience as being on par with clinical effectiveness and safety, transform approach to support people living with and beyond cancer
Necessary investments to deliver high quality services
Overhaul process for commissioning, accountability and provision

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16
Q

Body image

A

perceptions, thoughts and behaviours relating to ones appearance

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17
Q

biological disturbance

A

chronic illness leads to loss of confidence in the body, followed by loss of confidence in social interaction or self-identity

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18
Q

Examples of things which affect body image

A

scars, prosthetics, mastectomy, impact on sexuality, stoma, hairloss, weight loss/gain

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19
Q

Importance of hair

A

Important site for individual and group identity, symbol of femininity, stigma, loss of patient control of their status of sick

20
Q

functions of the clinical record

A

Support patient care, improve future patient care, social purposes at request of patients, medico-legal document

21
Q

What should be recorded in clinical record

A

presenting symptoms, relevant clinical findings, diagnosis/differentials, care/treatment options, risk/benefits of care and treatment, decisions about care/treatment, actions taken and outcomes

22
Q

features of paper records

A

continuous, portable, writer identified, legibility issues, must be dated and signed

23
Q

Electronic record features

A

Problem orientated, searchable, structured, safer prescribing, clinical decision support software

24
Q

Use of records in audit, research and management

A

support clinical audit, facilitates clinical governance, facilitates risk management, support clinical research

25
Q

duty of care

A

legal obligation imposed on an individual requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others

26
Q

negligence

A

failure to exercise the care that a reasonable prudent person would exercise in like circumstances

27
Q

4 ethical principles

A

Beneficence, non-maleficence, autonomy, justice

28
Q

3 ethical theories

A

consequentialism, deontology, virtue ethics

29
Q

consequentialism

A

correct moral response is related to the outcome or consequence of the act

30
Q

deontology

A

places value on the intentions of the individual and focuses on rules, obligations and duties

31
Q

virtue ethics

A

right living is derived from the moral character of the agent

32
Q

how do you evaluate an argument

A

get clear on logical form of the argument, query if valid and sound

33
Q

reasons an argument may be invalid

A

different premises may express different concepts, confusing necessary with sufficient, insensitive to the way in which claims are qualified, argument begs the question

34
Q

reasons an argument might be unsound

A

Argument is invalid, argument valid but one or more premise is false (false/controversial moral/empirical claim made)

35
Q

what should be avoided in arguments

A

Straw man fallacy, ab hominems, appealing to emotion, begging the question, argument from fallacy

36
Q

straw man fallacy

A

simply ignoring the person’s actual position and substituting it for a distorted, exaggerated or misrepresented version of that position

37
Q

ab hominems

A

directed against a person rather than the position they are maintaining

38
Q

argument from fallacy

A

conclusion must be false, because premises are false (non necessarily)

39
Q

Moral argument

A

seek to support a moral claim of some kind, must provide supporting reasons for claim

40
Q

deductive argument

A

purely logic, this means this, therefore this means this

41
Q

inductive argument

A

making an argument based on observation, more probable conclusions (seeing is believing but you may not have seen anything)

42
Q

Why are MDTs needed in cancer care

A

Modern management, delivery of care often fragmented over several hospital sites, probably better outcomes for patients managed in MDT

43
Q

Core medical MDT staff

A

Physicians, surgeons, oncologist, radiologist, histopathologist, specialist nurses, MDT coordinator

44
Q

Extended MDT staff

A

physio, dietician, palliative care, chaplin

45
Q

Functions of MDT in cancer care

A

Discuss new diagnoses, decide on management plans, inform primary care of plan, designate key worker for patient, develop referral, diagnosis and treatment guidelines, audit