Case Study Flashcards
1) Kayleigh attends her GP to discuss contraception. She wishes to use the combined pill, but heard that there was a study done that showed there were dangers associated with the pill.
You wish to discuss risk with her. What two different types of risk would be appropriate to discuss? Which is the most relevant for Kayleigh to take into account here?
Actual risk and relative risk – with Actual risk being the most important.
How might you communicate risk to her?
Verbally, using fractions, or perhaps by using illustrations.
2) What kinds of studies might have been performed to generate data that you are able to present to Kayleigh about treatments or illnesses?
Descriptive Studies Cross Sectional Studies Cohort Studies Case-Control Studies Randomised controlled trials (RCTs)
What one word that can affect the outcome of studies describes the tendency to select preferentially from a group.
Bias
If it turned out that one group also smoked more than the others, what kind of factor would smoking be?
A confounding Factor
You are unsure if you and your colleagues are prescribing the Contraceptive Pill according to national guidelines. What action might you take?
You might perform an audit.
What headings might you use to structure an audit according to the Royal College of General Practitioners (RCGP) audit guidelines?
Reason for the audit
Criteria or criterion to be measured Standard(s) set
Preparation and planning
Results and date of collection one
Description of change(s) implemented
Results and date of data collection two
Reflections
What model describes the stages Brenda has gone through in her smoking cessation?
Precontemplation -> smokes regularly
Contemplation -> considering giving up
Preparation -> making definite plans
Action -> actively not smoking
Maintanence -> non-smoker
Regression -> starts smoking again
OR
Maintaining healthier lifestyle
Define Health Promotion
1) Any planned activity designed to enhance health or prevent disease
2) The process of enabling people to increase control over, and to improve, their
health. Applied to a wide range of approaches to improving health of people,
communities and populations.
3) An over-arching principle/activity which enhances health and includes disease
preventing health education and health protection. It is usually planned but may be opportunistic, e.g. in a GP consultation.
(There are a number of ways of describing Health Promotion; all are correct and acceptable.)
What are the three theories of Health Promotion?
Educational - Provides knowledge and education to enable necessary skills to rate informed choices re health – may be one –to-one group workshop e.g. smoking, diet, diabetes
Socioeconomic – ‘Makes healthy choice the easy choice.’ National policies e.g. re unemployment, redistribute income.
Psychological - Complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change. (e.g. smoking, alcohol).
Following further consultation with his advisers, he decides that the government will fund group sessions on smoking cessation.
What type of health promoting activity does this demonstrate?
Health education-an activity involving communication with individuals or groups aimed at changing knowledge, beliefs, attitudes and behaviour in a direction which is conducive to improvements in health.
To which criteria would they refer when advising him about the appropriateness of a lung cancer screening programme. List the criteria.
Wilson and Jungner’s criteria
Illness – important, natural history understood, clinically detectable pre- symptomatic stage
Test – easy, acceptable, cost effective, sensitive and specific
Treatment – acceptable, cost effective, better if early
Steve works at B&Q moving stock. He frequently has some aches and pains, but one day was moving a bathroom suite and developed a sharp pain in his lower back, with some difficulty bending and twisting.
What is the likely diagnosis.
What is the prognosis?
Mechanical Low Back Pain
Generally good with some initial rest, painkillers and mobilisation with or without physio.
He comes to you for assessment, telling you he has bought over the counter medicines which make it bearable.
However, he does not think he is fit for work .
(he has mechanical back pain)
What might you provide for him?
Different analgesia
A Med 3 Fit Note, which may contain details about altered duties, adaptations, altered hours etc.
Possibly referral to Physiotherapy.
Steve comes back one month later. One of your colleagues signed him off for a further two weeks and he tells you he has just been at home. He does not look as distressed as when you last saw him.
What role could he be said to be adopting?
Is it always a negative role?
The Sick Role
Not necessarily negative. We live in a society that cares for it’s infirm and allows time to recover. On the individual, however, there is an expectation that they will endeavour to get well and return to their previous role.
