Concepts Flashcards
Give three things which can influence behaviour
o Attitude: positive or negative evaluation of behaviour based on its consequences and importance
o Subjective norm: beliefs about significant other’s behaviour and how important it is to comply with these
o Perceptions of control over behaviour: beliefs about internal and external factors which make behaviour easier or harder to perform and change
Give four conditions that make a person more likely to make a positive behavioural change
o Positive attitude towards it
o Brings about consequences important to them
o Believe others think its important they do it
o Feel have necessary resources, skills or opportunities to overcome barriers and lose weight
Describe six states of change
o Precontemplation o Contemplation o Preparation o Action o Maintenance o Relapse
Give four medical things that can influence uptake of medical care
New symptoms
Visible symptoms
Increasing severity
Duration
Suggest some non-medical things that can influence uptake of medical care
Crisis Peer pressure – “wife sent me” Patient beliefs Expectations Social class Economic Psychological Environmental Cultural Ethnic Age Gender
Describe the sick role of the patient
Exempt from daily responsibilities
Not responsible for being ill and unable to get better without help of HCP
Must seek help from HCP
Under social obligation to get better ASAP to be able to take up social responsibilities again
Describe the role of the health care professional
Must be objective and not judge pt morally
Must not act out of self-interest or greed but put pt’s interests first
Must obey to professional role of practice
Have and maintain necessary knowledge and skills to treat pts
Right to examine pt intimately, prescribe treatment and has wide autonomy in practice
Suggest some secondary gains from being classified as sick
Care and sympathy
Concern from family and friends
Financial allowances associated w/ disability
Using apparently disabling illness as explanation for failures
Avoiding work
Restoring status or domination in family
Achieving revenge for bad treatment or pay from employer or insurance company
What are the advantages of house calls?
Useful info on pt’s ability to cope with chronic condition or disability
Useful info obtained from relative or carer
Provides social contact for socially isolated
What are the disadvantages of house calls?
Lack of proper examination facilities -> delay in diagnosis
No chaperone
Time consuming
Presence of relative may lead to lack of confidentiality
Give four types of doctor who work in the community
GPs
Child health specialists
Geriatric specialists
Family planning services
What medical conditions are commonly seen by GPs?
Acute infections (usually upper respiratory) Skin disorders Psycho-emotional complaints Minor accidents Intestinal complaints Rheumatic complaints Symptomatic illnesses of uncertain origin Established chronic complaints
Suggest four physical factors which can influence a consultation
Site and environment
Adequacy of medical records
Time constraints
Patient status
Suggest personal factors which can influence a consultation
Age Sex Backgrounds and Origins Knowledge and Skills Beliefs The Illness
Give three styles of doctor/patient relationship
Authoritarian or paternalistic relationship
Guidance/co-operation
Mutual participation relationship
Give five examples of coping strategies
Problem solving - direct action, decision making or planning
Support seeking - social support, comfort and help
Escape avoidance - disengagement, denial and wishful thinking
Distraction - finding alternative activities to do
Cognitive restructuring - positive thinking and accommodation
How are coping strategies classified?
Emotion-focused - modifying response to the problem
Problem-focused - action to change or address the stressor
Describe the medical model of disability
- Disability intrinsic to individual and direct consequence of underlying disease
- Reduction can only be achieved via amelioration of underlying pathology
- Medical intervention means to restore “normality”
Describe the social model of disability
- Socio-cultural focus, disability placed outside individual
- People not per se limited by medical condition but by behavior of others towards them and environmental conditions
- Underpins legislation to remove barriers
- Reduces limitations e.g. wheelchair access, hearing aid loop systems etc
Give three guidelines/legislation relevant to disability
GMC good medical practive
Disability discrimination act (1995)
Equality act (2010)
Give three methods of clinical problem solving
Pattern recognition
Hypothetico-deductive reasoning
Inductive reasoning
Describe the Wilson and Junger criteria of screening
Knowledge of disease - condition should be important recognisable and adequately understood.
Knowledge of test - there must be a suitable test or examination, which is acceptable to the population.
Treatment of disease - must be an accepted treatment for patients with the disease, and an agreed policy re whom to treat.
Cost considerations - cost of diagnosis and treatment must be economically balanced in relation to possible expenditures on medical care as a whole.
Give seven types of discrimination, as defined by the 2010 equality act
o Direct discrimination o Associative discrimination o Indirect discrimination o Harassment o Harassment by a third party o Victimisation o Discrimination by perception
What is used to assess a patient’s independence?
Barthel Index of ADL (assessment of daily living)
Give ten items that are measured in the Barthel Index of ADL
Feeding Moving from wheelchair to bed and return Grooming Transferring to and from a toilet Bathing Walking on a level surface Going up and down stairs Dressing Continence of bladder and bowel
Suggest some interventions and/or initiatives that can preduce, prevent or limit the onset of disabling conditions
o Public health e.g. folic acid in early pregnancy to reduce spina bifida incidence
o Disease prevention interventions e.g. screening, immunization, health promotion and education (stop smoking)
o Disease modifying drugs e.g. RA
o Splints and aids e.g. arthritis
o Physiotherapy and OT
o Rehabilitation limits disability by supporting people to level of optimum function e.g. post stroke
o Occupational and environmental medicine initiatives ensure safe working conditions
Describe the Wilson and Junger criteria of screening
Knowledge of disease - condition should be important recognisable and adequately understood.
Knowledge of test - there must be a suitable test or examination, which is acceptable to the population.
Treatment of disease - must be an accepted treatment for patients with the disease, and an agreed policy re whom to treat.
Cost considerations - cost of diagnosis and treatment must be economically balanced in relation to possible expenditures on medical care as a whole.
Give seven types of discrimination, as defined by the 2010 equality act
o Direct discrimination o Associative discrimination o Indirect discrimination o Harassment o Harassment by a third party o Victimisation o Discrimination by perception
What is used to assess a patient’s independence?
Barthel Index of ADL (assessment of daily living)
Give ten items that are measured in the Barthel Index of ADL
Feeding Moving from wheelchair to bed and return Grooming Transferring to and from a toilet Bathing Walking on a level surface Going up and down stairs Dressing Continence of bladder and bowel
Suggest some interventions and/or initiatives that can preduce, prevent or limit the onset of disabling conditions
o Public health e.g. folic acid in early pregnancy to reduce spina bifida incidence
o Disease prevention interventions e.g. screening, immunization, health promotion and education (stop smoking)
o Disease modifying drugs e.g. RA
o Splints and aids e.g. arthritis
o Physiotherapy and OT
o Rehabilitation limits disability by supporting people to level of optimum function e.g. post stroke
o Occupational and environmental medicine initiatives ensure safe working conditions
List the different parts of a primary health care team
GP partners GP assistants and salaried doctors GP registrars Practice nurses Practice managers Receptionists Community nurses Midwives Health visitors Nurse practitioners
Give three broad types of skill that a GP might use during a consultation
Content skills
Perceptual skills
Process skills
Give five types of question
Open questions Closed questions Direct questions Leading questions (not good) Reflected questions
What factors put someone at risk of developing a long term condition?
Genetic factors Environmental factors (including lifestyle factors)
Give three examples of potential impacts of a long-term condition
On the individual e.g denial, self-pity and apathy
On family e.g financial, emotional, may affect their health
Community/society e.g. social isolation, may require physical adaptations and changes in attitude
How does the WHO classify disability?
Body and structure impairment
Activity limitation
Participation restrictions
Give two approaches that health care professionals may use to help someone overcome limitations of their disability
Therapeutic (changing the nature of the disability)
Prosthetic (changing the environment)
What factors may influence the way that an individual reacts to a diagnosis?
Her support network
The nature of the disability
The information base of the individual e.g. education, intelligence and access to information
The personality of the individual
The coping strategies of the individual
The role of the individual; loss of role or change of role
The mood and emotional reaction of the individual
The reaction of others around them
What three areas of an individual’s life may be affected by a diagnosis?
Economic
Social
Personal
