Exam Flashcards
Define Primary Healthcare
Cost-effective, efficient, care approach to preventing and/or managing health risks, enhance quality of life and affect enduring change. Primary health care uses person-centred care to address physical, mental, and social well-being.
Define Modifiable
Determinants that can be controlled or changed, to make an impact on a person’s health status behavioural risk factors include smoking, poor nutrition excess alcohol and physical inactivity.
These include Smoking, poor nutrition, alcohol misuse and physical inactivity.
Define Health Literacy
Health literacy is the skills, knowledge, motivation, and capacity of a person to access, understand, appraise, and apply information to make effective informed decisions about their health.
Define Chronic Illness
“a chronic illness/disease in a health condition that is persistent or otherwise long-lasting in its effects or a disease that progresses with time. The social and economic consequences of chronic disease can impact on peoples’ quality of life. The term chronic is generally applied when the course of the disease lasts for more than three months.”
Define non-modifiable risk factor
Determinants that CAN NOT be controlled or changed, to make an impact on a person’s health status. These include gender, race, family history and advancing age.
Define Person-centred care
The practice in which patients actively participate in their own medical treatment in close cooperation with their health professionals. Person-centred care considers the patients (and their families) goals, values and preferences when developing a health care plan.
Define Comorbidity
The presence of two or more chromic conditions in a person at the same time. Comorbidity means that one ‘index’ condition is the focus of attention, and others are viewed in relation to this.
Define Multimorbidity
The presence of two or more (unrelated) chronic conditions in a person without any of conditions holding priority over the other.
Define Social Determinants of Health
The social determinants of health are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.
Define Burden of disease
Burden of disease measures the impact of living with illness and injury and dying prematurely. The summary measure ‘disability-adjusted life years’ (or DALY) measures the years of healthy life lost from death and illness.
Define Self-management
The ability of individuals and their support networks to promote and maintain health, and prevent disease, or cope with illness or disability.
Define Motivational interviewing –
A strategy to encourage behavioural change, with the health professional working in partnership with individuals and families to offer non-judgmental information and strategies to facilitate positive change.
Define Empowerment
A process designed to facilitate self-directed behaviour change by encouraging a focus on strengths and abilities, empowerment allows patients to build capacities to gain access, networks and/or a voice, to gain control over their health decisions.
Define healthcare Strategy
A plan that guides the actions and goals of a healthcare organisation or system. It can help improve the quality, efficiency, and effectiveness of healthcare services, as well as address the challenges and opportunities in the changing healthcare environment
Principle of primary health care:
- Chronic illness/ disability can affect all
dimensions of a person’s life - physical,
psychological/ social, spiritual and
environmental - Care provision must be holistic & culturally sensitive
- Care must be relevant to the person (person-centred) who has the chronic illness and their family
- Care providers must take a ‘whole of life’ approach, with an understanding of risk factors that contribute to chronic illness
Define Advocacy
Promoting patient safety and quality care.
This includes protecting patients, provision of quality care and interpersonal relationship as well as educating patients. Additionally, advocacy gives patients a voice in situations or settings where they could possibly be ignored or disregarded.
Chronic illness statistics
Account for 9/10 deaths
1 in every 2 hospitalisations
1/5 Australians have a chronic illness= 11 million
How to improve health literacy:
With health educationà a strategy for fostering health literacy
Planned
Opportunistic
Principle of primary health care circle-
Equity-
- The quality of being fair and impartial - Absence of unjust, avoidable, or remediable differences among groups of people
Collaborative partnerships
- Partnership between providers, patients, and their families in shared decision-making, coordination, and cooperation has been defined as interprofessional collaborative practice
Access
- Opportunity or ease with which consumers or communities are able to use appropriate services in proportion to their needs
Evidence-based
- An approach to care that integrates the best available research evidence with clinical expertise and patient value
Accountability and Transparency
- Accountability is the process of holding people responsible
The right to access information
- Open and honest Shared responsibility approach in which responsibility for health goals is shared among community stakeholders
Sustainability (strategic planning and responsible management of resources)
- Allocating resources appropriately and developing a healthcare plan that has longevity
Person-centred
- Practice in which patients actively participate in their own medical treatment
- Ensuring that people’s preferences, needs and values guide clinical decisions, and providing care that is respectful of and responsive to the
The nurses role in chronic illness management:
Mange the disease and reduce exacerbation:
Prevent illness transition from impairment to disability
Encourage patients to play an active role in the management of their disease without letting it dominate their lives.
Increasing health literacy with health education promotes self management
Factors affecting learning:
- Education level
- Economic circumstances
- Language spoken
- Attention
- Readiness to learn/motivation
- Family and community support
- Emotional factors (fears, insecurities)
- Health condition (fatigue, discomfort)
Stages of behavioural change:
Precontemplation- Not recognise the need for change and is not consider change at this point
Contemplation- Recognises problems and is beginning to consider change
Roll with resistance
Preparation- Patient is getting ready to change
Action- initiated change
Give positive enforcement
Maintenance- Pt is adjusting to change and is practising their new skills
Relapse- Pt fell of the wagon
The role of the nurse in facilitating self management:
- Providing information
- Teaching chronic illness-specific management skills
- Promoting healthy lifestyle behaviours
- Assist the patient to develop their own problem-solving skills
- Recognise the psychological aspects that are attached to chronic conditions
- Providing regular and continued follow-up visits
- Encouraging individuals to be active participants in the management of their illness
The 5 A’s model: Made with the patients personal action plan in mind.
Assess:
Asses a person’s beliefs, behaviours and knowledge was well as their motivation and willingness to change
Advise:
Provide specific information about the health risks and benefits of changing behaviour. Involve patient and their families
Agree:
Collaboratively set goals based on the patient’s interest and confidence in their ability to change the behaviour,
Set smart goals
Develop action plans and progress towards the goal
Assist:
Identify personal barriers, strategies, problem-solving techniques and social and environmental support
-Motivational interview techniques
Teach and assist the pt
Arrange:
Specific plan for the follow up- phone calls, mailed reminders
- Providing the patient with self management support
Personal action plan:
List specific goals in behavioural terms
List barriers and strategies to address barriers. Specify the follow up plan
Share the plan with the multidisciplinary team and the patients social support and family
How can nurses tackle the problem of chronic illness:
Early identification of risk
Support patient in behaviour modification
Optimise evidence-based care
Facilitate patient self-management
Burden of disease:
Measure the impact of living with illness and injury and dying prematurely
DALY(Disability adjusted life years)
1 DALY = 1 year lost of health life due to illness and/or death
More DALY = greater burden
WHO Innovative Care for Chronic Conditions Framework 3 levels;
Macro: intersectoral collaboration between government sectors and other organisations:
-Policies-> Develop and allocate human resources
-Supportive legislation
Meso: Healthcare organisations and communities
- Health education and promotion.
- Heart Foundation, cancer council
Micro: Patient interaction and the need to empower patients
Chronic conditions in Australia:
Mental health is most prevalent followed by back pain arthritis, asthma, and diabetes
1 in 4 Aussies have 2 or more chronic conditions
Causal pathway of chronic conditions
- Underlying causes;
- Social economic, political, cultural, physical , environmental
- Modifiable risk factors;
SNAP - Modifiable intermediate risk factors: Elevated blood pressure, Elevated blood sugar, Overweight/obesity.
- Disease outcomes:- Diabetes, Cancer, heart disease, Stroke.
Protective factors:
- Protective factors that contribute to the wellness of the patient
- associated with lower likelihood of negative outcomes or reduced risk factors
- Do the opposite of snap
- Positive attitudes, values or beliefs
- Conflict resolution skills
- Good mental, physical, spiritual and emotional health
- Positive self-esteem
- Success at school
- Family support
- Strong social/community support
A patients readiness to acquire knowledge, skill and confidence for managing their health and healthcare
Level 1- Disengaged and overwhelmed
Level 2- Becoming aware but struggling
Level 3- Taking action
Level 4- Maintaining behaviours and pushing further
Measure with PAM- Patient activation measure ↑
Brief encounter
- Precedes motivation to change
- More effective when used multiple times
- To persons who are identified during an assessment
- Practiced by nurses in primary and tertiary care contexts
Motivational interview techniques -> an approach to interview a patient and encourage a behavioural change
