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Foundations of Primary Care AM > First year summary > Flashcards

First year summary Flashcards

1
Q

What is the aim of a GP consultation?

A 
Initiate session
Gather information
Provide structure
Build relationship
Explain and plan
Close session
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2
Q

What components is clinical competence made up of?

A

Knowledge
Communication skills
Physical examination
Problem solving

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3
Q

What are the 3 broad types of communication skills needed for a GP consultation?

A

Content skills- substance of questions
Perecptual skills- thoughts and feelings
Process skills- what the doctor actually does

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4
Q

What are the 3 types of doctor patient relationship?

A

Authoritarian- doctor uses position of authority and patient has no autonomy
Guidance- doctor still uses authority, but patient has slightly more autonomy and participates more actively
Mutual participation- patient and doctor have equal authority

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5
Q

What are the 3 types of interviewing technique?

A

Open ended questions
Listening and silence
Facilitation

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6
Q

What are the types of questions that can be asked?

A 
Open ended
Closed
Direct
Leading 
Refelcted
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7
Q

What are the types of non verbal communication?

A

Instinctive
Learned
Clinical observation

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8
Q

What are the factors that can affect body language?

A

Culture
Context
Gesture clusters
Congruence

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9
Q

What are the possible activities in a patient consultation?

A

Talking together
Examination
Performing procedures

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10
Q

What is the WHO definition of health?

A

A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity

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11
Q

What is the difference between the way younger and older people view health?

A

Younger people tend to view health in terms of strength and physical fitness
Older people tend to think of health in terms of functional ability

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12
Q

How do views on health depend on socioeconomic status?

A

Those in lower socioeconomic classes tend to think of health as functional

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13
Q

How do views on health depend on sex?

A

Women more likely to include a social aspect of health

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14
Q

How do cultural differences affect views on health?

A

Different cultures view illness in different ways

Afro-Caribbean moe likely to view hypertension as normal

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15
Q

What is a disease?

A

Biological problem/pathology

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16
Q

What is an illness?

A

Biological problemmand the way it affects the individual

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17
Q

What is a hazard?

A

Something with potential to cause harm

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18
Q

What are the types of hazard?

A 
Physical
Chemical
Mechanical
Biological
Psychosocial
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19
Q

What is risk?

A

Likelihood of harm occuring

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20
Q

What factors affect the degree of risk?

A

How much a person is exposed
How the person is exposed
Conditions of exposure

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21
Q

What does risk combine?

A

Probability of particular outcome and the severity of the heart involved

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22
Q

What factors about the risk affect our perception of it?

A

Feeling in control
Size of possible harm
Familiarity with the risk

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23
Q

What are the individual variables with risk perception?

A 
Previous experience
Attitude towards risk
Values/beliefs
Socioeconomic factors
Personality
Demographic
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24
Q

What is a risk factor?

A

Increases the risk of harm

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25
Q

What is a protective factor?

A

Decreases risk of harm

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26
Q

What is susceptibility?

A

Increases likelihood that something will cause harm

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27
Q

What is uncertainty?

A

State of not being completely confident

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28
Q

What is the purpose of summarising?

A

Patient can add of correct any information

Ensures nothing important is missed

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29
Q

What is safety netting?

A

Give patient information on what to do and who to contact should the situation worsen- and what the situation worsening would be

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30
Q

What is the purpose of safety netting?

A

Advise the patient of the expected course of the illness/recovery
Advise of symptoms indicating deterioration
Advise who to contact if patient deteriorates

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31
Q

What is hypotheticodeductive reasoning?

A
  • Differential
  • Exclude rare and not immediately concerning diagnoses
  • Actively exclude life threatening but less likely causes
  • Strengthened case for likely diagnoses through history and examination
  • Treat for likely cause, if this doesn’t work, go back to differential
32
Q

Who do the majority of healthcare misunderstanding happen in?

A

Patients with limited english- 73%

33
Q

How do cultural influences affect health?

A

Healthcare beliefs
Attitudes towards care
Trust in the system
Affect how information and healthcare is received, understood and acted upon

34
Q

What are the healthcare disparities between races?

A

Disease outcome

Disease prevalence

35
Q

How is disease outcome a healthcare disparity between races?

A

Death rates in lung cancer lower in white than black males

Ethnic minority women with breast cancer have worse survival than white women, even with similar access to care

36
Q

How is disease prevalence a healthcare disparity between races?

A

Rates of diabetes 5x higher in Pakistani and Bangladeshi women than general population
Black Caribbean men have higher rates of stroke

37
Q

What is transference?

A

Physicians or patients transfer past emotions, beliefs or experiences to the present situation

38
Q

What are the cultural barriers?

A 
Lack of knowledge
Fear and distrust
Bias and ethnocentrism
Stereotyping
Language barriers
Differences in perceptions and expectations
Situation
39
Q

What are the primary focuses in a consultation crossing cultures?

A

Eliminate misunderstanding in diagnosis or in treatment planning due to language barriers
Improves adherence to treatment
Eliminate healthcare disparities

40
Q

What is cultural competence?

A

Ongoing capacity of healthcare systems, organisations and professionals to provide for diverse patient populations high quality care that is safe, patient- and family-centred, evidence-based and equitable

41
Q

How are differences in beliefs dealt with?

A

Acknowledge the simultaneous existence of differing realities without comparison or judgement

42
Q

How are consultations crossing cultures prepared for and dealt with?

A

Anticipate likely areas of miscommunication, misinterpretation and misjudgement and have skills to set them right
Understand the meaning of culture and its important to healthcare
Have respect for variations in cultural norms
Elicit patients’ explanatory model of illness

43
Q

How is the patient’s explanatory model of illness elicited?

A

Asking questions to elicit patient’s understanding
Have strategies for identifying and bridging different communication styles
Have skills for assessing decision making preferences and the role of family

44
Q

What is the last resort for translation?

A

Family members

45
Q

Why are family members the last resort for translation?

A

Error
Lack of knowledge
Bias
Selective communication

46
Q

What are the direct pathological effects of the environment on health?

A

Physical- radiation
Chemical- pesticides
Biological- infectious/allergic agents

47
Q

What are the indirect effects of environment on health?

A

Housing- overcrowding
Transport
Town planning
Income/welfare/ wealth distribution

48
Q

What are occupational aspects to health?

A

Injury

Exposure to harmful working conditions

49
Q

What is spending most effect on?

A 
Sanitation
Immunisation
Housing
Education
Education
Human safety
Famine
Poverty
Social inequality
50
Q

What is prevalence?

A

Number of people in a population with a specific disease at a single point or defined period

51
Q

What is incidence?

A

Number of new cases of disease in a population in a specific period of time

52
Q

What is statistical norm?

A

Based on normal distribution curve/standard deviation

53
Q

What is cultural norm?

A

Based on norms and values within a certain group

54
Q

What is a gatekeeper?

A

Person who controls patients’ access to specialist/secondary care

55
Q

What are the advantages of GPs as gatekeepers?

A

Keep people out of expensive and unnecessary primary care
Continuity of the doctor patient relationship
Personal advocacy
Patient does not necessarily know which speciality to go to
Increase likelihood of referral to appropriate department
Limits exposure to certain investigations
GP acts as coordinator and can provide patient education

56
Q

What are the disadvantages of GPs as gatekeepers?

A

Patients have less choice in secondary care
Puts stress on GP and patient doctor relationship
Dependent on individual GP
Increases time to get required treatment

57
Q

What are the 4 ethical principles?

A

Beneficance
Non-maleficance
Justice
Autonomy

58
Q

What is culture?

A

Complex whole which includes knowledge/beliefs/arts/morals/law/customs

59
Q

What is ethnicity?

A

Cultural practises and outlooks that characterise and distinguish a certain group of people; may include a common language, common customs and beliefs and tradition

60
Q

What is race?

A

Group of people linked by biological/genetic factors

61
Q

What are the 6 occupational classes?

A 
Professional
Managerial and technical
Skilled non manual
Skilled manual
Partly skilled
Unskilled
62
Q

What are the kinds of healthcare professionals?

A 
GP
Practice nurse
Midwife
Health visitor
Pharmacist
Dietician
Phlebotamist
District nurse
Occupational therapist
Physiotherapist
Receptionist
Secretary
Counsellor
63
Q

What are methods on nonverbal communication?

A 
Listening
Use of silence
Posture
Body language
Specific gestures
Facial expressions
Eye contact
Layout of room
Stay in room
64
Q

How many patients are registered with each GP?

A

1200-2000

65
Q

What % of illnesses presenting to primary care are referred to secondary care?

A

3%

66
Q

What aspects should be covered in a consultation promoting a healthier lifestyle?

A 
Diet
Exercise
Alcohol
Smoking
Illicit drug use
Sexual health
67
Q

What are the aspects of health which are worse for children in deprived areas?

A

Lower birth weight
Less likely to benefit from breastfeeding
Poorer dental health
Higher rates of obesity
More likely to smoke
More likely to become pregnant in teenage years

68
Q

What are possible well recognised risks to foetal wellbeing?

A 
Smoking
Illicit drugs
Prescription drugs
OTC medication/herbal medication
X-rays
Diet
Infectious diseases
Maternal disease
69
Q

What are 5 factors that will motivate a patient to a behavioural change?

A

Advantages outweigh disadvantages
Patient anticipates positive reponse from others
Social pressure to change
Patient perceives new behaviour to be in line with self image
Behaviour sustainable

70
Q

What actions could the government take to stem the rise in obesity?

A 
Health education
Improve sports facilities
Tax on unhealthy foods
Subsidise healthy food
Legislation i.e. for proper labelling 
Enforcement of legislation
Transport policy
Funding of treatment for obesity
71
Q

What are the routes by which someone could be exposed to a hazardous substance?

A 
Skin
Blood
Sexual contact
Ingestion
Inhalation
72
Q

What are some social influences on health?

A 
Gener
Ethnicity
Housing
Employment
Financial security
Health system
Environment
Social classes
73
Q

What are the advantages of developmental milestones?

A

Provide GPs and health visitors with aid to manage child development and clear cut off point for referral
Easier to reassure anxious parents
Aids parental involvement
Allows comparison

74
Q

What are the disadvantages of developmental milestones?

A

Parental anxiety
Different guideline interpretation
Medicalisation of normal
Doctor in difficult position

75
Q

How can risk be minimised?

A

Safety netting
Summarise and verbally check
Handover to patient
Housekeeping

76
Q

What are the coping mechanisms for stress?

A

Problem focused
Emotion focused
Combined problem and emotion focused

Foundations of Primary Care AM (1 decks)

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